摘要：Objectives. We examined the association between diet quality and estimated diet costs. Methods. Freely chosen diets of 837 French adults were assessed by a dietary history method. Mean national food prices for 57 foods were used to estimate diet costs. Results. Diets high in fat, sugar, and grains were associated with lower diet costs after adjustment for energy intakes, gender, and age. For most levels of energy intake, each additional 100 g of fats and sweets was associated with a €0.05–0.40 per day reduction in diet costs. In contrast, each additional 100 g of fruit and vegetables was associated with a €0.18–0.29 per day increase in diet costs. Conclusions. Diets high in fats and sweets represent a low-cost option to the consumer, whereas the recommended “prudent” diets cost more. There is solid evidence that high fruit and vegetable consumption plays a major role in lowering risk of heart disease and stroke and in lowering total mortality. 1– 6 A “prudent” dietary pattern characterized by high intake of vegetables, fruits, whole grains, poultry, and fish has been associated with a lower risk of coronary heart disease 1, 2 and with better health status overall. In contrast, consumption of sugar-sweetened beverages, corn syrup, potatoes, and refined grains has been linked to a higher risk of heart disease and type 2 diabetes. 1, 7, 8 “Western” dietary patterns, characterized by high consumption of processed meats, fried foods, sweets, and desserts, fail to protect against disease risk. 7, 8 Excess consumption of energy-dense snacks, 9, 10 fast foods, 11, 12 and soft drinks 13– 15 has been linked to higher rates of overweight. A World Health Organization report on diet, nutrition, and prevention of chronic diseases pointed out causal links between fats and sweets consumption and the worldwide obesity epidemic. 16 Public policy proposals for prevention of obesity increasingly mention taxes and levies on energy-dense, sweet, and high-fat foods. 17 Replacement of fats and sweets with vegetables and fruit has become a standard public health recommendation. 18, 19 Studies on diet and health have focused on the glycemic index of foods, 7 on fat content, 20, 21 and on the energy density of the diet. 22, 23 Absent from the mainstream literature, however, has been any consideration of diet costs. 24– 26 Whereas fats and sweets provide dietary energy at a very low cost, the energy cost of lean meats, fish, vegetables, and fruit is likely to be higher. Following advice to replace one with the other, far from being a simple public health application, 7 will most likely entail higher consumer diet costs. In this study, we estimated the cost of freely chosen total diets in a community setting in France and examined relationships among diet quality, dietary energy density, and estimated diet costs.
