Which Dietary Changes to Achieve Nutritional Adequacy While Reducing Diet Cost in the French West Indies?

Abstract

ObjectivesThe French West Indies are facing increasing rates of obesity and diet-related chronic diseases. Food prices are ∼30% higher in these territories compared with mainland France, while a large part of their populations is socioeconomically disadvantaged. Economic affordability of a healthy diet is a key issue in this region. Our objective was to identify dietary changes that would allow Guadeloupean and Martinican adults to achieve nutritional adequacy while reducing the cost of their diets. MethodsDietary intakes of 1061 adults were obtained from a cross-sectional survey (2013–2014) conducted on a representative sample of the Guadeloupean and Martinican populations. Diet cost was based on mean prices of 1357 foods compiled from a Martinican supermarket website. For each adult, optimized diets respecting all nutritional recommendations and with minimized departure from initial diet were designed with linear programming under 3 scenarios: 1) all nutritional constraints, 2) all nutritional constraints without exceeding initial diet cost, and 3) all nutritional constraints while reducing diet cost by 30%. ResultsWhen cost was not constrained, achieving nutritional adequacy while departing the least from individual food intakes induced an increase in cost for most adults (74%). When cost was not allowed to increase, achieving nutritional adequacy induced an increase in the consumption of fruit & vegetables, unrefined starches, dairy products (especially milk), eggs and vegetable fats, and a decrease in sweetened beverages (especially for < 30 y), refined starches, sweetened products, meat and fish. When a 30% reduction of cost was imposed, achieving nutritional adequacy induced the same types of dietary changes than with scenario 2, but modified their magnitude (and thus the effort for consumers), notably a smaller increase in vegetables (+7 vs. +86g/d) but a larger increase in dairy (+90 vs. +72 g/d) and starchy foods (+112 vs. +54 g/d), and a larger reduction in meat (–48 vs. –12 g/d). Increases in fruits (∼+80g/d) and unrefined starches (+127 g/d) and decrease in sweetened beverages (∼–100 g/d) were still observed. ConclusionsNutrition prevention programs promoting the affordable dietary changes identified in this study could help improve nutritional adequacy of the Guadeloupean and Martinican populations. Funding SourcesFrench National Research Agency.