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Division of Nutritional Sciences and Department of Psychology, Cornell University, Ithaca, NY 14853-6301
1To whom correspondence should be addressed. E-mail: dal4{at}cornell.edu
See related article: J. Nutr. 132: 3764–3771, 2002.
Nicole Darmon, Elaine Ferguson and André Briend (1 ) utilized a mathematical technique, common to engineering and business, to produce a novel approach for estimating the importance of economics to the determination of food choice. Although their findings are not entirely original (2 –12 ), they add considerable support to the idea that economic constraints are a major factor in determining the nutritional value of foods purchased. The greater the economic constraints on individuals, the poorer the nutritional quality of foods selected. The approach taken by Darmon, Ferguson, and Briend stands apart from other "economic" studies of food choice because of the extent to which they went to use foods in their models that were indigenous to the people they were studying. Most of the previous economic work on "food elasticity curves" has relied on aggregate commodity data (13 –17 ).
One of the major assumptions these authors made in their analysis is that energy intake remained constant across economic conditions. Thus, under conditions of high economic constraint (poverty), the energy density (fat content) of the foods selected was found to increase. If energy intake were kept constant, then the consumption of the nonfat portion of the diet would decrease, resulting in a reduction in nutrient quality, which is exactly what Darmon and her colleagues observed. However, there is little evidence that humans reduce their intake of food when consuming a high fat (except when consuming a very low carbohydrate diet) or energy-dense diet (18 ). Indeed, there is abundant evidence showing that the energy density of the diet is a major determinant of obesity (18 ). If this is true, then the Darmon, Ferguson, and Briend paper may offer an answer to the paradox of why the incidence of obesity increases with poverty. Using either the assumption made by these authors that energy intake remains constant across diets or the one proposed here, the outcome is the same, i.e., increasing the economic constraints on the food purchase results in less healthy food choices.
The conclusion reached by Darmon et al. that "unhealthy eating patterns and nutritional inadequacy" are a result of "economic constraints" should serve as a major rallying cry for politically active nutritionists who want use data to change social policy. Although the analysis performed by these authors is correlational in nature, the results should serve as a persuasive argument for initiating the kinds of radical community intervention studies that are required to change social policy.
The next step to follow this paper is to examine the experimental effect of subsidizing lower fat, nutrient rich foods such as fruits and vegetables in supermarkets and observe the amount of the food purchased. Such a study should subsidize at various rates so that a function can be generated relating the cost of the subsidy to the amount purchased. If the results of such a study support the conclusion of Darmon et al., then further work must follow to determine how much of the subsidized food is actually consumed in a household and whether it is sufficient to change nutritional status.
If it can be shown that subsidizing nutritious food increases nutritional status, then the final link in this line of research would be to perform a cost-benefit economic analysis, much along the lines of David Rush’s (19 –21 ) evaluation of the Women, Infants and Children (WIC) program. The costs of subsidizing food would be compared with the cost of medically treating pathologies that would result if diet were not altered. If it can be shown that reducing "economic constraints" by subsidizing nutritious food would reduce the cost of medical care, particularly of the poor (as predicted by this model), then considerable political pressure can be applied to utilize food subsidy as a means of reducing the cost of government. At the same time, such a plan would reduce some of the disadvantages of poverty. Let us hope that there are nutritional researchers who have the courage to continue the challenge for social policy change that is inherent in the paper by Darmon, Ferguson, and Briend.
Manuscript received 4 December 2002. Revision accepted 10 December 2002.
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LITERATURE CITED |
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 TOP LITERATURE CITED |
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1. Darmon, N., Ferguson, E. L. & Briend, A. (2002) A cost constraint alone has adverse effects on food selection and nutrient density: an analysis of human diets by linear programming. J. Nutr. 132:3764-3771.
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17. Huang, K. S. & Lin, B. H. (2000) Estimation of Food Demand and Nutrient Elasticities from Household Survey Data. Economic Research Service, U.S. Department of Agriculture, Technical Bulletin no. 1887 2000 Washington, DC.
18. Levitsky, D. A. (2001) Macronutrient intake and the control of body weight. Monsen, E. eds. Nutrition and the Prevention and Treatment of Disease 2001 Academic Press San Diego, CA. .
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20. Rush, D. (1983) Birth weight and WIC. J. Am. Diet. Assoc. 83(76):78.
21. Rush, D. (1985) Further evidence on the value of the WIC program. Am. J. Public Health 75:828-829.
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