Healthy Diet Basket: Billions unable to afford the cheapest nutritious meals

An analysis finds that a healthy diet is unaffordable for 2.8 billion people worldwide. The review uses and validates the Healthy Diet Basket as a global benchmark for measuring the accessibility of healthy and sustainable diets. The metric shows that even the cheapest healthy diets cost more than low-income people can afford.

Based on national dietary guidelines, the Healthy Diet Basket shifts the measurement of food security from calorie sufficiency to diet quality. It also finds that more than 80% of the people in African countries cannot afford a healthy diet consisting of the cheapest, most basic foods.

“The indicator captures an implicit consensus on what countries around the world agree that people need for healthy diets,” says lead author Anna Herforth, co-director of Food Prices for Nutrition at the World Bank, which also uses the Healthy Diet Basket.

“The importance of meeting dietary needs has been recognized for a long time, but measuring whether people can actually do that has been elusive until now.”

Researchers from Tufts University, US, share that their ten-year project measuring healthy food accessibility worldwide will conclude next month. They highlight that the UN’s Food and Agriculture Organization (FAO) has been using their data and methods from the Food Prices for Nutrition project since 2020.

Cheaper, yet unaffordable

Apart from being a measuring tool, the Healthy Diet Basket is also a dietary standard, set by researchers who found the cheapest local foods available within each food group in countries.

Apart from being a measuring tool, the Healthy Diet Basket is also a dietary standard, set by researchers who found the cheapest local foods available within each food group in countries.These include starchy staples, vegetables, fruits, animal-source foods, legumes, nuts and seeds, and oils and fats. The collection was then used to measure whether people could afford a healthy diet relative to the nation and income.

Researchers suggest that when affordable, the Healthy Diet Basket meets 95% of the average person’s nutrient needs and also meets the WHO’s recommendations on the prevention of diet-related noncommunicable diseases. The cost averaged US$3.68 per person per day in 2021, which is slightly lower than meeting the national food-based dietary guidelines.

However, despite the lower cost, the Healthy Diet Basket reveals the degree to which healthy diets are unaffordable for billions. In 2021, the international extreme poverty line was US$2.15. “Many people in the world who are counted as ‘non-poor’ still can’t afford to meet the basic requirements for a healthy diet,” Herforth explains. 

The study, published in Nature Food, also finds that the Healthy Diet Basket’s water and carbon footprints were similar to the EAT-Lancet reference diet.

“For many people, even if they put all their resources into buying food, they wouldn’t have enough to meet dietary standards for lifelong health,” adds Will Masters, director of the project and professor of food policy and economics at the Friedman School, Tufts University.

Accessibility, affordability, and choices

The researchers seek to reveal gaps in prices, incomes, and other factors as potential causes behind malnutrition and provide potential solutions. 

More than 80% of the people in African countries cannot afford a healthy diet consisting of the cheapest, most basic foods.The paper shows that many people face unavailability or high prices. To tackle this, governments can intervene to make healthy diets more accessible and affordable by investing in innovations that lower food production and distribution costs, suggests Masters. People also need wage increases or social safety nets for a healthy life.

However, if people are choosing less nutritious foods when healthy foods are low-cost, then other factors need to be identified and addressed. It could be due to time use and the cost of meal preparation, cultural influence, or marketing tactics.

“Malnutrition happens because the poorest third of the world can’t afford to buy enough of the vegetables, fruits, dairy, and fish or other animal-source foods needed for health, and the rest of us all too often consume other foods instead,” comments Masters.

Data making waves 

The Healthy Diet Basket’s data is already making an impact in Nigeria, where labor unions negotiated a raise in the national minimum wage. The researchers reveal that others are using the data to change farm and trade policies. 

Nigeria also became the first to publish monthly bulletins on healthy diet costs in 2024. Ethiopia, Malawi, Pakistan, and others followed this.

New data on healthy diet costs has been used to negotiate a raise in the national minimum wage in Nigeria, Ethiopia, Malawi, and Pakistan. The data contributes to a global shift from focusing on calories to a more rigorous understanding of food and nutrition security, prioritizing economic access, human health, and sustainability.

“By providing internationally consistent metrics, we aim to inform evidence-based policymaking and hope to help catalyze broader multisectoral actions to make healthy diets more affordable and accessible to all,” says co-author Yan Bai.

Researchers plan to work with African food providers to create new metrics for healthy, affordable food supply chains, helping governments and international organizations measure cost and affordability.

“I’m just stunned by the speed of adoption,” says Masters. “People have talked about [food] affordability for decades. Now we have a practical way to measure it.”

“For the first time, governments are measuring whether people have access to the biological requisites of an active and healthy life.”