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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #354346
Title: Do healthier meals cost more?

Author
item HUANG, YUE - Tufts University
item HOUSER, ROBERT - Tufts University
item ROBERTS, SUSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Nutrition Today
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/30/2018
Publication Date: 6/4/2018
Citation: Huang, Y., Houser, R.F., Roberts, S.B., Lichtenstein, A.H. 2018. Do healthier meals cost more? Nutrition Today. 53(3):115-120. https://doi.org/10.1097/NT.0000000000000278.
DOI: https://doi.org/10.1097/NT.0000000000000278

Interpretive Summary: One barrier to achieving healthier eating patterns is the perceived higher cost of healthier food. The objective of this study was to determine whether there is a relationship between cost of entrees purchased from casual dining restaurants and the nutritional quality of the entree. Nutrient and price information were collected from 11 restaurants in Boston metropolitan area. To be included the restaurants needed to provide nutrition information on the web and operate at least one location in the Greater Boston area so pricing information could be verified. Steakhouses were excluded because they provided only a narrow variety of entrees. An estimated nutrient scoring system was developed based on the 2015-2020 Dietary Guidelines for Americans to allow for comparisons between more healthy and less healthy entrees within each casual dining restaurant. Of the 11 restaurant chains meeting the inclusion criteria, the association between estimated nutrition score and price was significant for a little over half (6). Of those, more healthy options were less expensive at 4 restaurants, and more healthy options were more expensive at 2 restaurants. After removing half and light options from the analyses the relationships between estimated nutrition score and price were no longer significant. Similarly, after removing calories from the estimated nutrition score the associations were no longer statistically significant for all 6 restaurants and introduced a negative statistical significant association for 2 additional restaurants. These data suggest that there was no consistent association between estimated nutrition score and entree price in the sample of restaurants assessed. Importantly, within the category of restaurants evaluated, customers can often choose healthier entrees that are priced less or equal to less healthy entrees.

Technical Abstract: Background: One barrier to achieving healthier eating patterns is the perceived higher cost of healthier food. The objective of this cross-sectional study was to investigate the potential association between cost and the nutrition quality among entrees from casual dining restaurants. Methods: Nutrition and price information were collected from 11 restaurants in Boston metropolitan area. A nutrition quality metric (Estimated Nutrition Score [ENS]) was developed based on the 2015-2020 Dietary Guidelines for Americans to allow comparisons between more healthy and less healthy entrees. Associations between entree price and ENS were assessed as continuous variables and dichotomized based on median ENS, availability of "small", "half", and "light" options and with or without calories as a component of the score. Results: Of the 11 restaurant chains meeting the inclusion criteria, the association between ENS and price was significant for 6. Of 6, more healthy options were less expensive at 4 restaurants, and more healthy options were more expensive at 2 restaurants. Eliminating small, half, and light options from the analyses resulted in a null association for 1 restaurant. Eliminating calories from the score resulted in loss of a significant association between price and ENS for all 6 restaurants, whereas for 2 additional restaurants, significant negative relationships were detected. Conclusions: There was no consistent association between ENS and entree price in the sample assessed. Hence, within the category of restaurants evaluated, customers can often choose healthier entrees that are priced less than or equal to less healthy entrees.