Development of a healthy food basket for Victoria
Ms Claire Palermo, Nutrition and Dietetics Department, Faculty of Medicine Nursing and Health Sciences, Southern Clinical School, Monash Medical Centre, level 5 block E 246 Clayton Road, Clayton, Victoria 3168 Fax: (03) 9594 6509; e-mail: firstname.lastname@example.org
Objective: Access to an affordable, nutritious food supply is an important determinant of population health. Healthy food basket surveys have been used across Australia as a tool to monitor food cost, quality and variety. The release of the revised Nutrient Reference Values, together with local interest in food security, highlighted the need to develop a Victorian Healthy Food Basket to reflect the food access issues of the Victorian population.
Method: The development took place at Monash University, Victoria, in December 2006. Demographic and food purchasing data were used to define the family types and foods in the healthy basket, respectively. The revised Nutrient Reference Values were used to benchmark the nutritional adequacy of the basket.
Results: A Victorian Healthy Food Basket consisting of 44 core and non-core foods was developed. The quantities of the 44 items in the basket were modified to meet the nutritional needs of four different family types most common in Victoria and those most vulnerable to food insecurity: two adults and two children; a single mother and two children; a single adult male; and a single elderly female.
Conclusions: Victoria has a local tool to monitor healthy food cost and accessibility that meets at least 85% of all individual nutrient requirements and at least 95% of all energy requirements for four family types for a fortnight.
Implications: The Victorian Healthy Food Basket provides an additional tool to monitor the cost and access to healthy food in Victoria.
Access to an affordable and nutritious food supply has been recognised as an important determinant of people's nutrition and thus health outcomes.1 While the Australian consumer price index monitors changes in food cost, no national tool exists to investigate the cost, availability or quality of healthy foods. Queensland,2 the Northern Territory,3 the Illawarra area4 and South Australia5 have each developed different healthy food baskets to measure food access including cost, availability and quality. Some groups have used the Queensland Healthy Food Access Basket to assess food access in Victoria,6,7 but there has been criticism of its use in this context as the Victorian population does not share the same issues associated with food cost, access and availability in Queensland. The existing baskets may need to be reassessed for nutritional adequacy against the revised Nutrient Reference Values (NRVs) released in 2006.8
This report describes the development of a Victorian Healthy Food Basket (VHFB) based on the Queensland model, although modified to reflect the Victorian population in terms of family composition, food choices and food accessibility and to meet revised nutrient recommendations.
Development – the families
The VHFB was developed to reflect the nutritional needs for an array of family sizes and compositions. The selected reference families were also chosen based on those most affected by food insecurity.9 The composition of these families was determined by ascertaining the most common age and sex characteristics of these respective family types from Australian Bureau of Statistics Family Characteristics Survey10 and Census of Population and Housing11 data. This data indicated that 71% of households were families, with 84% of those being couple families and 60% of these families having children. Eighty-six per cent of dependent children in couple families were aged between 5–11 years and 50% of non-dependents were aged 18–24 years. The data indicated that 14% of families had one parent. Seventy-four per cent of dependent children in one-parent families were aged between 5–11 years and 40% of non-dependents were aged 18–24 years. The most common lone dweller was a female aged over 75 years and the most common age for a male living alone was between 33–44 years.10–11
Four reference families were chosen to allow for varying nutritional needs. These were:
- •‘Typical family’ (44-year-old male and female, 18-year-old female, eight-year-old male).
- •‘Single parent family’ (44-year-old female, 18-year-old female, eight-year-old male).
- •‘Elderly pensioner’ (71-year-old female).
- •‘Single adult’ (adult male >31 years).
