ESPEN Congress Geneva 2014 FOOD: THE FACTOR RESHAPING THE SIZE OF THE PLANET

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1 ESPEN Congress Geneva 2014 FOOD: THE FACTOR RESHAPING THE SIZE OF THE PLANET Buy 2 and take 3: are we benefitting from cheaper food? P. Marques-Vidal (CH)

2 Pedro Marques-Vidal Department of Internal Medicine Lausanne University Hospital (CHUV) Buy 2 and take 3: are we benefitting from cheaper food?

3 Cocoa ¾ Theobroma cacoa ¾ Drink of Gods (Xocoatl) theo = God broma = drink ¾ Mexico (Maya, Incas, Aztecs) ¾ Aphrodisiac

4 Layout Is healthy eating expensive? Quality of generic foods Effect of promotions Conclusion

5 IS HEALTHY EATING EXPENSIVE? content/uploads/2012/10/healthy and cheap foods.jpg

6 Healthy eating

7 Fruits & vegetables: expensive calories Drewnowski Am J Clin Nutr 2010,91(suppl):1095S

8 Food expenditures, USA 30 Percentage of income

9 Food expenditures, Expressed as % of househould final consumption expenditures United States ERS estimate Singapore United Kingdom Canada Austria Ireland Australia Germany Switzerland Denmark Netherlands Finland Qatar Sweden South Korea Norway France Czech Republic Hong Kong, China Taiwan Japan Belgium Bahrain Spain Italy United Arab Emirates New Zealand Slovenia Brazil Israel Hungary Chile Greece Portugal Slovakia Uruguay Colombia Kuwait Venezuela Latvia South Africa Malaysia Poland Estonia Argentina Bulgaria Ecuador Turkey Costa Rica Turkmenistan Dominican Republic Mexico India Iran Lithuania Saudi Arabia China Romania Bolivia Uzbekistan Croatia Bosnia Herzegovina Russia Thailand Jordan Indonesia Macedonia Kazakhstan Tunisia Vietnam Belarus Peru Ukraine Guatemala Nigeria Georgia Morocco Azerbaijan Egypt Philippines Algeria Kenya Cameroon Pakistan products/food expenditures.aspx

10 Percent of food budget, 2005 data 30% 25% Fruits Vegetables 20% 15% 10% 5% 0% Slovakia Czech rep Hungary France Croatia Lithuania Poland Portugal Austria Finland Belgium Estonia Ireland Norway Luxembourg Spain Sweden Italy Romania Denmark Greece Latvia The Netherlands Macedonia Malta Slovenia Bulgaria UK Cyprus Turkey epp.eurostat.ec.europa.eu/portal/page/portal/household_budget_surveys/data/database#

11 Cost of foods, Belgium Meat Fish Fruit Vegs All non processed foods economie.fgov.be/fr/binaries/rapport_annuel_2013_observatoire_prix_tcm pdf

12 Cost of vegetables, Portugal A two fold variation within a single year span Boletim Mensal da Agricultura e Pescas Abril de 2014

13 Cost of fruits and vegetables, France Amount purchased Expenditure Av. price ( /kg) Increasing cost per kg leads to lower amounts purchased and higher expenditures et legumes.net/consommation/document/achatsfruitslegumes2014.pdf

14 Who buys? Age groups Families France [40 49[ [60 69[ 30[ [50 59[ [70+ w/ baby w/ children w/ adolescent Young people and families with babies or young children buy less fruits & vegetables et legumes.net/consommation/document/achatsfruitslegumes2014.pdf

15 Is healthy eating expensive? Fruits and vegetables represent 1/5 of the household food budget. Prices are increasing and fluctuate considerably due to climateric conditions. Many households cannot afford it.

16 QUALITY OF GENERIC FOODS blog.fooducate.com/2013/07/03/is food in america too cheap/

17 Quality of generic foods UK Comparison of four economy line foods to branded ones in four major English supermarkets Cooper et al. J Hum Nutr Dietet 2003,16:339

18 Quality of generic foods UK Sum of ranks relating to nutrient content Some economy foods better than branded ones! Cooper et al. J Hum Nutr Dietet 2003,16:339

19 Quality of generic foods UK Sum of ranks relating to nutrients per pence Cost of basket: 7.26 (Tesco) to (branded) Cooper et al. J Hum Nutr Dietet 2003,16:339

20 Quality of generic foods France Comparison of four types of commodities best price (i.e. lowest price) discount (i.e. hard discounter s brand) own brand (i.e. Carrefour s) brand foods (i.e. Buitoni) Ingredient quality score depending on category (i.e. percentage of fish in fish fingers) Darmon et al. Publ Health Nutr 2009,12:808

21 Quality of generic foods France P=0.001 Own Brand Discount P=0.007 Best Darmon et al. Publ Health Nutr 2009,12:808

22 Quality of generic foods Australia Percentage cost saving between cheapest generic and cheapest branded products A B Chapman et al. Publ Health Nutr 2013,16:894

23 Quality of generic foods Generic foods have an adequate nutrient quality when compared to brand foods. Generic foods could be used as a cheaper alternative to improve dietary quality. No information for most countries.

24 EFFECT OF PROMOTIONS news/supermarkets agree tighter rules on misleading promotions html fairer special offers

25 Effect of promotions Virtual supermarket, 25% discount on fruits and vegetables Amount (g) Fruits Vegetables Both Participants in the discount condition did not spend the money they saved from the discounts on other foods than fruits and vegetables. Waterlander et al. Int J Behav Nutr Phys Act 2012,9:11

26 Effect of promotions The Netherlands RCT comparing 50% discount on fruits and vegetables 50% discount + nutrition education Nutrition education alone Nothing On supermarket purchases at 6 months (end of intervention) and at 9 months Waterlander et al. Am J Clin Nutr 2013,97:886

27 Effect of promotions 10 Amount purchased relative to baseline (kg/household/2 w) Discount and education 3.9 Discount only 1.1 Education only The effect disappeared 3 months after the end of the intervention! Waterlander et al. Am J Clin Nutr 2013,97:886

28 Effect of promotions New Zealand Effect of 12.5% discounts on healthier foods Discounts + education Discounts Education Control Ni Mhurchu et al. Am J Clin Nutr 2010,91:736

29 Effect of promotions Discounts on healthier foods have larger effects than education alone. Education is only effective when healthy foods availability increases. The effect only lasts while the promotions are effective.

30 Conclusion Fruits & vegetables: 20% of food budget, great seasonal variations in price. Generic foods of adequate quality, but limited data. Promotions increase consumption while they last only.

31 THANK YOU!

32 Annual income spent on food healthimpactnews.com/wp content/uploads/2013/09/annual income spent on food.png

33 Cost of foods, Belgium