title: Association of increased monetary cost of dietary intake, diet quality and weight management in Spanish adults.
abstract: Higher monetary diet cost is associated with healthier food choices and better weight management. How changes in diet cost affect changes in diet quality and weight remains unknown. The aim of this study was to assess the impact of changes in individual monetary diet cost on changes in diet quality, measured by the modified Mediterranean diet score recommendations (MDS-rec) and by energy density (ED), as well as changes in weight and BMI. We conducted a prospective, population-based study of 2181 male and female Spaniards aged between 25 and 74 years, who were followed up to the 2009-2010 academic year. We measured weight and height and recorded dietary data using a validated FFQ. Average food cost was calculated from official Spanish government data. We fitted multivariate linear and logistic regression models. The average daily diet cost increased from 3·68(SD0.0·89)€/8·36 MJ to 4·97(SD1·16)€/8·36 MJ during the study period. This increase was significantly associated with improvement in diet quality (Δ ED and Δ MDS-rec; P<0·0001). Each 1€ increase in monetary diet cost per 8·36 MJ was associated with a decrease of 0·3 kg in body weight (P=0·02) and 0·1 kg/m(2) in BMI (P=0·04). These associations were attenuated after adjusting for changes in diet quality indicators. An improvement in diet quality and better weight management were both associated with an increase in diet cost; this could be considered in food policy decisions.
authors.affiliation: 1Cardiovascular Risk and Nutrition Research Group (CARIN),Hospital del Mar Medical Research Institute (IMIM),08003 Barcelona,Spain.
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröder
authors.affiliation: 3Research Institute of Biomedical and Health Sciences,University of Las Palmas de Gran Canarias,35016 Las Palmas,Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: 2CIBER Epidemiology and Public Health (CIBERESP),Instituto de Salud Carlos III,28029 Madrid,Spain.
authors.forename: Isaac
authors.initials: I
authors.lastname: Subirana
authors.affiliation: 4CIBER Physiopathology of Obesity and Nutrition (CIBEROBN),Instituto de Salud Carlos III,28029 Madrid,Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Izquierdo-Pulido
authors.affiliation: 1Cardiovascular Risk and Nutrition Research Group (CARIN),Hospital del Mar Medical Research Institute (IMIM),08003 Barcelona,Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
authors.affiliation: 5Cardiovascular Epidemiology and Genetics Research Group (EGEC),Hospital del Mar Medical Research Institute (IMIM),08003 Barcelona,Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002755:Choice Behavior; D003132:Commerce; D003365:Costs and Cost Analysis; D015930:Diet Records; D038441:Diet, Mediterranean / Q000191:economics*; D002149:Energy Intake; D005260:Female; D005518:Food Preferences; D063427:Food Quality; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Diet cost; Diet quality; MDS-rec modified Mediterranean diet score-recommended intake; Prospective studies; Weight gain; rEI reported energy intake