title: Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study.
abstract: BACKGROUND
  Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake.
  
  
  OBJECTIVE
  We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size.
  
  
  METHODS
  Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection.
  
  
  RESULTS
  Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection.
  
  
  CONCLUSIONS
  Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.
authors.affiliation: 1 Children's Hospital at Downstate, SUNY - Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Karp
authors.forename: Gary
authors.initials: G
authors.lastname: Wong
authors.forename: Marguerite
authors.initials: M
authors.lastname: Orsi
mesh_terms: D003365:Costs and Cost Analysis; D004032:Diet / Q000191:economics / Q000592:standards; D002149:Energy Intake; D005502:Food / Q000191:economics*; D005504:Food Analysis; D006801:Humans; D009518:New York; D009753:Nutritive Value; D011203:Poverty
keywords: food availability; food costs; micronutrient costs; nutrient density; poverty