WASHINGTON — High prices of nutritious foods in low- and middle-income countries partly explain high rates of undernutrition, according to new research from the International Food Policy Research Institute.
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While prior research has been conducted on the link between nutritious food prices and obesity, a study conducted by IFPRI and published in the Journal of Nutrition on Tuesday is the first to examine a link between food prices and undernutrition.
Researchers broke down caloric prices using World Bank income levels to examine associations with dietary indicators for women and children, including under-5 stunting and adult overweight.
The richer a country gets, the cheaper healthier and nutrient-dense foods get, said Derek Headey, a senior fellow at IFPRI. But unhealthy foods get cheaper, too.
“That finding is of importance because it has implications both for what we should be doing in developing countries in terms of undernutrition, and that’s trying to improve the food system so that it delivers healthy foods more cheaply,” Headey said.
“People in developing countries don’t just have poor income, they also live in poor food systems.”— Derek Headey, senior fellow, IFPRI
Researchers used food prices from the World Bank’s International Comparison Program, a statistical database used to measure cost of living around the world. The standardization of this system allowed them to compare different varieties of the same food, like basmati rice versus jasmine rice. Each of those would qualify as a separate food product among the 657 food products examined in the study. Those foods were then put into 21 specific food groups that could be measured against one another.
The study found that most noncereal foods were relatively cheap in high-income countries, but in lower-income countries healthy foods were generally expensive, including animal-sourced foods and fortified infant cereals. In seven of nine food groups, children were less likely to eat foods with higher relative caloric prices. Higher milk prices were associated with a 2.8 percentage point increase in stunting, while higher soft drink prices saw obesity rates drop by 3.6 percentage points.
As countries develop, processed foods become cheaper, which plays a role in the choices people make about what to eat, Headey said. Sugary foods decrease in price as large international food companies expand distribution to LMICs countries. Access to nutritious food isn’t just a matter of someone’s income, but the availability of such items in their local market when often the healthiest foods are the most perishable.
“People in developing countries don’t just have poor income, they also live in poor food systems,” Headey said. “Their dollar or their rupee or whatever doesn’t go as far because the foods that we really want them to eat, especially young children, are really expensive.”
While it’s not surprising that different foods would cost different amounts in different places throughout the world, Headey said it’s the depth of the disparities that are particularly striking, such as in Africa, where milk and eggs are relatively expensive.
The EAT-Lancet Commission attempted to map out a healthy, sustainable diet to feed the world's growing population — but some say it is not realistic for low-income settings.
This is one reason that nutrition-sensitive agriculture is so important, Headey explained. Managing costs across the food system allows people access to nutritious foods at more affordable prices, and more emphasis must be put into agricultural investment in nutrient-dense foods rather than staple foods, as well as bringing down the cost of fortified foods.
“We have a significant problem in that most of the history of investment in agricultural research and development in poor countries has been focused on staple foods. And there’s been good rationale for that, poor people grow a lot of staple foods and they spend a lot of money of their household budget on staple foods,” Headey said, noting that many approaches have been focused on food security and poverty reduction.
“But the problem is that those staple foods are really not what young kids need to be fed. They need to be fed nutrient-dense foods. Their mothers need to be eating these nutrient-dense foods.”
High-income countries have been debating the merits and future of animal-based diets, but animal proteins are often the best way for children to be eating this diversity of nutrients they need, Headley said. He’d like to see his research inform sensible nutrition interventions by incorporating price considerations into program design so practitioners are taking into account relative caloric prices.
“It’s not going to be feasible for a woman to feed her child eggs if eggs are 10 or more times expensive than rice. That’s really important, to change the mindset of the role of prices, or you might say the food system, in constraining nutritious behaviors,” Headey said. “When we’re doing interventions [we need] to think about the consequences: Are we doing things that are really going to make healthy foods more affordable?”
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