• Colin D Rehm, Pablo Monsivais, and Adam Drewnowski.
• Department of Epidemiology and Center for Public Health Nutrition, University of Washington, Box 353410, Seattle, WA 98195, USA; Friedman School of Nutrition Science & Policy, Tufts University, 150 Harrison Ave, Room 247, Boston, MA 02111, USA. Electronic address: crehm@uw.edu.
• Prev Med. 2015 Apr 1; 73: 70-5.

BackgroundFood prices may be one reason for the growing socioeconomic disparities in diet quality.ObjectiveTo evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010).MethodsCross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the dietary guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components.ResultsThere was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruits, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars.ConclusionsLower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account.Copyright © 2015. Published by Elsevier Inc.

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