A cost-analysis of adopting a healthful diet in a family-based obesity treatment program

Objective: To assess dietary costs during a family-based pediatric obesity intervention. Design: Families were randomized to one of two groups. Dietary and cost data were collected from a parent or child using three 24-hour recalls: at baseline, 6 months, and 12 months. Subjects: Thirty-one families with an obese 8- to 12-year-old child entered treatment, with complete dietary data provided from 20 families. Intervention: The 20-week behavior modification intervention emphasized increasing diet nutrient-density. Families attended group and individual sessions or group sessions. Main outcome measures: Energy intake; percent of energy from protein, fat, and carbohydrate; servings and percent servings from food groups classified by nutrient density; and daily food costs. Statistical analyses performed: Mixed analyses of variance, with group as the between-subject factor, and time as the within-subject factor. Results: No significant effect of group was found in any analyses. Significant decreases in percent overweight were observed at 6 and 12 months for children (-10.0±8.7 and - 8.0±10.3, respectively) (mean±standard deviation) and parents (-6.7±10.3 and -5.3±14.1). Energy intake for parents and children combined significantly decreased from baseline (1,881±462) to 6 months (1,412±284), and 1 year (1,338±444). Servings from low-nutrient-dense foods significantly decreased from baseline (34.7±16.2) to 6 months (16.0±8.6) and 1 year (18.6±9.2), causing a significant increase in diet nutrient density. Dietary cost did not change at 6 months, but significantly decreased from baseline to 1 year ($6.77±2.41 to $5.04±1.80). Cost per 1,000 kcal did not significantly change. Applications/Conclusions: Adopting a lower-energy, nutrient-dense diet did not increase dietary costs over time. Consequently, cost should not be a barrier in the adoption of a healthful diet.