title: The Six-Food Elimination Diet for Eosinophilic Esophagitis Increases Grocery Shopping Cost and Complexity.
abstract: The six-food elimination diet (SFED), where dairy, wheat, eggs, soy, nuts, and seafood are avoided, is an effective treatment for eosinophilic esophagitis (EoE). Patient-related costs of this approach, however, are unknown. We aimed to assess the cost of and ease of shopping for an SFED compared to an unrestricted diet. A dietitian with expertise in EoE generated menus meeting dietary requirements for a week's worth of meals for the SFED and an unrestricted diet. We compared prices and the number of missing items for both diets at standard and specialty grocery stores. The average weekly price of the SFED at a standard supermarket was $92.54 compared to $79.84 for an unrestricted diet (p = 0.0001). A patient shopping at a standard grocery store needed a higher proportion of items from a second store compared to an unrestricted diet (32 vs. 3 %, p = 0.0001). The prices of the SFED and unrestricted diet using a specialty supermarket were comparable ($106.47 vs. $105.96, p = 0.81), as was the percentage of items requiring a trip to a second store (6 vs. 2 % items, p = 0.03). Shopping at a specialty grocery store increased weekly grocery costs by $13.93 (p = 0.04) for the SFED and $26.12 (p = 0.03) for the unrestricted diet. In conclusion, for patients shopping at standard grocery stores, the cost of an SFED is higher, and an SFED requires more items from a second store. These differences disappear at specialty grocery stores, but costs were significantly higher. This cost and logistical burden can inform patients when selecting dietary therapy.
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, CB #7080, Bioinformatics Building, 130 Mason Farm Rd.,, Chapel Hill, NC, 27599-7080, USA.
authors: W
authors: W
authors: Asher Wolf
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, CB #7080, Bioinformatics Building, 130 Mason Farm Rd.,, Chapel Hill, NC, 27599-7080, USA.
authors: Kevin Z
authors: KZ
authors: Huang
authors: Asthma & Allergy Specialists, 8045 Providence RD, Ste 300, Charlotte, NC, 28277, USA.
authors: Raquel
authors: R
authors: Durban
authors: Department of Medicine, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
authors: Zahra J
authors: ZJ
authors: Iqbal
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, CB #7080, Bioinformatics Building, 130 Mason Farm Rd.,, Chapel Hill, NC, 27599-7080, USA.
authors: Benjamin S
authors: BS
authors: Robey
authors: Department of Medicine, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
authors: Farah J
authors: FJ
authors: Khalid
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, UNC-CH, CB #7080, Bioinformatics Building, 130 Mason Farm Rd.,, Chapel Hill, NC, 27599-7080, USA. edellon@med.unc.edu.
authors: Evan S
authors: ES
authors: Dellon
mesh_terms: D003132:Commerce; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D004032:Diet / Q000191:economics* / Q000379:methods; D057765:Eosinophilic Esophagitis / Q000178:diet therapy* / Q000191:economics; D005502:Food / Q000191:economics*; D006801:Humans; D014481:United States
keywords: Cost analysis; Deglutition; Deglutition disorders; Dietary therapy; Eosinophilic esophagitis; Six-food elimination diet; Targeted elimination diet