Repository logo
 

Dietary cost associated with adherence to the Mediterranean diet, and its variation by socio-economic factors in the UK Fenland Study.

Accepted version
Peer-reviewed

Change log

Authors

Imamura, Fumiaki 
Monsivais, Pablo 
Brage, Søren 
Griffin, Simon J 

Abstract

High cost of healthy foods could be a barrier to healthy eating. We aimed to examine the association between dietary cost and adherence to the Mediterranean diet in a non-Mediterranean country. We evaluated cross-sectional data from 12 417 adults in the UK Fenland Study. Responses to 130-item FFQ were used to calculate a Mediterranean diet score (MDS). Dietary cost was estimated by matching food consumption data with retail prices of five major supermarkets. Using multivariable-adjusted linear regression, we examined the association of MDS and individual foods with dietary cost in absolute and relative scales. Subsequently, we assessed how much the association was explained by education, income, marital status and occupation, by conducting mediation analysis and testing interaction by these variables. High compared with low MDS (top to bottom third) was associated with marginally higher cost by 5·4 % (95 % CI 4·4, 6·4) or £0·20/d (95 % CI 0·16, 0·25). Participants with high adherence had higher cost associated with the healthier components (e.g. vegetables, fruits and fish), and lower cost associated with the unhealthy components (e.g. red meat, processed meat and sweets) (P for trend<0·001 each). In total, 20·7 % (95 % CI 14·3, 27·0) of the MDS-cost association was explained by the selected socio-economic factors, and the MDS-cost association was of greater magnitude in lower socio-economic groups (P interaction<0·005). Overall, greater adherence to the Mediterranean diet was associated with marginally higher dietary cost, partly modified and explained by socio-economic status, but the potential economic barriers of high adherence might be offset by cost saving from reducing unhealthy food consumption.

Description

Keywords

MDS Mediterranean diet score, Dietary cost, Mediterranean diet, Socio-economic status, Adult, Animals, Costs and Cost Analysis, Cross-Sectional Studies, Diet, Healthy, Diet, Mediterranean, Female, Fishes, Fruit, Health Behavior, Humans, Male, Meat, Middle Aged, Patient Compliance, Seafood, Socioeconomic Factors, United Kingdom, Vegetables

Journal Title

Br J Nutr

Conference Name

Journal ISSN

0007-1145
1475-2662

Volume Title

119

Publisher

Cambridge University Press (CUP)
Sponsorship
Medical Research Council (MC_UU_12015/5)
MRC (MC_PC_13046)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0515-10119)
Medical Research Council (MC_UU_12015/4)
Medical Research Council (MC_UU_12015/3)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_U106179473)
Medical Research Council (MC_PC_13046)