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Differences in Cost-Effectiveness of Adherence to Nutritional Recommendations: Why, Where, and What?

Author

Listed:
  • Aline Veroneze de Mello

    (School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil)

  • Flavia Mori Sarti

    (School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil)

  • Marilisa Berti de Azevedo Barros

    (School of Medical Sciences, State University of Campinas, Campinas 13083-894, Brazil)

  • Moises Goldbaum

    (School of Medicine, University of Sao Paulo, Sao Paulo 01246-903, Brazil)

  • Chester Luiz Galvão Cesar

    (School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil)

  • Regina Mara Fisberg

    (School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil)

Abstract

Cost-effectiveness analysis of diets may comprise an important tool to promote food security; however, studies show divergent evidence regarding the relationship between diet quality and cost in diverse populations. Thus, this study assesses differences in cost-effectiveness ratios regarding adherence to nutritional recommendations using data representative of the population level in Sao Paulo municipality, Brazil. Information from adolescents and adult individuals ( n = 1742) was used to estimate diet quality and cost in 2015. Differences in cost-effectiveness ratios were investigated through application of two diet quality indexes and exploration of individuals’ personal and contextual characteristics. Results indicated that higher diet cost was associated with higher adherence to nutritional recommendations at the national level and inversely associated with adherence to international recommendations. Purchasing foods in street markets was linked to healthier diets at lower costs, and protein consumption was associated with higher diet cost regardless of diet quality; however, diet quality was linked to type of protein consumed by individuals. Differences in cost-effectiveness ratios were attributable to methodological choices in measuring dietary quality (why); individuals’ personal and contextual characteristics, in particular, access to retail equipment (where); and certain food choices (what). Therefore, cost-effectiveness analyses should be tailored to policy goals and local environments to ensure proper assessment of nutrition programs and to foster improvements in nutritional diet quality at lower cost.

Suggested Citation

  • Aline Veroneze de Mello & Flavia Mori Sarti & Marilisa Berti de Azevedo Barros & Moises Goldbaum & Chester Luiz Galvão Cesar & Regina Mara Fisberg, 2022. "Differences in Cost-Effectiveness of Adherence to Nutritional Recommendations: Why, Where, and What?," IJERPH, MDPI, vol. 20(1), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:772-:d:1021619
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    References listed on IDEAS

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    1. Burggraf, Christine & Teuber, Ramona & Brosig, Stephan & Meier, Toni, 2018. "Review of a priori dietary quality indices in relation to their construction criteria," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 76(10), pages 747-764.
    2. Carla Tomazini, 2022. "Pioneering anti-poverty policies in Brazil and Mexico: ambiguities and disagreements on conditional cash transfer programs," Post-Print hal-03642660, HAL.
    3. Eliseu Verly Jr & Nicole Darmon & Rosely Sichieri & Flavia Mori Sarti, 2020. "Reaching culturally acceptable and adequate diets at the lowest cost increment according to income level in Brazilian households," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-15, March.
    4. Luana Romão Nogueira & Mariane De Mello Fontanelli & Breno Souza de Aguiar & Marcelo Antunes Failla & Alex Antonio Florindo & Ligia Vizeu Barrozo & Moisés Goldbaum & Chester Luiz Galvão Cesar & Maria , 2018. "Access to Street Markets and Consumption of Fruits and Vegetables by Adolescents Living in São Paulo, Brazil," IJERPH, MDPI, vol. 15(3), pages 1-12, March.
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