CHAPTER FOUR

Diet Affordability

Understanding the High Cost of Healthy Diets

Derek Headey, Kalle Hirvonen, Harold Alderman, Saskia de Pee, and Kalyani Raghunathan

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Shifting toward sustainable healthy diets will require bridging the gap between the current food budgets of the world’s poor and the high cost of nutritious foods

OVERVIEW

Healthy diets that provide a range of safe and nutritious foods are not yet affordable for much of the world’s population, especially in South Asia and Africa. The cost of a healthy diet is defined as the least expensive combination of locally available items that meet a food-based dietary guideline. This metric, which is relatively new, indicates that between 2 and 3 billion people cannot afford a healthy diet.
Poverty is a primary factor limiting diets. There is a huge gap between the current food budgets of the world’s poor and the spending needed for a healthy diet. Current social protection transfers in Asia and Africa barely begin to fill the healthy diet affordability gap.
High prices of nutritious foods also limit access to healthy diets. Nutrient-dense foods — especially fruits, vegetables, and animal-source foods — are relatively expensive compared with calorie-dense foods, in part because agricultural policies and consumer subsidies have long favored production of staple crops.
Provisional evidence suggests healthy diet costs are much higher in countries with poor transport, storage, and logistics infrastructure and services.

To shift actual diets toward healthy diets, we need to:

Improve national and subnational monitoring of healthy diet affordability, including food prices, expenditures, and wages, in order to strengthen knowledge and provide a strong platform for nutrition interventions.
Accelerate pro-poor economic growth in low- and middle-income countries (LMICs) through reforms to catalyze more equitable and inclusive growth.
Increase availability and reduce prices of nutritious foods by repurposing agricultural policies toward nutritious foods and increasing investment in transport, infrastructure, and logistics.
Scale up nutrition-sensitive social protection in LMICs, including appropriate targeting of vulnerable groups, delivering transfers that come closer to bridging the healthy diet affordability gap, and linking social protection with nutrition education interventions that increase demand for healthy foods and decrease demand for unhealthy foods.

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