title: Is healthy eating for obese children necessarily more costly for families?
abstract: BACKGROUND
  During consultations on weight management in childhood obesity clinics, the additional costs incurred by healthy eating are often cited, as an economic barrier to achieving a better nutritional balance.
  
  
  OBJECTIVE
  To examine whether adopting an improved  theoretical, balanced diet compared to current dietary habits in children incurs additional cost.
  
  
  METHODS
  Children aged 5-16 years (body mass index [BMI] ≥98th percentile) recruited to a randomised trial comparing a hospital-based and primary care childhood  obesity clinics provided data for this study.
  
  
  METHODS
  Three-day dietary diaries collected at baseline were analysed for energy and fat intake and then compared to a theoretical, adjusted healthy-eating diet based on the Food Standards Agency, 'Eatwell plate'.  Both were priced contemporaneously using the appropriate portion size, at a neighbourhood, mid-range supermarket, at a budget supermarket, and on the local high street.
  
  
  RESULTS
  The existing diet purchased at a budget supermarket was cheapest (£2.48/day). The healthier,  alternative menu at the same shop cost an additional 33 pence/day (£2.81). The same exercise in a mid-range supermarket, incurred an additional cost of 4 pence per day (£3.40 versus £3.44). Switching from an unhealthy mid-range supermarket menu to the healthier, budget-outlet  alternative saved 59 pence per day. The healthier, alternative menu was cheaper than the existing diet if purchased on the high street (£3.58 versus £3.75), although for both menus this was most expensive.
  
  
  CONCLUSIONS
  For many obese children, eating healthily  would not necessarily incur prohibitive, additional financial cost, although a poor diet at a budget supermarket remains the cheapest of all options. Cost is a possible barrier to healthy eating for the most economically disadvantaged.
authors.affiliation: Academic Unit of Primary Health Care, School of Social and Community Medicine, University of Bristol, Bristol.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Banks
authors.forename: Jessica
authors.initials: J
authors.lastname: Williams
authors.forename: Tina
authors.initials: T
authors.lastname: Cumberlidge
authors.forename: Tânia
authors.initials: T
authors.lastname: Cimonetti
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Sharp
authors.forename: Julian P H
authors.initials: JP
authors.lastname: Shield
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005502:Food / Q000191:economics*; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy* / Q000191:economics
chemical_list: D004041:Dietary Fats