Novel method to achieve price-optimized, fully nutritious, health-promoting and acceptable national food baskets

Purpose: The purpose of this study was to generate a framework for the development of health-promoting, fully nutritious, socially acceptable, and affordable national food baskets to be used as an advocacy tool by governments. In addition to containing all (micro-)nutrient requirements, food baskets should also reflect dietary guidelines to prevent non-communicable diseases and be optimized to achieve the highest possible social acceptance. So far, integrative approaches that include all these aspects are lacking. Methods: Food composition, local availability, food prices, national and international recommendations on ‘healthy’ nutrition, and current respective preferences of the corresponding populations were optimized using linear programming (LP) methods (Dantzig’s simplex algorithm). The desired outcomes were ‘best-for-price’ solutions (= food baskets) from a list of 150-190 locally available foods. The study was designed to obtain healthy, affordable, and socially acceptable diets for three European countries (Denmark, Slovenia, and Romania) and in three regions within Canada, Argentina, and Switzerland. Moreover, the costs for the “limiting” micronutrients and relative price increases were calculated after including a range of constraints (e.g. dietary recommendations vs nutrient requirements; wider range of biodiversity (increased number of foods included) and social acceptability). All data were collected in the respective countries using standard methodology. Results: Key micronutrients influencing the increased cost of food baskets were calcium, potassium, and the vitamins A, B2, C, and D. When additional constraints were applied by integrating food-based dietary guidelines and social acceptability (as measured by current consumption patterns, central 80% percentile), the cost increased by approximately one third and three fold, respectively. The wider range of biodiversity resulted in just minor increases in cost. Conclusions: The cost of health-promoting, fully nutritious, and socially acceptable food baskets depended primarily on their adaptation to local dietary patterns. Fully nutritious and health-promoting food baskets can be achieved at a relatively low price. However if these are not socially acceptable to the target population, the use of a framework using linear programming based solely on nutritional values seems limited.

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