Development Strategy and Governance Division, International Food Policy Research Institute, Bole Sub-City, Addis Ababa, Ethiopia.
Friedman School of Nutrition, Tufts University, Boston, MA, USA.
Lancet Glob Health. 2020 Jan;8(1):e59-e66. doi: 10.1016/S2214-109X(19)30447-4. Epub 2019 Nov 7.
The EAT-Lancet Commission drew on all available nutritional and environmental evidence to construct the first global benchmark diet capable of sustaining health and protecting the planet, but it did not assess dietary affordability. We used food price and household income data to estimate affordability of EAT-Lancet benchmark diets, as a first step to guiding interventions to improve diets around the world.
We obtained retail prices from 2011 for 744 foods in 159 countries, collected under the International Comparison Program. We used these data to identify the most affordable foods to meet EAT-Lancet targets. We compared total diet cost per day to each country's mean per capita household income, calculated the proportion of people for whom the most affordable EAT-Lancet diet exceeds total income, and also measured affordability relative to a least-cost diet that meets essential nutrient requirements.
The most affordable EAT-Lancet diets cost a global median of US$2·84 per day (IQR 2·41-3·16) in 2011, of which the largest share was the cost of fruits and vegetables (31·2%), followed by legumes and nuts (18·7%), meat, eggs, and fish (15·2%), and dairy (13·2%). This diet costs a small fraction of average incomes in high-income countries but is not affordable for the world's poor. We estimated that the cost of an EAT-Lancet diet exceeded household per capita income for at least 1·58 billion people. The EAT-Lancet diet is also more expensive than the minimum cost of nutrient adequacy, on average, by a mean factor of 1·60 (IQR 1·41-1·78).
Current diets differ greatly from EAT-Lancet targets. Improving diets is affordable in many countries but for many people would require some combination of higher income, nutritional assistance, and lower prices. Data and analysis for the cost of healthier foods are needed to inform both local interventions and systemic changes.
Bill & Melinda Gates Foundation.
EAT-柳叶刀委员会利用所有可用的营养和环境证据，构建了第一个能够维持健康和保护地球的全球基准饮食，但它没有评估饮食的可负担性。我们使用食品价格和家庭收入数据来估计 EAT-柳叶刀基准饮食的可负担性，这是指导改善全球饮食的干预措施的第一步。
我们从国际比较计划中获取了 2011 年 159 个国家 744 种食品的零售价格数据。我们利用这些数据确定了最实惠的食品，以满足 EAT-柳叶刀的目标。我们比较了每天的总饮食成本与每个国家的人均家庭收入，计算了最实惠的 EAT-柳叶刀饮食超过总收入的人的比例，还衡量了相对于满足基本营养需求的最低成本饮食的可负担性。
2011 年，最实惠的 EAT-柳叶刀饮食在全球范围内的中位数为每天 2.84 美元（IQR 2.41-3.16），其中最大的部分是水果和蔬菜的成本（31.2%），其次是豆类和坚果（18.7%）、肉、蛋和鱼（15.2%）以及奶制品（13.2%）。这种饮食的成本仅占高收入国家平均收入的一小部分，但对世界贫困人口来说是不可负担的。我们估计，EAT-柳叶刀饮食的成本超过了至少 15.8 亿人的家庭人均收入。EAT-柳叶刀饮食的成本也比平均最低营养充足成本高出 1.60 倍（IQR 1.41-1.78）。
目前的饮食与 EAT-柳叶刀的目标有很大差异。在许多国家，改善饮食是负担得起的，但对许多人来说，这需要收入增加、营养援助和价格降低的结合。需要有关更健康食品成本的数据和分析，以告知当地干预措施和系统变革。
比尔和梅琳达·盖茨基金会。
