Higher diet quality is associated with higher diet costs when eating at home and away from home: National Health and Nutrition Examination Survey, 2005-2016.

Conrad, Zach; Reinhardt, Sarah; Boehm, Rebecca; McDowell, Acree

OBJECTIVES To evaluate the association between diet quality and cost for foods purchased for consumption at home and away from home. DESIGN Cross-sectional analysis. Multivariable linear regression models evaluated the association between diet quality and cost for all food, food at home, and food away from home. SETTING Daily food intake data from the National Health and Nutrition Examination Survey (2005-2016). Food prices were derived using data from multiple, publicly available databases. Diet quality was assessed using the Healthy Eating Index-2015 and the Alternative Healthy Eating Index-2010. PARTICIPANTS 30,564 individuals ≥20 y with complete and reliable dietary data. RESULTS Mean per capita daily diet cost was $14.19 (95% CI: $13.91-14.48), including $6.92 ($6.73-7.10) for food consumed at home and $7.28 ($7.05-7.50) for food consumed away from home. Diet quality was higher for food at home compared to food away from home (P<0.001). Higher diet quality was associated with higher food costs overall, at home, and away from home (P<0.001 for all comparisons). CONCLUSIONS These findings demonstrate that higher diet quality is associated with higher costs for all food, food consumed at home, and food consumed away from home. This research provides policymakers, public health professionals, and clinicians with information needed to support healthy eating habits. These findings are particularly relevant to contemporary health and economic concerns that have worsened because of the COVID-19 pandemic.