The Cost of a Healthy Diet in Trinidad and Tobago

Abstract

BackgroundThe chronic non‐communicable diseases (diabetes mellitus, hypertension, cancers and cardiovascular diseases) are major contributors to adult illness and death locally. In fact, diabetes mellitus and hypertension account for over half of all annual visits to local healthcare facilities. Healthy dietary practices play important roles in the prevention and management of these diseases. In this study, we evaluated the cost of consuming diets that are consistent with good health.MethodsThe study was a cross‐sectional in nature. Participants (18–65 years) completed a self‐administered questionnaire consisting of socio‐demographic, physical activity and a food frequency questionnaire. The food frequency questionnaire was designed to capture the usual dietary intake of the Trinidad and Tobago population over a one month period. For each food example of serving sizes were given. Serving sizes were multiplied by frequency to estimate the amount the food item consumed. These were converted to number serving per day. For each individual the serving sizes for foods consumed were entered in to the Nutrigenie 7 (Optimum Nutrition Software) and analysed for nutrients and calories. This software uses the 2002–2005 Institute of Medicine (IOM) Dietary Reference Intakes for nutrients and calories to rate overall diet quality. It ranks the overall diet by assigning a star rating from 1 to 5, with 1 being the lowest in quality. A star rating of 3 or more suggests that the diet has met or exceeded the level for acceptability. Anthropometry was self‐reported with 10% of the population having measurements done according to recommended procedures. The Scofield equation was used to determine basal metabolic rate (BMR). The Goldberg ratio of reported energy intake to BMR was used to determine the level of plausible reporting. Plausible reporters were categorised with a cut‐off point where energy intakes that were 1.21 to 2.39 times BMR. All participation was voluntary. The University of the West Indies Ethics Committee approved the study.ResultsEleven Thousand Seven Hundred and Eighty persons participated in the study. Approximately 67% (Females = 4549; Male = 3,300) met the Goldberg criteria for plausible reporting of energy intakes. Based on the Goldberg criteria for plausibility males had significantly higher intakes of calories (2223 ± 652 Kcal vs 1987 ± 594 Kcal; P, 0.001). Forty‐three percent of participants consumed diets that had adequate levels of vitamins while 72.2 had adequate levels of mineral intakes. Only 37% of participants met the IOM of Medicine 2002–2005 criteria for dietary adequacy. Mean BMI was 23.9 ± 4.9 with 36% of participants being overweight and obese. Our calculations revealed that persons consuming a healthy diet (≥ 3 stars) would have to spend on average 10 TT dollars (1.50 US) dollars per day compared to those consuming less healthy diets.ConclusionThe cost of improving diets to ensure compliance with the IOM standards is approximately 45 US dollars per month or 540 US dollars per year. For a family of 4 persons this would represent a substantial cost. This could be easily offset by the cultivation of fruits and vegetables as part of a home garden.Support or Funding InformationNone