Kachwaha Shivani, Nguyen Phuong Hong, DeFreese Michelle, Avula Rasmi, Cyriac Shruthi, Girard Amy, Menon Purnima
International Food Policy Research Institute, Washington, DC, USA.
Congressional Hunger Center, Washington, DC, USA.
Curr Dev Nutr. 2020 Nov 13;4(12):nzaa169. doi: 10.1093/cdn/nzaa169. eCollection 2020 Dec.
Healthy diets can help reduce undernutrition, morbidity, and mortality. However, evidence on the accessibility and affordability of recommended diets is limited, particularly in poor-resource settings including India.
This study examined: ) the minimum cost of different types of household diets; ) how economic constraints can prevent households from accessing a nutritious diet; and ) how home production and social protection can improve access to nutritious diets.
We conducted 24 market and 125 household surveys in Uttar Pradesh, India, to obtain food prices and consumption patterns. Cost of Diet, a linear programming software, was used to assess the minimum cost of different diets, estimate affordability of nutritious diets, and model scenarios of home production and social protection interventions to improve affordability.
The minimum-cost nutritious diet that met all recommended nutrient requirements [904 US dollars (US$)/y] was over twice as expensive as the diet that only met energy requirements (US$393/y). The nutritious diet was unaffordable for 75% of households given current income levels, consumption patterns, and food prices. Household income and dietary preferences, rather than food availability, were the key barriers to obtain nutritious diets. Home production had potential to reduce the cost of nutritious diets by 35%, subsidized grains by 19%, and supplementary food by 10%. The poorest households could only afford recommended nutritious diets with access to multiple interventions.
Practical, habitual, diet-related behavior change communication to middle- and high-income households and additional social protection for poorer households could enable individuals to achieve optimal nutrient intakes.
健康饮食有助于减少营养不良、发病率和死亡率。然而，关于推荐饮食的可及性和可负担性的证据有限，尤其是在包括印度在内的资源匮乏地区。
本研究考察了：（1）不同类型家庭饮食的最低成本；（2）经济限制如何阻碍家庭获得营养饮食；（3）家庭生产和社会保护如何改善营养饮食的可及性。
我们在印度北方邦进行了24次市场调查和125次家庭调查，以获取食品价格和消费模式。使用线性规划软件“饮食成本”来评估不同饮食的最低成本，估计营养饮食的可负担性，并模拟家庭生产和社会保护干预措施以提高可负担性的情景。
满足所有推荐营养需求的最低成本营养饮食[904美元/年]比仅满足能量需求的饮食（393美元/年）贵两倍多。鉴于当前收入水平、消费模式和食品价格，75%的家庭无法负担营养饮食。家庭收入和饮食偏好而非食物供应是获得营养饮食的关键障碍。家庭生产有可能将营养饮食成本降低35%，补贴谷物成本降低19%，补充食品成本降低10%。最贫困家庭只有在获得多种干预措施的情况下才能负担得起推荐的营养饮食。
对中高收入家庭进行实用、习惯性、与饮食相关的行为改变宣传，并为贫困家庭提供额外的社会保护，可使个人实现最佳营养摄入。
