Although, the cost of food is commonly described as a barrier to consuming a healthy diet, the evidence for this viewpoint has been inconsistent to date. The purpose of this study was to assess whether a healthy diet is affordable for a sample population with major depressive disorder and current unhealthy eating patterns, enrolled in supporting the modification of lifestyle in lowered emotional states (SMILES) trial. The first 20 participants of the SMILES trial were invited to complete a 7-day food diary at baseline. A cost analysis of a modified Mediterranean diet (recommended for trial participants) and 7-day food diaries of participants enrolled in the randomized controlled trial was conducted. Trial participants spent an estimated mean of $138 per week on food and beverages for personal consumption, whereas the total food and beverage costs per person per week for the recommended modified Mediterranean diet was estimated at $112, both based on mid-range product cost. The modified Mediterranean diet at $1.54 per mega-joules (MJ) was cheaper per energy unit than the cost of the current dietary intake of the SMILES participants included in this study at a mean of $2.35 per MJ. These study findings suggest that the adoption of a healthy modified Mediterranean diet does not cost more than a poor quality diet. Thus, failure to comply with healthy diets is unlikely to reflect affordability. Public health messages should incorporate the finding that healthy eating is not associated with increased costs and in fact may well involve savings to the household budget. Practical strategies and techniques for selecting healthy nutritious foods on a budget could support the achievement of desired dietary goals for preventing and managing chronic disease.
Key words: Depression, cost analysis, food cost, healthy diet, Mediterranean diet.
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