The estimated average requirements (EARs) from the new NRVs were used to determine the nutritional requirements of the individuals in the families.8 If an EAR was not available for a given nutrient then the adequate intake (AI) amount was used.8 Standard daily targets (SDTs) were also used for nutrients where recommended.8 The National Heart Foundation's recommendation that less than 10% of dietary energy be derived from saturated fat as well as a P:M:S ratio of 1:2:1 was also set.12 The VHFB aimed to meet more than 80% of nutrient requirements for individuals and at least 95% of energy requirements for the reference families for a fortnight (14 days). These nutrient and energy levels were chosen as they were the same as or greater than the levels used in the Queensland basket2 and the Northern Territory's Nutritionist's Market Basket Survey.3
Development – the foods
The foods contained in the VHFB were based on the Queensland Healthy Food Access Basket2 for potential comparative purposes but modified to suit Victorian purchasing trends. The ACNielson Grocery Report13 and ABS Household Expenditure surveys14 were used as a more up-to-date source of information on food consumption (instead of the 1995 National Nutrition Survey) to arbitrarily devise the basket. The limitations of using this data are significant and noted by the authors. The final basket contains a total of 44 foods from the five core food groups and one non-core food group (see Table 1). A chocolate bar and a soft drink are included in the survey to provide a cost comparison but do not contribute to the nutritional analysis.
Table 1. Food quantities to meet nutritional requirements of the family members for a fortnight.
|Breads and cereals|| || || || || |
| White bread||680 g||1.4 loaves||0.7 loaves||0.2 loaves||0.8 loaves|
| Wholemeal bread||680 g||5.8 loaves||3.6 loaves||1.3 loaves||2.3 loaves|
| Crumpets (rounds, 6pk)||300 g||3.1 packets||2.2 packets||0.9 packets||0.9 packets|
| Weet-bix||750 g||1.4 packets||0.9 packets||0.2 packets||0.5 packets|
| Instant oats||500 g||1.5 packets||1.2 packets||0.4 packets||0.4 packets|
| Pasta||500 g||1.7 packets||1.1 packets||0.4 packets||0.6 packets|
| White rice||1 kg||1.4 bags||0.9 bags||0.3 bags||0.6 bags|
| Instant noodles||85 g||9 packets||0.6 packets||2 packets||3 packets|
| Premium biscuits||250 g||1.3 packets||0.8 packets||0.2 packets||0.5 packets|
|Fruit|| || || || || |
| Apples||1 kg||5.8 kg||4.3 kg||1.8 kg||1.4 kg|
| Oranges||1 kg||5.7 kg||4.6 kg||1.4 kg||1.1 kg|
| Bananas||1 kg||4.1 kg||2.8 kg||0.9 kg||1.3 kg|
| Tinned fruit salad, natural juice||450 g||9 tins||4.9 tins||1.8 tins||3.7 tins|
| Sultanas||250 g||0.84 packets||1 packet||0.2 packets||0.4 packets|
| Orange juice 100%, no added sugar||2 L||2.5 L||1.5 L||0.5 L||0.8 L|
|Vegetables, legumes|| || || || || |
| Tomatoes||1 kg||4.7 kg||2.8 kg||1.1 kg||1.9 kg|
| Potatoes||1 kg||2.6 kg||1.7 kg||0.7 kg||1 kg|
| Pumpkin||1 kg||2.7 kg||1.7 kg||0.7 kg||1 kg|
| Cabbage||Half (500 g)||3.7 kg||2.8 kg||0.9 kg||0.9 kg|
| Lettuce||Whole||2.8 kg||1.8 kg||0.8 kg||1.1 kg|
| Carrots||1 kg||3.1 kg||2.2 kg||0.8 kg||0.9 kg|
| Onions||1 kg||1.2 kg||0.85 kg||0.3 kg||0.4 kg|
| Frozen peas||1 kg||1 kg||0.7 kg||0.3 kg||0.3 kg|
| Tinned tomatoes||400 g||8 tins||6 tins||2 tins||2 tins|
| Tinned beetroot||450 g||0.8 tins||0.4 tins||0.2 tins||0.4 tins|
| Tinned corn kernels||440 g||2.1 tins||1.6 tins||0.6 tins||0.6 tins|
| Tinned baked beans||420 g||9.5 tins||5.7 tins||1.9 tins||3.8 tins|
|Meat and alternatives|| || || || || |
| Fresh bacon, shortcut, rindless||1 kg||0.75 kg||0.5 kg||0.2 kg||0.3 kg|
| Fresh ham||1 kg||0.54 kg||0.3 kg||0.12 kg||0.2 kg|
| Beef mince, regular||1 kg||1.1 kg||0.7 kg||0.34 kg||0.3 kg|
| Lamb chops, forequarter||1 kg||0.8 kg||0.4 kg||0.2 kg||0.4 kg|
| Chicken fillets, skin off||1 kg||1.3 kg||1 kg||0.3 kg||0.3 kg|
| Sausages||1 kg||0.9 kg||0.5 kg||0.3 kg||0.4 kg|
| Tinned tuna (unsat. oil)||425 g||2.8 tins||2.1 tins||0.7 tins||0.7 tins|
| Tinned salmon, pink (water)||210 g||2.9 tins||2.1 tins||0.7 tins||0.7 tins|
| Large eggs (min. 50 g, caged)||700 g dozen||1.6 boxes||1.2 boxes||0.4 boxes||0.4 boxes|
