Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil.
MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, Montpellier, France.
PLoS One. 2020 Mar 11;15(3):e0229439. doi: 10.1371/journal.pone.0229439. eCollection 2020.
To identify food choices allowing the fulfillment of nutritionally adequate diets resembling actual food patterns at the lowest cost achievable for the Brazilian population, stratified by income level.
Food consumption and prices were obtained from the Household Budget Survey (n = 55,970 households) and National Dietary Survey (n = 32,749 individuals). The sample was stratified into capitals of the states and further by income levels according to the official minimum wage (totaling 108 geographic-economic strata, or GES). Linear programming models were performed for each GES in order to find the lowest cost of diets that meet a set of nutritional constraints. In order to find realistic diets, constraints referring to preferences were introduced in the models allowing optimized food quantities to depart progressively from the current intake for each food and food group. The impact of meeting each target nutrient was assessed by performing models removing each nutrient at the time.
The observed and optimized diet costs were US$2.16 and US$2.58 per capita/day. The highest cost increment and the greatest food shifts were observed in the lowest income level. The nutrient adequacy was reached by mainly increasing fruits and vegetables, beans, fish and seafood, dairy, nuts, and eggs; and reducing red and processed meat, chicken, margarine and butter, cookies, cakes, sugar-sweetened beverages, and sauces. As the departure from the current intakes increase, the optimized healthy diet cost reduced. In the lowest income, the lowest cost increment was about US$ 0.10; in the higher income levels, it tended to be cheaper than the observed cost. Calcium was the most expensive nutrient to meet adequacy.
Nutritionally adequate diets are possible but costlier than the observed.
确定在巴西人口可负担的最低成本下,能够满足营养充足饮食的食物选择,这些饮食选择类似于实际的食物模式,并按收入水平进行分层。
从家庭预算调查(n = 55970 户家庭)和国家饮食调查(n = 32749 人)中获取食物消费和价格数据。该样本按州首府进一步按官方最低工资(共 108 个地理经济区,或 GES)进行分层。为每个 GES 执行线性规划模型,以找到满足一系列营养限制的最低成本饮食。为了找到现实的饮食,在模型中引入了与偏好相关的限制,允许优化的食物量逐渐偏离每种食物和食物组的当前摄入量。通过逐个营养素的模型来评估满足每个目标营养素的影响。
观察到的和优化的饮食成本分别为每人每天 2.16 美元和 2.58 美元。在最低收入水平下,观察到最高的成本增加和最大的食物变化。通过主要增加水果和蔬菜、豆类、鱼类和海鲜、乳制品、坚果和鸡蛋,以及减少红肉和加工肉、鸡肉、人造黄油和黄油、饼干、蛋糕、加糖饮料和酱汁来实现营养充足。随着与当前摄入量的偏差增加,优化的健康饮食成本降低。在最低收入水平下,最低成本增加约为 0.10 美元;在较高收入水平下,成本往往比观察到的成本便宜。钙是最昂贵的满足充足性的营养素。
营养充足的饮食是可能的,但成本高于观察到的。