title: Low-energy-density diets are associated with higher diet quality and higher diet costs in French adults.
abstract: Low-energy-density diets are often recommended for weight control. Such diets have a higher nutrient content than do high-energy-density diets. This study tested the hypothesis that energy-dense diets have a relatively low monetary cost, whereas less energy-dense diets are more expensive. In this cross-sectional study, dietary intakes of 1,474 French adults (672 men, 802 women), aged 15 to 92 years, were assessed using 7-day diet records. Dietary energy density (kcal/g) was calculated by dividing total dietary energy by the edible weight of foods and caloric beverages consumed. Diet cost ($/7 days or $/2,000 kcal) was estimated using mean national food prices for 895 foods. The relationship between dietary energy density and diet cost was examined in a linear regression model. Within each quintile of energy intakes, the more energy-dense diets were associated with lower diet quality and with lower diet costs (r(2)=0.38 to 0.44). In a regression model, the more energy-dense diets cost less, whereas low-energy-density diets cost substantially more, adjusting for energy intakes, sex, and age. The finding that energy-dense diets cost less per 2,000 kcal may help explain why the highest rates of obesity are observed among groups of limited economic means. The finding that low-energy-density diets are associated with higher diet costs suggests that lasting improvements in diet quality may require economic as well as behavioral interventions.
authors.affiliation: School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA. adamdrew@u.washington.edu
authors.forename: Adam
authors.initials: A
authors.lastname: Drewnowski
authors.forename: Pablo
authors.initials: P
authors.lastname: Monsivais
authors.forename: Matthieu
authors.initials: M
authors.lastname: Maillot
authors.forename: Nicole
authors.initials: N
authors.lastname: Darmon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics* / Q000592:standards*; D004038:Diet, Reducing / Q000191:economics; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005502:Food / Q000191:economics*; D005504:Food Analysis / Q000191:economics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009753:Nutritive Value; D009765:Obesity / Q000178:diet therapy / Q000209:etiology*; D012959:Socioeconomic Factors; D015431:Weight Loss