title: Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia.
abstract: BACKGROUND
  The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.
  
  
  OBJECTIVE
  We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.
  
  
  METHODS
  A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.
  
  
  RESULTS
  Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90%) and refined cereals (-90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.
  
  
  CONCLUSIONS
  This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Brimblecombe
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Ferguson
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: Selma C
authors.initials: SC
authors.lastname: Liberato
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia ; Division of Health Sciences (School of Population Health), University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.affiliation: Commonwealth Scientific Industrial Research Organisation (Animal, Food and Health Sciences), Parkville, Victoria, Australia.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Riley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics*; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005523:Food Supply / Q000191:economics; D006291:Health Policy / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015876:Northern Territory; D009751:Nutritional Requirements