Shopping for healthier groceries, like whole wheat bread instead of white bread and lean meat instead of fattier cuts, would cost a family of four about $1,500 (S$2,025) more a year at their regular stores, according to a new US study.
The small survey focused on 23 families of children with type 1 diabetes. Parents are urged to feed kids with diabetes a low-fat diet, but they may need help with problem-solving skills to provide healthy foods without a heavy burden of extra costs or prep time, researchers say.
Healthy diets are important for everyone, and people with type 1 diabetes don't have drastically different food requirements from everyone else, said lead author Susana R. Patton of the pediatrics department at the University of Kansas Medical Center in Kansas City.
"The biggest thing we think about is a lower total fat intake," Patton told Reuters Health. Diabetes increases the risk for cardiovascular disease, so managing fat intake is important, she said.
"There are no specific restrictions, but some foods are harder to manage, like fruits and fruit juices," she said.
For the study, researchers went shopping at the usual grocery sources reported by 23 families in the northeastern Kansas and western Missouri area. The families all had a child with type 1 diabetes under age seven in the home.
At the stores, the researchers recorded the lowest non-sale price for items on a typical two-week grocery list for a family of four living on a modest food budget, and did the same for a healthier version of the same list including healthier substitutes for the original dairy, meats, canned fruit, fats, breads and other grain products. The healthier list results in four times the total amount of fiber and one-fifth the grams of total fat compared to the regular list.
For example, the regular list calls for canned fruit in heavy or light syrup and for chicken thighs, whereas the healthier list calls for canned fruit in juice and for chicken breasts.
The average shopping trip using the regular list totaled $324.71, compared to $380.07 for the healthier list, as reported in the Journal of Nutrition Education and Behavior.
The researchers also found that small independent markets tended to be missing more specific healthy foods than chain supermarkets or big box stores.
Kids with type 1 diabetes typically see a provider at a diabetes centre four times per year, and at least one visit will be with a dietitian, Patton said.
"We need to give these families these other options," she said.
Often counselors focus on recommending fresh fruits and vegetables, but canned or frozen options can be more affordable, she said.
"A lot of families will tell me, 'I'm supposed to give my child fruits and vegetables, but he only eats strawberries, and they're not in season all year round'," she said. Buying frozen strawberries can take into account the child's taste and the family's budget.
"A lot of independent stores didn't have whole grain options, or these were more expensive," but things like oatmeal can be an affordable source of fiber as well, she said.
Parents should discuss how to shop for healthy items at their local stores with their providers, she said.
"I'm hesitant to tell people where to shop," as families choose grocery sources by convenience and other factors, Patton said.
Even with workarounds, families trying to eat healthy for any reason may end up shouldering some extra cost, she said.
"Earlier research shows similar findings: healthier diets cost more," said Ingrid Steenhuis of VU University Amsterdam in The Netherlands. This is true of many Western industrialized countries, she said.
Families looking for financial support may be eligible for the Supplemental Nutrition Assistance Program (SNAP), and during the school year public schools provide reduced or free meals based on federal nutrition guidelines to children whose families qualify, said Judith Wylie-Rosett, a professor of health promotion and nutrition research at Albert Einstein College of Medicine in New York, who was not part of the new research.
"Other studies show that price is an important factor in food choice, so changing the prices in favour of the healthier choices is a good option to influence dietary behaviour," Steenhuis, who also was not involved in the new research, told Reuters Health by email.
"The challenge is to eat as healthy as possible, within the restraints of the budget you have," she said.