Researcher links food prices, obesity

If fruits and vegetables were cheaper, would we eat more of those and fewer potato chips? And would this turn us into the lean machines we long to be?

Such questions spring from the somewhat surprising discoveries about food prices reported by Adam Drewnowski, director of the nutritional sciences program at the University of Washington.

Drewnowski believes his research findings give added weight to food costs as a factor in America's rising obesity epidemic. Federal experts say nearly two-thirds of Americans are overweight or obese, and many have weight-related health problems.

Drewnowski, who reported on his work at a recent forum in Washington, D.C., acknowledges that his findings — and his related recommendations for government produce subsidies — are controversial.

Conventional wisdom holds that the calorie-dense, high-fat or high-sugar convenience foods scarfed down by millions are generally more expensive than lower-calorie, high-nutrition, unprocessed foods, such as fresh fruits and vegetables.

But, by checking the prices of about 200 products at a Seattle supermarket, Drewnowski found that, calorie for calorie, the opposite tends to be true.

In other words, with some exceptions, the less-convenient foods recommended by most experts for all-around good health and weight control — particularly fresh vegetables, fruits, fish and lean meat — tend to cost more than packaged convenience foods when measured on a cents-per-calorie basis, even when including the costs of processing and packaging convenience foods.

"It's astounding, isn't it?" says Drewnowski.

Many shoppers might not be terribly astounded. Anyone who buys produce likely has been taken aback by prices for some items at certain times — witness avocados now at $2.49 apiece in some stores. And fish prices are sometimes stunning.

Still, the impression of convenience foods as generally more costly widely holds sway, leading Drewnowski to raise his contrarian findings.

For instance, he says, most fresh fruit costs more per calorie than convenience dessert options such as packaged cookies.

And lean, unprocessed meat generally costs more per calorie than processed, usually higher-fat, meats such as bologna, sausage or bacon. For milk products, prices-per-calorie range from relatively low to high, he said.

Drewnowski looked primarily at mid-priced or cheaper convenience foods and a mix of house brands and national brands, as well as fresh items.

In the national fight against flab, it means cost may play a bigger role than some have realized in obesity-linked eating patterns, especially among low-income groups, Drewnowski contends. Most studies find obesity rates higher among low-income people.

Drewnowski sees this as an argument to subsidize fresh fruits and vegetables to encourage people to eat more of those and less of the high-calorie convenience fare.

"We should be addressing this issue in a responsible way, instead of just telling people to eat more healthfully," he said.

His ideas raise questions and controversies on several fronts.

The prices

Drewnowski says one government health agency, in a letter turning down his application for a research grant, implied that his price findings were questionable by referring to "supposedly" lower costs for convenience foods. (The USDA's Economic Research Service is funding part of his research.)

He counters that more nutrition scientists ought go into stores, as he did, and check out real-life prices.

John Cawley, a Cornell University economist specializing in the economics of obesity — a growing field — calls Drewnowski's data "really convincing," though Cawley disagrees about subsidies as a solution.

Sue Butkus, Washington State University Extension nutrition specialist, says certain convenience products clearly cost less than some fresh, unprocessed foods — and many low-income families snatch them up for that reason.

A popular and cheap example, she said, are ramen noodles packaged with flavorings (often high in sodium) and a few dried vegetables. She's seen them at $1 for 10 packs, she said.

Some question the cost-per-calorie ratio as a way to judge produce prices.

"It's not a very complete evaluation," said Barbara Berry of the Produce for Better Health Foundation. The foundation is a partner in the national 5-A-Day Program, which promotes consuming at least five servings of fruit or vegetables every day.

More meaningful, she said, would be a cost/nutrient ratio. Drewnowski agrees this is an important information gap and says he is working on such a study.

Food-choice forces

Even if fresh produce, fish and lean meats suddenly all cost less than calorie-loaded convenience foods, it's unclear whether most people would switch to healthier eating.

"The USDA has for years supported a cheap food policy (publishing its Thrifty Food Plan of low-cost meals), based on the idea that economics is what drives people to buy," said Butkus.

"But our (low-income) focus groups tell us they're very concerned about time and willing to put money into convenience foods" for time's sake, she said. Like most people, these families have jobs, children and other time-eating responsibilities, Butkus said.

Then there's taste. Millions relish processed lunch meats, pizza, packaged chicken tenders, potato chips and every other sort of convenience product. While some choose less-processed foods for better health or weight control, nobody knows whether vast numbers would do so if these foods were cheaper.

Drewnowski contends the government's Thrifty Food Plan, while nutritious and economical, is too long on potatoes, rice, beans, cabbage and canned or frozen fruits and vegetables to hold people's interest.

Studies indicate that higher-income people tend to choose more healthful foods.

"As you move up the income scale you get different eating patterns. You get more use of fruits and vegetables and leaner meats," said Butkus.

Education levels, as well as income, may help drive that trend, she said.

Exposure seems to help change eating habits, said Butkus. "There is some research showing that if kids have fruits available, vs. convenience foods, they will choose the fruits."

Most experts, including Drewnowski, say many factors, besides food costs, contribute to rising obesity: supersized portions; too much TV and too little exercise; and busy schedules that leave little time for cooking and promote reliance on those high-calorie convenience foods.

Food-cost philosophies

As Drewnowski advocates, some subsidies intended to put more fresh fruits and vegetables on American tables already exist.

For instance, government-issued coupons help seniors and low-income women and children afford produce at farmers markets. And there are experimental farm-to-school programs that lower produce costs by cutting out the middle man.

Drewnowski calls for expanding such programs in volume and variety.

He and Berry urge adding more fruits and vegetables to the federal food-aid program for low-income women, infants and children (WIC), which they say is woefully short on these foods.

Berry's organization also advocates doubling the value of federal food stamps when used to purchase fruits and vegetables.

Not everyone favors subsidies. Cawley, the obesity economist, contends that except for children, who can't make informed decisions, subsidies represent too much government intervention in people's personal food choices.

Meanwhile, a radically different cost-linked proposal cropped up last week in Britain, which is also struggling with rising obesity rates. The British Medical Association urged lawmakers to add a 17.5 percent tax on high-fat foods.

Drewnowski considers that idea regressive because it would hit hardest the poor, who eat more high-fat foods.

But Butkus thinks it's worth looking into in this country.

"It may be regressive, but maybe that's how you begin to affect food choices," she said.

In the long run, many experts say, vegetables, fruits and other low-fat, low-sugar, nutritious foods are a bargain at any price, helping fend off disease and health-related costs for individuals and society.