Healthier diet for children with type 1 diabetes costly, difficult for families

Families with young children with type 1 diabetes face obstacles when trying to follow a healthy diet, including limited access to healthful foods and increased food costs, according to research in Journal of Nutrition Education and Behavior.

In a market-basket study examining the availability and cost of healthier foods in stores used for routine food shopping in Kansas and Missouri, researchers found that several stores do not carry certain healthy foods recommended by the U.S. Department of Agriculture, and that healthier options, such as whole grains and lower-fat proteins, often are out of reach due to higher cost.

“Families may incur some real and significant costs when trying to purchase healthier food options,” Susana R. Patton, PhD, CDE, of the department of pediatrics at University of Kansas Medical Center, told Endocrine Today. “They can also encounter barriers in finding some of these healthier options at their local food stores.”

Susan Patton

Susana R. Patton

Patton and colleagues analyzed data from 23 families with children younger than 6 years with type 1 diabetes (mean age of children, 4.6 years; 43.5% girls; 78.3% white). Parents provided demographic information and the name and location of the primary store where they completed their food shopping during a home study visit.

Dietetic students, masked to the study questions, then went to the identified food stores to price 164 items included on the USDA Thrifty Food Plan (items include refined breads, standard canned vegetables, vegetable oil and enriched pasta) and a healthier version of the Thrifty Food Plan (items include whole-grain bread, low-sodium vegetables, canola oil and whole wheat pasta). Researchers grouped 20 stores based on type: chain supermarkets, small/independent markets and big box stores that sold bulk items.

Researchers found that 14.3% of small and independent markets did not have all items on the healthier Thrifty Food Plan list vs. 3.4% of chain supermarkets and 2.5% of big box stores. Within the cohort, 14 families reported shopping at a chain supermarket, six at a big box store and three at an independent market.

Researchers found the healthier version of the Thrifty Food Plan was more expensive than the regular food plan, with the average cost of $380.07 compared with $324.71. Proteins and grains were the most expensive items, with an average increase in cost of $23.06 for healthier proteins and $15.48 for healthier grains.

“The results show that a healthier market basket can cost 18% more than the standard basket,” the researchers wrote. “Moreover, families can face barriers in finding specific healthier foods at their local stores.”

Researchers said simple correlations revealed no association between family socioeconomic score and the price they might pay for items on the two Thrifty Food Plans.

“To extend the results, it would be valuable to conduct similar projects in other communities across the U.S. to see if the differences hold for large metropolitan areas or rural areas,” Patton said. “Related, this was a cross-sectional study. To really understand the potential volatility of food purchases for families, a prospective and longitudinal study would be needed. For example, recruiting families and surveying their food shopping stores using these standardized food baskets multiple times in a year to capture potential changes in price due to season [and] availability of foods.” by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.

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