Regions Energy sufficient diet Nutrient adequate diet Healthy diet
WORLD 0.79 2.33 3.75
AFRICA 0.73 2.15 3.87
Northern Africa 0.75 2.90 4.12
Sub-Saharan Africa 0.73 2.06 3.84
Eastern Africa 0.61 1.98 3.67
Middle Africa 0.73 2.09 3.73
Southern Africa 0.86 2.29 3.99
Western Africa 0.80 2.05 4.03
ASIA 0.88 2.18 3.97
Central Asia 0.84 2.04 3.39
Eastern Asia 1.27 2.63 4.69
South-eastern Asia 0.92 2.42 4.20
Southern Asia 0.80 2.12 4.07
Western Asia 0.74 1.87 3.58
LATIN AMERICA AND THE CARIBBEAN 1.06 2.83 3.98
Caribbean 1.12 2.89 4.21
Latin America 1.00 2.78 3.75
Central America 1.13 3.04 3.81
South America 0.91 2.61 3.71
OCEANIA 0.55 2.07 3.06
NORTHERN AMERICA AND EUROPE 0.54 2.29 3.21
COUNTRY INCOME GROUPS
LOW-INCOME COUNTRIES 0.70 1.98 3.82
LOWER-MIDDLE-INCOME COUNTRIES 0.88 2.40 3.98
UPPER-MIDDLE-INCOME COUNTRIES 0.87 2.52 3.95
HIGH-INCOME COUNTRIES 0.71 2.31 3.43
NOTES: The table shows the USD cost per person per day of the three reference diets (energy sufficient, nutrient adequate and healthy diet) by region and country income group in 2017. The analysis is based on a sample of 170 countries for which retail food price data are available in year 2017. Prices are obtained from the World Bank’s International Comparison Program (ICP) for internationally standardized items, converted to international dollars using purchasing power parity (PPP). The cost of each diet represents a simple average of the cost incurred by countries belonging to a specific region or country income group. See Box 10 for the definition of the three diets and Box 11 for a brief description of the cost methodology. For the full methodological notes and data sources, see Annex 3.
SOURCE: Herforth, A., Bai, Y., Venkat, A., Mahrt, K., Ebel, A. & Masters, W.A. 2020. Cost and affordability of healthy diets across and within countries. Background paper for The State of Food Security and Nutrition in the World 2020. Rome, FAO.
on average, would have to pay 6 times more to move from an energy sufficient to a healthy diet.
Dairy, fruits, vegetables and protein-rich foods (plant and animal-sourced) are the highest-cost food groups globally, in terms of quantity recommended for consumption per day for a healthy diet (Figure 27A). There are regional differences, with fruits and vegetables being notably more expensive in Eastern Asia, and dairy being more expensive in sub-Saharan Africa, Eastern and South-eastern Asia but cheaper in Western and Northern Europe, Australia and New Zealand. Starchy staples and oils account for only 16 percent of the cost of a healthy diet. Fruits and vegetables account for a little less than 40 percent of its cost, and dairy and protein-rich foods combined account for a little more than 44 percent (Figure 27B).
These proportions vary somewhat by country income group, with dairy being notably more expensive in low-income countries (see Annex 5, Figures A5.1 and A5.2). These findings imply that the cost of nutritious foods that contribute to a healthy diet, particularly dairy, vegetables, fruits and protein-rich foods, needs to decrease in order for their consumption to increase.
Affordability of the three diets around the world After analysing the cost of this report’s three reference diets, the next important step is to examine their affordability. In this analysis, affordability is measured comparing the estimated cost of the least-cost diet per person per day for each of the three reference diets described for these analyses with: i) the international poverty line; ii) typical food expenditures in each country; and iii) estimated income distribution in each country.
The methodology is described in Box 12.
Affordability comparing cost of the diets to the international poverty lines
Findings show that while most of the poor around the world can afford an energy sufficient diet, as defined here, they cannot afford either a nutrient adequate or a healthy diet (Figure 28).
