Cambridge Journals Online

Research Article

Costs of a healthy diet: analysis from the UK Women's Cohort Study

Janet Cadea1 c1, Hendrike Upmeiera2, Claire Calverta1 and Darren Greenwooda1 a1 Nuffield Institute for Health, University of Leeds, 71–75 Clarendon Road, Leeds LS2 9PL, UK a2 Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen, c/o Bundesministerium für Gesundheit, Am Propsthof 78a, 53121 Bonn, Germany

Article author query cade j   upmeier h   calvert c   greenwood d

Abstract

Objective: To investigate the direct and indirect cost differences associated with eating a ‘healthy’ or ‘unhealthy’ diet.

Design: Analysis of data from a baseline postal questionnaire for the UK Women's Cohort Study, including a detailed food frequency questionnaire (FFQ), supplemented by a telephone interview on a sub-sample.

Subjects: The first 15 191 women who responded to the questionnaire, aged 35–69 years with similar numbers of meat eaters, fish eaters and vegetarians.

Results: A healthy diet indicator (hdi), with values from 0 (lowest) to 8 (highest) was developed based on the WHO dietary recommendations. Direct monetary cost of the diet was calculated using prices from the 1995 National Food Survey and the Tesco home shopping catalogue. Women in the healthy diet group were almost four times as likely to be vegetarian and have a higher educational level. For direct costs, the difference between the most extreme hdi groups was £1.48 day⁻¹ (equivalent to £540 year⁻¹), with fruit and vegetable expenditure being the main items making a healthy diet more expensive. Forty-nine per cent of the food budget was spent on fruit and vegetables in hdi group 8 compared to 29% in hdi group 0. Interestingly, 52% of those questioned in both extreme hdi groups did not think that it was difficult to eat healthily.

Conclusions: To achieve a particularly healthy diet independent predictive factors were spending more money, being a vegetarian, having a higher energy intake, having a lower body mass index (BMI) and being older.

(Received September 30 1998)

(Accepted March 10 1999)

Key Words: Cost; Direct cost; Indirect cost; Healthy diet

Correspondence:

^c1 Corresponding author: Email cme6cade@leeds.ac.uk