A cost-analysis of adopting a healthful diet in a family-based obesity treatment program

J Am Diet Assoc. 2002 May;102(5):645-56. doi: 10.1016/s0002-8223(02)90148-3.


Objective: To assess dietary costs during a family-based pediatric obesity intervention.

Design: Families were randomized to one of two groups. Dietary and cost data were collected from a parent or child using three 24-hour recalls: at baseline, 6 months, and 12 months.

Subjects: Thirty-one families with an obese 8- to 12-year-old child entered treatment, with complete dietary data provided from 20 families.

Intervention: The 20-week behavior modification intervention emphasized increasing diet nutrient-density. Families attended group and individual sessions or group sessions.

Main outcome measures: Energy intake; percent of energy from protein, fat, and carbohydrate; servings and percent servings from food groups classified by nutrient density; and daily food costs.

Statistical analyses performed: Mixed analyses of variance, with group as the between-subject factor, and time as the within-subject factor.

Results: No significant effect of group was found in any analyses. Significant decreases in percent overweight were observed at 6 and 12 months for children (-10.0+/-8.7 and -8.0+/-10.3, respectively) (mean+/-standard deviation) and parents (-6.7+/-10.3 and -5.3+/-14.1). Energy intake for parents and children combined significantly decreased from baseline (1,881+/-462) to 6 months (1,412+/-284), and 1 year (1,338+/-444). Servings from low-nutrient-dense foods significantly decreased from baseline (34.7+/-16.2) to 6 months (16.0+/-8.6) and 1 year (18.6+/-9.2), causing a significant increase in diet nutrient density. Dietary cost did not change at 6 months, but significantly decreased from baseline to 1 year ($6.77+/-2.41 to $5.04+/-1.80). Cost per 1,000 kcal did not significantly change.

Applications/conclusions: Adopting a lower-energy, nutrient-dense diet did not increase dietary costs over time. Consequently, cost should not be a barrier in the adoption of a healthful diet.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anthropometry
  • Behavior Therapy / economics
  • Behavior Therapy / methods
  • Child
  • Cohort Studies
  • Costs and Cost Analysis
  • Diet / economics*
  • Energy Intake
  • Exercise / physiology
  • Female
  • Follow-Up Studies
  • Food, Organic / economics*
  • Humans
  • Male
  • Nutritive Value
  • Obesity / diet therapy*
  • Obesity / economics
  • Obesity / therapy
  • Program Evaluation
  • Treatment Outcome