Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia.
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ABSTRACT:
SUBMITTER: Lewis M
PROVIDER: S-EPMC8703846 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Few Australians consume a healthy, equitable and more sustainable diet consistent with the Australian Dietary Guidelines (ADGs). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health problems. However, granular information on dietary intakes and affordability of recommended diets was lacking for low SEGs. The Healthy Diets Australian Standardised Affordability and Pricing protocol was modified for low SEGs to align with relevant dietary intakes reported in the National Nutrition Survey 2011-2012(which included less healthy and more discretionary options than the broader population), household structures, food purchasing habits, and incomes. Cost and affordability of habitual and recommended diets of low SEGs were calculated using prices of 'standard brands' and 'cheapest options'. With 'standard brands', recommended diets cost less than habitual diets, but were unaffordable for low SEGs. With 'cheapest options', both diets were more affordable, but recommended diets cost more than habitual diets for some low SEGs, potentially contributing to perceptions that healthy food is unaffordable. The study confirms the need for an equity lens to better target dietary guidelines for low SEGs. It also highlights urgent policy action is needed to help improve affordability of recommended diets.
| S-EPMC8402089 | biostudies-literature
Project description:BackgroundSocioeconomic status has an important effect on cardiovascular disease (CVD). Data on the economic implications of CVD by socioeconomic status are needed to inform healthcare planning.ObjectivesThe aim of this study was to project new-onset CVD and related health economic outcomes in Australia by socioeconomic status from 2021 to 2030.MethodsA dynamic population model was built to project annual new-onset CVD by socioeconomic quintile in Australians aged 40-79 years from 2021 to 2030. Cardiovascular risk was estimated using the Pooled Cohort Equation (PCE) from Australian-specific data, stratified for each socioeconomic quintile. The model projected years of life lived, quality- adjusted life-years (QALYs), acute healthcare medical costs, and productivity losses due to new-onset CVD. All outcomes were discounted by 5% annually.ResultsPCE estimates showed that 8.4% of people in the most disadvantaged quintile were at high risk of CVD, compared with 3.7% in the least disadvantaged quintile (p < 0.001). From 2021 to 2030, the model projected 32% more cardiovascular events in the most disadvantaged quintile compared with the least disadvantaged (127,070 in SE 1 vs. 96,222 in SE 5). Acute healthcare costs in the most disadvantaged quintile were Australian dollars (AU$) 183 million higher than the least disadvantaged, and the difference in productivity costs was AU$959 million. Removing the equity gap (by applying the cardiovascular risk from the least disadvantaged quintile to the whole population) would prevent 114,822 cardiovascular events and save AU$704 million of healthcare costs and AU$3844 million of lost earnings over the next 10 years.ConclusionOur results highlight the pressing need to implement primary prevention interventions to reduce cardiovascular health inequity. This model provides a platform to incorporate socioeconomic status into health economic models by estimating which interventions are likely to yield more benefits in each socioeconomic quintile.
| S-EPMC8761535 | biostudies-literature
Project description:We have sought to explore the impact of dietary Pi intake on human age related health in the pSoBid cohort (n=666) to explain the disparity between health and deprivation status in this cohort. As hyperphosphataemia is a driver of accelerated ageing in rodent models of progeria we tested whether variation in Pi levels in man associate with measures of biological ageing and health.We observed significant relationships between serum Pi levels and markers of biological age (telomere length (p=0.040) and DNA methylation content (p=0.028), gender and chronological age (p=0.032). When analyses were adjusted for socio-economic status and nutritional factors, associations were observed between accelerated biological ageing (telomere length, genomic methylation content) and dietary derived Pi levels among the most deprived males, directly related to the frequency of red meat consumption.Accelerated ageing is associated with high serum Pi levels and frequency of red meat consumption. Our data provide evidence for a mechanistic link between high intake of Pi and age-related morbidities tied to socio-economic status.
