IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2022i1p772-d1021619.html
   My bibliography  Save this article

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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/1/772/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/1/772/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Krivonos, Ekaterina & Kuhn, Lena, 2019. "Trade and dietary diversity in Eastern Europe and Central Asia," Food Policy, Elsevier, vol. 88(C).
    2. Jessica M. Phelan & Richard R. Rosenkranz & Connor J. Phelan & Sara K. Rosenkranz, 2023. "Holistic Framework to Contextualize Dietary Quality Assessment: A Critical Review," IJERPH, MDPI, vol. 20(5), pages 1-13, February.
    3. Mejía, Gonzalo & Aránguiz, Raúl & Espejo-Díaz, Julián Alberto & Granados-Rivera, Daniela & Mejía-Argueta, Christopher, 2023. "Can street markets be a sustainable strategy to mitigate food insecurity in emerging countries? Insights from a competitive facility location model," Socio-Economic Planning Sciences, Elsevier, vol. 86(C).
    4. repec:zbw:iamodp:285031 is not listed on IDEAS
    5. I. D. Brouwer & M. J. Liere & A. Brauw & P. Dominguez-Salas & A. Herforth & G. Kennedy & C. Lachat & E. B. Omosa & E. F. Talsma & S. Vandevijvere & J. Fanzo & M. Ruel, 2021. "Reverse thinking: taking a healthy diet perspective towards food systems transformations," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 13(6), pages 1497-1523, December.
    6. Ting Zhang & Bo Huang, 2018. "Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong," IJERPH, MDPI, vol. 15(10), pages 1-15, October.
    7. João Paulo dos Anjos Souza Barbosa & Paulo Henrique Guerra & Crislaine de Oliveira Santos & Ana Paula de Oliveira Barbosa Nunes & Gavin Turrell & Alex Antonio Florindo, 2019. "Walkability, Overweight, and Obesity in Adults: A Systematic Review of Observational Studies," IJERPH, MDPI, vol. 16(17), pages 1-17, August.
    8. Francisca de Castro-Mendes & Pedro Cunha & Inês Paciência & João Cavaleiro Rufo & Mariana Farraia & Diana Silva & Patrícia Padrão & Luís Delgado & André Moreira & Pedro Moreira, 2021. "The Influence of Eating at Home on Dietary Diversity and Airway Inflammation in Portuguese School-Aged Children," IJERPH, MDPI, vol. 18(5), pages 1-15, March.
    9. Tian, Xu & Lin, Faqin, 2023. "Trade liberalization and nutrition transition: Evidence from China," Economics & Human Biology, Elsevier, vol. 51(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:772-:d:1021619. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.