Nutritional Pearls: Comparing the Costs of Popular Diets

Ronald is a 36-year-old overweight man who has been attempting to lose weight for many years.

He has tried several popular diets, but has struggled both to maintain each diet for more than a few weeks and to afford the healthier foods associated with each diet.

He asks you if there is any inexpensive, effective diet that would help him to lose weight.

How do you advise your patient?
(Answer and discussion on next page)

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Answer: It is less expensive in the long run to eat a healthier diet.  

There's been plenty of discussion about the supposed higher cost of eating healthy. The truth is that on the large scale, not only is it cheaper in the long run to eat healthier (because you'll spend so much less on health care), but on the small scale it's cheaper on a cost-per-serving basis as well.
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Mind you, this is basically comparing the cost of cooking at home to the cost of eating something similar at a fast food joint or out of a box. There's been some research, however, showing that the cost of a healthier diet is in fact higher than a less-healthy diet—as long as you compare the least-healthy versions of a food to the most-healthy versions of a food.

The Background

Back in 2000, registered dietitian Mary Flynn, PhD, designed a 6-week cooking program for food pantry clients that is both plant-based (no meat whatsoever) and utilizes olive oil exclusively (no butter or margarine). The goal of her original research was to see if using the recipes in her program for 3 meals per week would help reduce clients' food cost. The good news is that those clients did use the recipes for meals, on average, between 2.8 and 4.1 times per week, which did indeed reduce their weekly food costs along with their body mass index.

The Research

With this in mind, Dr. Flynn and her colleagues compared the cost of her plant-based olive oil (PBOO) diet with the cost of a MyPlate diet, based on USDA and HHS recommendations.¹ They used 2 7-day meal plans for each diet and set a goal of 2000 calories per day. The PBOO diet used the recipes Dr. Flynn had developed for food pantry clients, while the diet for MyPlate was based on a sample 2000-calorie menu created by the USDA and described as "economical in cost."

The authors determined the amounts of each ingredient used in the 2 diets and based the cost of each ingredient on pricing information available at a single local supermarket chain. The ingredients for the PBOO diet used shelf-stable items like those found in food pantries and used fresh or canned fruit; fresh, canned, or frozen vegetables, and only extra virgin olive oil. The MyPlate diet followed the USDA's instruction to choose low sodium or low fat options and both canola oil and margarine. For both diets the authors chose non-sale prices of either the store brand of the item or the cheapest comparable item when a store brand was not available.

The Results

Overall, the PBOO diet did indeed cost less than the MyPlate diet, at $38.75 for the week compared to $53.11. The PBOO diet also had more servings of vegetables, fruit, and whole grains than the MyPlate diet, yet both "meal plans were equivalent in most nutrients."

Concerns

On paper, it would seem clear that the PBOO meal plan is superior to the MyPlate diet. Reading closely, however, brought up some concerns: first, the PBOO diet used olive oil exclusively, while the MyPlate diet used only canola oil and margarine. Dr. Flynn makes the interesting statement that her plan "uses only extra virgin olive oil, which is the juice of the olive fruit and has numerous health benefits" then adds "...it is a plant product." But canola oil, made from the rapeseed, is also a plant product and has its own health benefits.

Further, Dr. Flynn states that "frequent red meat consumption has been associated with an increased risk of chronic diseases and mortality." This is quite true, which is why I recommend limiting your red meat intake to no more than 1 serving in 2 weeks. However, she also recommends against the inclusion of poultry or seafood even though fish and shellfish are excellent sources of omega-3 fatty acids. While there are plant sources of omega-3s, including walnuts and canola oil, there don’t appear to be comparable sources in the PBOO diet.

What’s the Take-Home?

The biggest issue I have with this research is the same one I have with fad diets like the Atkins diet or the Paleo diet: for most people this (a wholly plant-based diet) is not sustainable for the long term (nor is it realistic to think that people will cook every single night, as they do here in both the PBOO diet and the MyPlate diet). They simply are not going to give up the occasional bacon burger or their turkey at Thanksgiving or the Sunday roast chicken. Certainly, some people will—but most won't, and my goal is to meet people where they are: with tasty, healthy, familiar foods that people can live with for the long haul.

Reference:

1. Flynn MM, Schiff AR. Economical healthy diets (2012): including lean animal protein costs more than using extra virgin olive oil. J Hunger Env Nutr. 2015;10:467-482.