| S-EPMC4931858 | biostudies-other
Project description:BackgroundThe perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. However, assessment of the relative cost of healthy and unhealthy foods and diets is fraught methodologically. Standardised approaches to produce reliable data on the cost of total diets and different dietary patterns, rather than selected foods, are lacking globally to inform policy and practice.MethodsThis paper reports the first application, in randomly selected statistical areas stratified by socio-economic status in two Australian cities, of the Healthy Diets Australian Standardized Affordability and Pricing (ASAP) method protocols: diet pricing tools based on national nutrition survey data and dietary guidelines; store sampling and location; determination of household incomes; food price data collection; and analysis and reporting. The methods were developed by the International Network on Food and Obesity/NCD Research, Monitoring and Action Support (INFORMAS) as a prototype of an optimum approach to assess, compare and monitor the cost and affordability of diets across different geographical and socio-economic settings and times.ResultsUnder current tax policy in Australia, healthy diets would be 15-17% less expensive than current (unhealthy) diets in all locations assessed. Nevertheless, healthy diets are likely to be unaffordable for low income households, costing more than 30% of disposable income in both cities surveyed. Households spent around 58% of their food budget on unhealthy food and drinks. Food costs were on average 4% higher in Canberra than Sydney, and tended to be higher in high socioeconomic locations.ConclusionsHealth and fiscal policy actions to increase affordability of healthy diets for low income households are required urgently. Also, there is a need to counter perceptions that current, unhealthy diets must be less expensive than healthy diets. The Healthy Diets ASAP methods could be adapted to assess the cost and affordability of healthy and unhealthy diets elsewhere.
| S-EPMC7309977 | biostudies-literature
Project description:Global food demand is increasing due to population growth and dietary transitions, resulting from rising incomes, are associated with increased prevalence of non-communicable diseases. Improving the sustainability of the food sector is also critical for achieving the Sustainable Development Goals. This study assesses for the first time the greenhouse gases emissions (Carbon Footprint - CF), the water footprint (WF) and the cost of three omnivorous diets recommended in Spain due to their health benefits: the Mediterranean diet (MD), the Southern European Atlantic diet (SEAD) and the Spanish dietary guidelines (NAOS). Analysis was conducted using standard Life Cycle Assessment and WF methods together with current Spanish food price data. The dietary energy recommendation of the SEAD is greater than that of MD and NAOS (11 and 15% respectively), and SEAD also has greater animal source food content than the other two diets. SEAD has a concomitantly higher CF, WF and cost scores in comparison with MD (+30%, +23% and +21% respectively) and NAOS (+15%, +9% and +21% respectively). Adjusting recommendations to meet the suggested Spanish adult dietary energy of 2228 kcal.capita-1.day-1 changed the environmental profiles of the diets and the NAOS has the highest environmental impact. However, the isocaloric diets had approximately the same cost. Analysis of the WF of the diets identified the major contribution of precipitation (the green WF) to the overall WF (88% of the total) and the significant contribution of animal-source foods to dietary WF. Regardless of the dietary scenario, better scores were identified for the Spanish recommendations analysed than those reported for other healthy diets identified in Europe. Differences in the recommended intake levels of certain food groups, cooking techniques and the origin of food products are behind these results. Environmental indicators should be considered alongside nutrition and health metrics when defining national dietary guidelines. Supporting citizens to follow healthy and environmentally-friendly dietary recommendations through, among other things, information campaigns and nutritional education programmes is essential. It is recommended the incorporation not only of health, but also of environmental indicators of these dietary options in the national dietary guidelines, as well as implementation of information campaigns and nutritional education programs among citizens to promote their adhesion since balanced dietary habits rich on plant-based products and low on animal-based ones involve multiple health and environmental benefits.
