Dr. Brown-Fraser began by showing a brief YouTube video featuring cells in all their
complexity and beauty. What we put into our bodies, she noted, definitely affects our cells,
tissues, organs, and systems. Health can be defined both as a state of being free from illness and,
separately, as a state of complete physical, mental, and social well-being. There are five basic
determinants of health: 1) biology & genetics; 2) individual behavior; 3) social environment; 4)
physical environment; and 5) access to health care and health services.
Several measurable health benefits related to good nutrition include: decrease in symptoms,
risk reduction, health maintenance, increased longevity, delayed onset of disease. One writer,
McKeown, argues that “Better nutrition is the most important factor” in explaining 19
th
century
American and British mortality declines. Preston, however, argues that public health technology
improvements account for most of the difference.
Either way, Dr. Brown-Fraser suggests that basic questions include “Does our income
influence what we eat?” and “Does it cost more to eat more nutritious food?” She noted that
trends in income inequality are consistent with trends in poverty. One expert in the field (Lynch)
argues that the loss of life from such inequity is huge. A study in 161 countries showed that as
GDP/capita increased, people live longer. The developed countries that have the highest share of
income going to the 70% least well off also have the longest life expectancy.
Dr. Brown-Fraser also noted the large shift in American causes of death from 1900, when
most deaths were due to infectious disease, to 2010, when most deaths were due to conditions
related to prosperity such as heart disease, cancer, obesity, and diabetes. Lifestyle definitely
makes a large difference in longevity.
What about the comparative cost of nutritious food versus less nutritious food, especially as
it relates to the poorest people? Cost, taste, convenience, availability, and cultural background
all affect people’s choice of foods. Some studies have shown that healthy foods actually are
more affordable per portion, but that sweet and high-fat foods are cheaper based on cost/calorie.
They also are convenient. Unhealthy diets may also cost less because food policies have focused
on subsidizing the production of inexpensive high volume commodities.
“It’s a common perception that healthy foods are more expensive than less healthy foods.
This perception, real or hypothetical, may prevent many individuals from choosing healthy
foods.” According to the USDA, prices for fruits and vegetables seem to be rising, while the cost
of meat and poultry seems to be going down. It may be a bit more expensive initially to eat
healthier foods, but after including long-term costs such as health care, that may not be the case.
Legumes also are the only food that gives us fats, protein, and carbohydrates all in one food.
On average, a healthy diet pattern can cost about $1.50 more/day/person, or about $550/year.
This would represent a real burden for some families, although the difference is small in
comparison to the overall long term health benefits, health savings, and economic costs.
Are we paying a high price? It depends on who you ask. Nutrition Economics is a new
discipline that is being developed and that will be helpful in studying this issue.
