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Influence of food cost on diet quality and risk factors for chronic disease: A systematic review


  • J.H. Lee, BND, Honours Student

  • R. Ralston, MS, RD, Assistant Lecturer

  • H. Truby, PhD, APD, Head of Department

  • Author contributions: JL conducted the database search, determined studies for exclusion and inclusion, extracted data from retrieved studies, and drafted the manuscript. RR and HT oversaw and advised the review process, contributed ideas throughout the review, and revised and prepared manuscript for publication. All authors approved the final manuscript.

R. Ralston, Department of Nutrition and Dietetics, Monash Medical Centre, Level 5, Block E, 246 Clayton Road, Clayton, VIC 3168, Australia. Email:


Aim:  To undertake a systematic literature review to examine the effect of food cost on diet quality and risk factors for chronic disease, specifically focusing on diet-related lifestyle diseases affecting the Australian population.

Methods:  A search of six databases resulted in the inclusion of one systematic review, three cohort studies, 41 cross-sectional studies and four modelling studies in this review.

Results:  Between 2000 and 2006, the price of healthy foods has increased more than the price of less healthy foods. Healthy Food Access Basket surveys show that a healthy diet may often be unaffordable for low- and average-income households. Diets of higher energy density were associated with lower diet cost, whereas diets of higher nutrient density and nutritional quality were associated with higher diet cost. Recent studies report an inverse association between food price and food consumption. Consequently, an increase in food cost was associated with a significant reduction in weight, waist circumference, body mass index, obesity and insulin resistance.

Conclusions:  Manipulation of food cost may alter food consumption and therefore risk factors for chronic disease. Further longitudinal studies investigating the impact of pricing strategies on diet quality and disease risk are needed.