| S-EPMC7610673 | biostudies-literature
Project description:There is no complete explanation for the association between socioeconomic status (SES), fibre, and whole diet described by dietary patterns. The aim of this short report was to increase the understanding of adolescent dietary patterns related to fibre in their social context. A cross-sectional study was conducted involving 1176 adolescents aged 13-18 years from central and north-eastern Poland. The overall SES was composed of five single factors: place of residence, self-declared economic situation of family, self-declared economic situation of household, paternal and maternal education. The consumption frequency of nine dietary fibre sources was collected using Block's questionnaire and was expressed in points. Fibre dietary patterns (DPs) were drawn by cluster analysis and odds ratios (ORs) adjusted for age, sex, and BMI were calculated. Three fibre-related DPs were identified: "High-fibre" (mean frequency of total fibre intake 22.7 points; range: 0-36), "Average-fibre" (17.7 points), "Low-fibre" (14.6 points). The "High-fibre" DP was characterized by a relatively higher frequency consumption of white bread, fruit, fruit or vegetable juices, potatoes, green salad and prepared vegetables, and a moderate frequency consumption of high-fibre or bran cereals and wholegrain bread compared to the "Low-fibre" DP. The "Average-fibre" DP was characterized by a relatively higher frequency consumption of wholegrain bread and high-fibre or bran cereals and a moderate frequency consumption of fruit, fruit or vegetable juices, green salad and prepared vegetables compared to the "Low-fibre" DP. Less likely to adhere to the "High-fibre" DP were adolescents with low SES (OR: 0.55, 95% CI: 0.39-0.77) or average SES (0.58, 95% CI: 0.41-0.81) in comparison with high SES (reference) as a result of elementary or secondary paternal or maternal education, rural residence, and lower household economic situation. Similar associations were found for the "Average-fibre" DP. Low and average socioeconomic status resulting from lower parents' education, rural residence, and lower economic situation were inversely associated with achieving a relatively high fibre intake in Polish adolescents. Consuming single high-fibre foods was not sufficient to achieve a high-fibre diet in Polish adolescents. These data suggest that the consumption of a wide variety of dietary fibre sources-both relatively high-fibre and low-fibre foods-may help Polish adolescents in achieving a relatively high-fibre diet.
| S-EPMC5490569 | biostudies-other
Project description:To assess the association between socioeconomic status (SES) and dietary sodium intake, and to identify if the major dietary sources of sodium differ by socioeconomic group in a nationally representative sample of Australian children. Cross-sectional survey. 2007 Australian National Children's Nutrition and Physical Activity Survey. A total of 4487 children aged 2-16 years completed all components of the survey. Sodium intake was determined via one 24 h dietary recall. The population proportion formula was used to identify the major sources of dietary salt. SES was defined by the level of education attained by the primary carer. In addition, parental income was used as a secondary indicator of SES. Dietary sodium intake of children of low SES background was 2576 (SEM 42) mg/day (salt equivalent 6.6 (0.1) g/day), which was greater than that of children of high SES background 2370 (35) mg/day (salt 6.1 (0.1) g/day; p<0.001). After adjustment for age, gender, energy intake and body mass index, low SES children consumed 195 mg/day (salt 0.5 g/day) more sodium than high SES children (p<0.001). Low SES children had a greater intake of sodium from processed meat, gravies/sauces, pastries, breakfast cereals, potatoes and potato snacks (all p<0.05). Australian children from a low SES background have on average a 9% greater intake of sodium from food sources compared with those from a high SES background. Understanding the socioeconomic patterning of salt intake during childhood should be considered in interventions to reduce cardiovascular disease.
| S-EPMC3585971 | biostudies-literature
Project description:Maternal nutrition is critically involved in the development and health of the fetus. We evaluated maternal methyl-group donor intake through diet (methionine, betaine, choline, folate) and supplementation (folic acid) before and during pregnancy in relation to global DNA methylation and hydroxymethylation and gene specific (IGF2 DMR, DNMT1, LEP, RXRA) cord blood methylation. A total of 115 mother-infant pairs were enrolled in the MAternal Nutrition and Offspring's Epigenome (MANOE) study. The intake of methyl-group donors was assessed using a food-frequency questionnaire. LC-MS/MS and pyrosequencing were used to measure global and gene specific methylation, respectively. Dietary intake of methyl-groups before and during pregnancy was associated with changes in LEP, DNMT1, and RXRA cord blood methylation. Statistically significant higher cord blood LEP methylation was observed when mothers started folic acid supplementation more than 6 months before conception compared with 3-6 months before conception (34.6 ± 6.3% vs. 30.1 ± 3.6%, P = 0.011, LEP CpG1) or no folic acid used before conception (16.2 ± 4.4% vs. 13.9 ± 3%, P = 0.036 for LEP CpG3 and 24.5 ± 3.5% vs. 22.2 ± 3.5%, P = 0.045 for LEP mean CpG). Taking folic acid supplements during the entire pregnancy resulted in statistically significantly higher cord blood RXRA methylation as compared with stopping supplementation in the second trimester (12.3 ± 1.9% vs. 11.1 ± 2%, P = 0.008 for RXRA mean CpG). To conclude, long-term folic acid use before and during pregnancy was associated with higher LEP and RXRA cord blood methylation, respectively. To date, pregnant women are advised to take a folic acid supplement of 400 µg/day from 4 weeks before until 12 weeks of pregnancy. Our results suggest significant epigenetic modifications when taking a folic acid supplement beyond the current advice.
