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Eating Healthy Too Expensive for Some?
The study compared the cost accessibility of 2005 guidelines for produce consumption with guidelines issued in 1995 for a family of four over the course of two weeks. In terms of the overall fruit and vegetable shopping list, the newer guidelines were slightly cheaper. However, meeting the newer guidelines for recommended amounts of fruits and certain types of vegetables came with a much bigger price tag: Low-income families would have to spend between 40 percent and 70 percent of their food-at-home budgets in order to purchase the additional servings.

"The new dietary guidelines, which include more dark green vegetables, orange vegetables and legumes, are based on solid science and have the potential to help protect Americans from some of the leading causes of death, including stroke, heart disease and diet-related cancers," said lead author Diana Cassady , an assistant professor of public health sciences and researcher at the UC Davis Center for Advanced Studies in Nutrition and Social Marketing. "But, we need to take the next step to ensure that all consumers can actually afford to follow the guidelines. Low-income families have less discretionary income than more affluent families. Buying the recommended amounts of fruits and vegetables would take up a large proportion, perhaps an unacceptable proportion, of their food budgets."

Noting that the economically disadvantaged have higher rates of heart disease and some cancers, Cassady said the report was part of a larger research effort she has undertaken in recent years to understand why low-income consumers have poorer health and whether or not the availability and affordability of healthy foods contribute to those outcomes. In 2006, she authored a paper that found that better after-school snack choices boost nutrition for low-income children. In 2005, she headed up a project to improve the produce offerings at a grocery store in a hard-pressed Sacramento neighborhood. In 2003, her research found that inner-city supermarkets could improve their profit margins and the health of the communities they serve by offering shoppers free transportation.

Cassady's objective in the present study was to determine if price is a barrier for low-income families in meeting the new fruit and vegetable consumption guidelines. She investigated this objective in these ways:

* Comparing the average costs of total fruits and vegetables recommended under the Dietary Guidelines for Americans 2005 with the Thrifty Food Plan, part of a 1995 effort by the U.S. Department of Agriculture to demonstrate that Americans on food stamps could eat healthfully. The recommended minimum numbers of cups of fruits and vegetables were calculated for a hypothetical family of four - a man aged 19 to 30 years, a woman aged 19 to 30 years, a boy aged 4 to 8 years and a girl aged 9 to 13 years.

* Comparing the costs of purchasing specific quantities of fruit and vegetable subgroups recommended in the newer guidelines.

* Conducting price surveys at a total of 25 supermarkets and other types of grocery stores in Sacramento and Los Angeles serving consumers living on differing income levels.

* Estimating the influence of the 2005 guidelines on the food budget of a low-income family.

The investigation produced some surprising findings, including a 4 percent lower average price for the total fruit and vegetable shopping basket for the 2005 dietary guidelines when compared to the earlier Thrifty Food Plan. This outcome, Cassady said, was mostly due to fewer recommended servings of fruit, which tend to be more expensive than vegetables, and much fewer recommended servings of starchy vegetables, such as potatoes and French fries.

Another surprise was that the average price of fruits and vegetables was significantly less expensive in very-low- and low-income neighborhoods when compared to more affluent areas, particularly in Los Angeles. Previous studies found that lower-income neighborhoods frequently had higher food prices, in part because warehouse and super-center food stores with the lowest prices have largely bypassed those areas. Cassady explained that most of those studies were done in the eastern United States and may not apply to California, where urban development has taken a different course.

Despite the lower overall cost and value options at certain stores, meeting the newer guidelines would require families to spend up to 70 percent more of their total at-home food budget on additional recommended servings of fruits and vegetables in specific categories, especially dark green vegetables, orange vegetables and legumes. Currently, Americans only spend about 15 percent of their food-at-home budgets on fruits and vegetables, with the rest going to other food groups such as meat, dairy products, and breads and grains. Given that price is a leading influence on food choices, low-income Americans may not be able to afford to eat as healthfully as they should.

Cassady said that it is not necessary to revise the new guidelines, which were developed by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. Instead, she advises that public policymakers and nutrition educators help ensure that the dietary standards are attainable for everyone. Her study suggests a combination of strategies, including distributing discount coupons for fruits and vegetables; increasing food stamp allocations; promoting low-cost sources of produce such as farmers' markets, community-supported agriculture and warehouse grocery centers or bulk stores; and counseling consumers on household budgeting approaches that could help them purchase more vegetables.

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This story originated from the UC Davis Health System news office.