Diet cost, diet quality and socio-economic position: how are they related and what contributes to differences in diet costs?

Public Health Nutr. 2011 Sep;14(9):1680-92. doi: 10.1017/S1368980010003642. Epub 2011 Jan 24.


Objective: To examine diet costs in relation to dietary quality and socio-economic position, and to investigate underlying reasons for differences in diet costs.

Design: Dietary intake was assessed by a 4 d food diary and evaluated using the 2005 Healthy Eating Index (HEI). National consumer food prices collected by Statistics Sweden and from two online stores/supermarkets were used to estimate diet costs.

Setting: Sweden.

Subjects: A nationally representative sample of 2160 children aged 4, 8 or 11 years.

Results: Higher scores on the HEI resulted in higher diet costs and, conversely, higher diet costs were linked to increased total HEI scores. Children who consumed the most healthy and/or expensive diets ate a more energy-dilute and varied diet compared with those who ate the least healthy and/or least expensive diets. They also consumed more fish, ready meals and fruit. Regression analysis also linked increased food costs to these food groups. There was a positive, but weak, relationship between HEI score and diet cost, parental education and parental occupation respectively.

Conclusions: Healthy eating is associated with higher diet cost in Swedish children, in part because of price differences between healthy and less-healthy foods. The cheapest and most unhealthy diets were found among those children whose parents were the least educated and had manual, low-skill occupations. Our results pose several challenges for public health policy makers, as well as for nutrition professionals, when forming dietary strategies and providing advice for macro- and microlevels in society.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Diet / economics*
  • Diet Records
  • Eating
  • Feeding Behavior*
  • Female
  • Food / economics*
  • Food Preferences
  • Fruit / economics
  • Humans
  • Male
  • Nutritional Status
  • Parents / education*
  • Public Health
  • Socioeconomic Factors
  • Sweden
  • Vegetables / chemistry