| S-EPMC5270634 | biostudies-literature
Project description:The cost of diet has been recognized as a major determinant of overall diet quality and nutritional outcomes. We aimed to estimate the minimum cost and affordability of the recommended diet based on the updated food-based dietary guidelines (FBDG) in Bangladesh. To compute the cost of the recommended diet (CoRD), we collected retail prices of foods corresponding to each of the food groups in the latest Bangladeshi FBDG. For affordability, the household size and daily food expenditure data were used from the most recent Household Income and Expenditure survey (HIES). The CoRD was calculated based on the average number of servings recommended for each food group; the CoRD was adjusted by a deflation factor and divided by the household's daily food expenditure to estimate affordability. We found that the CoRD was $0.87 (83 BDT) per person per day at the national level. Nationally, about 43% of households could not afford the CoRD, with rural areas bearing a disproportionate share of the burden. We also found households to overspend on starchy staples while underspending on protein-rich foods, fruits, and dairy. These findings highlight the need for immediate implementation of interventions to improve the affordability of the CoRD and redesign policy instruments to create a sustainable food system.
| S-EPMC9956371 | biostudies-literature
Project description:BACKGROUND:Invasive Group A Streptococcal (iGAS) disease exerts an important burden among Australian children. No Australian hospitalisation cost estimates for treating children with iGAS disease exist, so the financial impact of this condition is unknown. AIM:To determine the minimum annual healthcare cost for children (< 18 years) hospitalised with iGAS disease in Australia from a healthcare sector perspective. METHODS:A cost analysis including children with laboratory-confirmed iGAS disease hospitalised at the Royal Children's Hospital (Victoria, Australia; July 2016 to June 2019) was performed. Results were extrapolated against the national minimum iGAS disease incidence. This analysis included healthcare cost from the 7 days prior to the index admission via General Practitioner (GP) and Emergency Department (ED) consultations; the index admission itself; and the 6 months post index admission via rehabilitation admissions, acute re-admissions and outpatient consultations. Additional extrapolations of national cost data by age group, Aboriginal and Torres Strait Islander ethnicity and jurisdiction were performed. RESULTS:Of the 65 included children, 35% (n = 23) were female, 5% (n = 3) were Aboriginal and Torres Strait Islander, and the average age was 4.4 years (SD 4.6; 65% aged 0-4). The iGAS disease related healthcare cost per child was $67,799 (SD $92,410). These costs were distributed across the 7 days prior to the index admission via GP and ED consultations (0.2 and 1.1% of total costs, respectively), the index admission itself (88.7% of the total costs); and the 6 months post index admission via rehabilitation admissions, acute re-admissions and outpatient consultations (5.3, 4.5 and 0.1% of total costs, respectively). Based on a national minimum paediatric incidence estimation of 1.63 per 100,000 children aged < 18 (95%CI: 1.11-2.32), the total annual healthcare cost for children with iGAS in 2019 was $6,200,862. The financial burden reflects the overrepresentation of Aboriginal and Torres Strait Islander people in the occurrence of iGAS disease. Costs were concentrated among children aged 0-4 years (62%). CONCLUSION:As these cost estimations were based on a minimum incidence, true costs may be higher. Strengthening of surveillance and control of iGAS disease, including a mandate for national notification of iGAS disease, is warranted. TRIAL REGISTRATION:The current study is a part of ongoing iGAS surveillance work across seven paediatric health services in Australia. As this is not a clinical trial, it has not undergone trial registration.
| S-EPMC8670128 | biostudies-literature