Unhealthy diets and low physical activity contribute to many chronic diseases and disability; they are responsible for some 2 in 5 deaths worldwide and for about 30% of the global disease burden. Yet surprisingly little is known about the economic costs that these risk factors cause, both for health care and society more widely. This study pulls together the evidence about the economic burden that can be linked to unhealthy diets and low physical activity and explores - How definitions vary and why this matters - The complexity of estimating the economic burden and - How we can arrive at a better way to estimate the costs of an unhealthy diet and low physical activity, using diabetes as an example The review finds that unhealthy diets and low physical activity predict higher health care expenditure, but estimates vary greatly. Existing studies underestimate the true economic burden because most only look at the costs to the health system. Indirect costs caused by lost productivity may be about twice as high as direct health care costs, together accounting for about 0.5% of national income. The study also tests the feasibility of using a disease-based approach to estimate the costs of unhealthy diets and low physical activity in Europe, projecting the total economic burden associated with these two risk factors as manifested in new type 2 diabetes cases at 883 million euros in 2020 for France, Germany, Italy, Spain and the United Kingdom alone. The "true" costs will be higher, as unhealthy diets and low physical activity are linked to many more diseases. The study's findings are a step towards a better understanding of the economic burden that can be associated with two key risk factors for ill health and they will help policymakers in setting priorities and to more effectively promoting healthy diets and physical activity.

Although healthy foods can be affordable, if less healthy foods are cheaper, individuals may have an economic incentive to consume a less healthful diet. Using the Quarterly Food-at-Home Price Database, the authors explore whether a select set of healthy foods (whole grains, dark green vegetables, orange vegetables, whole fruit, skim and 1% milk, fruit juice, and bottled water) are more expensive than less healthy alternatives. They find that not all healthy foods are more expensive than less healthy alternatives. They also find considerable geographic variation in the relative price of healthy foods. This price variation may contribute to geographic variation in diet and health outcomes. Charts and tables. This is a print on demand report.

Price and affordability are key barriers to accessing sufficient, safe, nutritious food to meet dietary needs and food preferences for an active and healthy life. In this study, the least-cost items available in local markets are identified to estimate the cost of three diet types: energy sufficient, nutrient adequate, and healthy (meeting food-based dietary guidelines). For price and availability the World Bank’s International Comparison Program (ICP) dataset is used, which provides food prices in local currency units (LCU) for 680 foods and non-alcoholic beverages in 170 countries in 2017. In addition, country case studies are developed with national food price datasets in United Republic of Tanzania, Malawi, Ethiopia, Ghana and Myanmar. The findings reveal that healthy diets by any definition are far more expensive than the entire international poverty line of USD 1.90, let alone the upper bound portion of the poverty line that can credibly be reserved for food of USD 1.20. The cost of healthy diets exceeds food expenditures in most countries in the Global South. The findings suggest that nutrition education and behaviour change alone will not substantially improve dietary consumption where nutrient adequate and healthy diets, even in their cheapest form, are unaffordable for the majority of the poor. To make healthy diets cheaper, agricultural policies, research, and development need to shift toward a diversity of nutritious foods.