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Is price a barrier to eating more fruits and vegetables for low-income families?

Efforts to increase the fruit and vegetable consumption of Americans include the Dietary Guidelines for Americans 20051. This most recent edition of the Guidelines increased the recommended daily servings for fruits and vegetables from previous recommendations of five to nine servings a day, and also recommended specific amounts of certain types of vegetables, including legumes, dark-green vegetables and orange vegetables.

Despite these and other efforts to increase fruit and vegetable consumption to the whole population and to high-risk groupse.g. 2, 3, 4, there are still disparities between high- and low-income consumerse.g. 5, 6. Higher income consumers are more likely to meet dietary recommendations.

Increasing attention has been focused on how the food environment supports the choice to eat more healthilye.g. 7. Price, along with taste and convenience, is a leading influence on food choices8. Price may pose a significant challenge to the ability of low-income consumers to meet the 2005 Dietary Guidelines recommendations for fruits and vegetables. This is because :

  1. a greater number of servings are recommended, increasing the total cost above the previous 5-A-Day targets and
  2. dark green and orange vegetables and legumes encourage by the 2005 Dietary Guidelines tend to cost more than starchy vegetables9.

The purpose of this market basket study was to examine the price environment for fruits and vegetables by investigating three research questions:

  1. Is the cost significantly more if they purchased a fruit and vegetable market basket that meets the newer 2005 Dietary Guidelines compared to the 1995 guidelines reflected in the Thrifty Food Plan?
  2. Do fruit and vegetable prices vary by neighbourhood income level and store type? And
  3. What is the effect of the new dietary guidelines for fruit and vegetables on the food budget of a low-income family?

The 2005 Dietary Guidelines vs. the 1995 Thrifty Food Plan

In terms of quantity, it was found that a family of four would purchase fewer fruit and vegetables compared to the shopping list for the Thrifty Food Plan. The largest increases from the Thrifty Food Plan to the 2005 Dietary Guidelines market basket were in dark-green vegetables (239%), orange vegetables (83%) and legumes (52%). The average price per serving was highest among the fruit, dark green vegetables and legume subgroups. In terms of average cost, the new guidelines market basket cost 4% less than the Thrifty Food Plan market basket. There was a 63% decrease in the cost of starchy vegetables and a 20% decrease in the cost of fruits. This decrease in cost offset significant cost increases for dark green vegetables (111%), orange vegetables (83%) and legumes (55%). The total cost difference was not significant but the change in cost for each subgroup was significant (P<0.001) given the changes in amounts for each market basket.

Price of fruit and vegetable by neighbourhood income level and store type

The study found that the average price of fruit and vegetables was significantly less expensive in very-low- and low-income neighbourhoods, and in bulk supermarkets. However the results of the study suggest that several important cost barriers exist for low-income consumers who wish to meet dietary guidelines. For example, only a careful selection of the store will guarantee that low-income shoppers pay less because prices vary across stores in very-low-income areas. Even within the same chain prices varied noticeably. Also, the cost of the new guidelines’ fruit and vegetable market basket will require substantial changes in the family food budget.

Influence of the 2005 Dietary Guidelines fruit and vegetable basket on the family food budget

It was found that a family of four shopping in a very low income neighbourhood would spend on average $1688 annually to meet the 2005 Dietary Guidelines recommendations. A family of four using food stamps in California receives on average $3888 each year10, so the new dietary guidelines would require 43% of the food stamp budget. Households in the lowest two income quintiles spend an average of $2410 each year on food at home11, which means lower-income households would have to allocate 70% of their food at home budget to the new dietary guidelines fruit and vegetable market basket.

Conclusions

The results of this study suggest that the budgetary cost of increasing fruit and vegetable consumption to levels recommended in the new dietary guidelines may be more of a barrier to healthful eating than the price per serving of fruit and vegetables. Public policies should examine ways to make fruits and vegetables more affordable to low income families.

  1. US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th edition. Washington, DC: US Government Printing Of?ce, January 2005.
  2. Johnson FC, Hotchkiss DR, Mock NB, McCandless P, Karolak M. The impact of the AFDC and Food Stamp programs on child nutrition: Empirical evidence from New Orleans. J Health Care Poor Under- served. 1999;10:298-312.
  3. Lee BJ, Mackey-Bilaver L, Goerge RM. The Patterns of Food Stamp and WIC Participation and Their Effects on Health of Low-Income Children. Chicago, IL: Chapin Hall Center for Children of the University of Chicago; 2000. JCPR Working Paper No. 129.
  4. Variyam J, Blaylock J, Lin B-H, Ralston K, Smallwood D. Mother’s nutrition knowledge and children’s dietary intakes. Am J Agric Econ. 1999;81:373-384.
  5. Jetter K. Does 5-9 a day pay? Paper presented at International Fruit and Vegetable Alliance. Ottawa, Canada: October 16, 2006.
  6. Krebs-Smith SM, Kantor LS. Choose a variety of fruits and vegetables daily: Understanding the complexities. J Nutr. 2001;131(suppl 2-1): 487S-501S.
  7. French SA, Story M, Jeffery RW. Environmental in?uences on eating and physical activity. Annu Rev Public Health. 2001;22:309-335.
  8. Glanz K, Basil M, Maibach E, Goldberg J, Snyder D. Why Americans eat what they do: Taste, nutrition, cost, convenience, and weight control concerns as in?uences on food consumption. J Am Diet Assoc. 1998;98:1118-1126.
  9. Reed J, Frazao E, Itskowitz R. How much do americans pay for fruits and vegetables? Available at:
    http://www.ers.usda.gov/publications/aib790/aib790fm.pdf. Accessed August 11, 2007.
  10. US Department of Agriculture. Food Stamp Program: Average monthly bene?t per person. Available at: http://fns.usda.gov/pd/fsavgben.htm. Accessed April 24, 2006.
  11. US Department of Labor. Consumer Expenditures in 2002. Washington, DC: Bureau of Labor Statistics; 2004.
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