By David L. Katz, MD, MPH, FACPM, FACP
The conventional wisdom is that more nutritious foods cost more. Here in the proverbial ‘nutshell’ is what’s right, wrong, and downright ugly about this persistent bit of prevailing perception.
High Quality Foods Don’t Necessarily Cost More
Poor Quality Items Are Not Always Cheap
What’s right is what made it conventional wisdom in the first place. In the modern food world, government subsidies are largely tied up with mass-production of crops used for purposes other than feeding people. Corn, for instance, is subsidized both for use in fattening feed animals, which are in turn consumed by people, and for production of such derivatives as high-fructose corn syrup. Soybeans are subsidized, and put to an astonishing variety of uses – many having nothing to do with the nourishment of man, or beast.
Where the subsidies have not gone traditionally is to the most nutritious foods, such as vegetables and fruits intended for human consumption. It is perhaps ironic that the foods best suited to extend the ‘shelf life’ of human beings tend to have the shortest shelf life themselves. The converse, of course, is also true: Some highly processed, glow-in-the-dark foods are all but immortal, while conspiring against the longevity of those consuming them.
Frailty and short shelf life is among the factors that tend to make produce pricey. Spoilage happens, and cuts into profit margins; higher prices compensate. Produce is also subject to the vagaries of climate, and the price built into bumper crops must account for the years when an early frost or lack of rain wrought devastation.
Crops can fail, fish can be hard to find – but marshmallows, chips, and cookies tend to be perfectly reliable. And thus, less costly.
But there is, as well, a downright ugly, hidden face to the cost of nutritious food. Namely, some food pretends to be nutritious, presumably so that a premium may be charged for it.
How do I know this to be true? Having been devoted to the world of nutrition for 20 years or more, I have long had this perception. But my focus has certainly sharpened since the launch of the NuVal system. NuVal has now scored the overall nutritional quality of well over 90,000 foods. Along the way, we have seen innumerable examples of food products in almost every conceivable category that sport front-of-pack messages about better nutrition (e.g., lower fat, lower sodium, lower sugar, more vitamins, more whole grain, etc.) – but that are actually less nutritious overall.
In one instance, we saw the nutrition score decline when a popular children’s cereal came out in a “1/3 less sugar” version. It indeed had 1/3 less sugar, but it also had a lot more salt, a lot less fiber, less whole grain, more harmful fats and so on. A fancy multigrain bread will charge you a premium, but may have no more “whole” grain than white bread, and less than a humbly packaged, far less expensive whole wheat bread.
The average NuVal score for regular peanut butter is about 20. The average score for fat-reduced peanut butter, for which health-conscious and “choosy” moms will pay a premium, is a 7! A bit of healthful oil is taken out, while copious additions of sugar and salt are made. The front of the jar is mum on those topics.
But let’s move on to what is merely wrong with the conventional wisdom about nutrition and cost. Having long heard the two were linked, I did what researchers tend to do: I asked, where are the data? It turns out that there are hardly any. So I set out to get some.
We devised a study, just published in Public Health Nutrition, in which we sent a volunteer shopping in some typical U.S. supermarkets with criteria for more and less nutritious foods based on our Nutrition Detectives program. We asked the volunteer to buy equal numbers of products meeting, and failing, the criteria in diverse food categories. We then used NuVal to confirm that the seemingly more and less nutritious products truly were just that – and we then compared the prices. NuVal has, itself, been validated against actual health outcomes in over 100,000 people.
Sometimes the more nutritious foods were more expensive, sometimes less. Except in the produce aisle, price and nutrition did not correlate. More nutritious food does NOT cost more. The trouble is that most people have difficulties identifying the truly more nutritious foods in the first place.
Cost is still a barrier, of course, and some of the least nutritious foods do offer the most calories for the buck. We need to address this with policies, such as linking food prices directly to objectively measured nutritional quality, especially for those struggling financially, such as SNAP program participants. We have the means to do this, and should put it to the test.
We need to make an objective measure of nutritional quality available to all, so that the false perception of nutrition and cost is dispelled.
Fundamentally, though, we need a new societal perspective on the value of food. Throughout most of human history, calories have been relatively scarce and hard to come by. More calories per dollar was a logical metric for food value in such a world.
But that is no longer our world. Ours is a world of epidemic obesity, and more calories per dollar simply means the chance to gain more weight at no extra charge. Perhaps it’s time to recognize that nutrition per dollar is the better measure of value.
Supersize me and my kids? No thanks. Supervitalize us? We’ll take it – and at no extra charge, please.
David L. Katz, MD, MPH, FACPM, FACP
David is the founding director of Yale University’s Prevention Research Center. He is a board certified specialist in both Internal Medicine and Preventive Medicine/Public Health. He is the director and founder of the Integrative Medicine Center at Griffin Hospital in Derby, CT. For more information visit http://www.davidkatzmd.com
The articles written by guest contributors are the sole responsibility of the individual writers in terms of factual accuracy and opinion and do not necessarily reflect the views of the publisher of this blog.
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