title: The availability and cost of healthier food alternatives.
abstract: BACKGROUND
  Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products.
  
  
  METHODS
  Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005.
  
  
  RESULTS
  In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with <10% fat is limited. Among all items that were unavailable, 64% were in small grocery stores. For the 2-week shopping list, the average TFP market-basket cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year.
  
  
  CONCLUSIONS
  The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.
authors.affiliation: Agricultural Issues Center, Department of Public Health Sciences, School of Medicine, University of California-Davis, Davis, California 95616, USA. jetter@primal.ucdavis.edu
authors.forename: Karen M
authors.initials: KM
authors.lastname: Jetter
authors.forename: Diana L
authors.initials: DL
authors.lastname: Cassady
mesh_terms: D002140:California; D003132:Commerce / Q000191:economics; D003258:Consumer Behavior / Q000191:economics*; D003365:Costs and Cost Analysis; D018752:Diet, Fat-Restricted / Q000191:economics*; D005249:Fees and Charges; D005382:Financing, Personal; D005502:Food / Q000145:classification / Q000191:economics / Q000592:standards*; D019649:Food Industry / Q000191:economics* / Q000592:standards*; D005518:Food Preferences; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D015141:Los Angeles; D018673:Nutrition Policy; D009749:Nutrition Surveys; D011203:Poverty; D012923:Social Class