|Dairy|| || || || || |
| Fresh full cream milk||1 L||2 L||1.5 L||0.5 L||0.5 L|
| Fresh reduced fat milk||2 L||13.8 L||10.4 L||3 L||3.4 L|
| Reduced fat flavoured yoghurt||1 kg tub||8.4||6.8 kg||2 kg||1.6 kg|
| Full fat long life milk||1 L||0.6 L||0.4 L||0.1 L||0.14 L|
| Cheese, block||500 g||2.1 blocks||1.2 blocks||0.5 blocks||0.9 blocks|
|Non-core foods|| || || || || |
| Polyunsaturated margarine||500 g||1.4 tubs||0.8 tubs||0.3 tubs||0.5 tubs|
| White sugar||1 kg||0.1 kg||0.07 kg||0.03 kg||0.03 kg|
| Canola oil||500 ml||0.6 bottles||0.5 bottles||0.2 bottles||0.2 bottles|
Seven-day menu plans using all and only foods from the VHFB were constructed for each of the five reference individuals. The Australian Guide to Healthy Eating15 was used as a guide for these menus, but manipulated to meet the revised NRVs. Energy requirements were estimated using self-reported height and weight data from the 2004/05 National Health Survey16 and Centre for Health Statistics growth charts.17 Although this data are know to under-represent overweight and obesity, the lower requirements ensured the basket met nutritional requirements with less food quantity and therefore lower cost. Sugar was included in the menus as a ‘honey’ equivalent because of its similar energy (and nutritional) content.
The nutritional adequacy of the menus was assessed using the FoodWorks nutrient analysis program18 with the AusNut food composition database.19
Target individual nutritional requirements were predominantly derived from the 2006 NRVs, resulting in a total of 14 vitamin and 14 mineral target values and target values for fatty acids. The FoodWorks nutritional analysis program has the capacity to provide details for only six of the 14 vitamins, only seven of the 14 minerals, and cannot calculate the linolenic and linoleic fatty acid contents of foods. The menus and thus VHFB were found to meet at least 85% of all individual nutrient requirements and at least 95% of all energy requirements for the families for a fortnight. Assessment of the target macronutrient percentage energy contributions outlined in the NRVs for reducing chronic disease risk found that the VHFB menus were within these recommendations, and the Australian Heart Foundation recommendations for energy provisions from saturated fat was also met. Sodium values exceeded target values for all individuals, but salt-reduced versions of food items were not chosen to mimic the Queensland basket and to be realistic (see Table 2).
Table 2. Percentage of family types nutritional requirements met by fortnightly baskets.
|Sat. fat %EER||8b,c||9b,c||9c||9.5c|
The instructions for use of the basket are based on those developed for the Queensland basket.2 The total cost of the basket, including the total costs of each core food group for each of the four respective family types, can be calculated. The basket was pilot tested with three community nutritionists to tease out any data collection and analysis issues.
The VHFB provides a new tool with which to monitor the cost and access to nutritious food in Victoria. The lack of current food composition data meant that the items included in the basket were arbitrarily assigned. A new National Nutrition Survey would provide valuable information to assist in choosing foods to be included. Because of the limitations of the AusNut food composition databases, the menus’ nutrient analysis could only assess a limited number of the vitamins and minerals for which there are nutrient reference values, suggesting a need to update Australia's food composition tables. The VHFB sample menus also provide examples of dietary modelling for populations against the new nutrient recommendations, however the inconsistency between the NRVs and Australian Guide to Healthy Eating identified an urgent need to update core food group modelling using the revised NRVs. The development of a national healthy food basket is the next step forward to assessing national food security.
The authors would like to acknowledge the support, editing and advice of the academic team from the Nutrition and Dietetics Department at Monash University.