A healthy diet is far more expensive than the full value of the international poverty line of USD 1.90 PPP per day, let alone the upper bound portion of the poverty line that can
credibly be reserved for food (63 percent) of USD 1.20 PPP per day (Figure 28). It is assumed that a minimum of 37 percent of expenditures must be reserved for non-food expenditures, such as housing, transport, education and health, and farm inputs.51,52,53,54 On average, the cost of a nutrient adequate diet and a healthy diet are respectively 2 and 3 times greater than the poverty threshold of USD 1.20 per person per day. This is true by any of the definitions of healthy diets (based on national food-based dietary guidelines) used in these analyses (see Annex 4, Figure A4.1).
A nutrient adequate diet and a healthy diet are unaffordable for those living below the poverty line. They are also unaffordable for even the populations who are vulnerable to become poor because their incomes are just above the poverty line, and the cost of these diets well exceeds the poverty line of USD 1.90 per person per day.
This holds true across regions as well. Both the nutrient adequate and the healthy diets exceed USD 1.20 (63 percent of the poverty line) in sub-Saharan Africa, as they are 1.7 and 3.2 times higher than the poverty line, respectively.
In Latin America and the Caribbean, they are 2.3 and 3.3 times higher, respectively, and in Asia, they are 1.8 and 3.3 times higher, respectively. In Northern America and Europe, both the nutrient adequate and heathy diets are unaffordable for the poor, as they are 1.9 and 2.6 times higher than the poverty line, respectively.
While a healthy diet costs more than USD 1.20 in every country, the least-cost nutrient adequate diet falls below this threshold only in Qatar, and falls between USD 1.20 and USD 1.90 for seventeen African, eleven Asian, six European, one Latin American and one Oceanian country.
In comparison, the least-cost energy sufficient diet is affordable (still using the USD 1.20 threshold) for the poor around the world, except in Bolivia (Plurinational State of) (USD 1.42), British Virgin Islands (USD 1.56), Dominica (USD 1.22), Ecuador (USD 1.31), El Salvador (USD 1.46), Grenada (USD 1.33), Japan
(USD 3.03), Nicaragua (USD 1.44), Saint Vincent and the Grenadines (USD 1.32), Sint Maarten (USD 1.72), South Africa (USD 1.26), Taiwan
(USD 1.46) and Togo (USD 1.94). »
NOTES: The bar chart in panel A) shows the cost per person per day of six food categories by a set of subregions and the stacked columns in panel B) show the ratio between the average regional cost of each food group and the total cost of a healthy diet. The analysis is based on a sample of 170 countries for which retail food price data are available in year 2017. Prices are obtained from the World Bank’s International Comparison Program (ICP) for internationally standardized items, converted to international dollars using purchasing power parity (PPP). See Box 10 for the definition of the three diets and Box 11 for a brief description of the cost methodology. For the full methodological notes and data sources, see Annex 3.
For the analysis on food group cost contribution by country income group, see Annex 5, Figures A5.1 and A5.2.
SOURCE: Herforth, A., Bai, Y., Venkat, A., Mahrt, K., Ebel, A. & Masters, W.A. 2020. Cost and affordability of healthy diets across and within countries. Background paper for The State of Food Security and Nutrition in the World 2020. Rome, FAO.
0 0.2 0.4 0.6 0.8 1.0 1.2 1.4
Dairy Protein-rich foods Fats Fruits Vegetables Starchy staples
Northern Africa Sub-Saharan Africa Australia and New Zealand
Melanesia
Eastern Europe Northern Europe Southern Europe Western Europe
Latin America and the Caribbean Northern America
Australia and
New Zealand Central
Asia Eastern Asia Eastern
Europe Latin America
and the Caribbean
Melanesia Northern
Africa Northern America Northern
Europe South-eastern
Asia Southern Asia Southern
Europe Sub-Saharan
Africa Western
Asia Western
Europe
Fruits
Dairy Protein-rich foods Fats Vegetables Starchy staples
0 10 20 30 40 50 60 70 80 90 100
PERCENTAGE SHARE OF TOTAL COST OF A HEALTHY DIETCOST PER PERSON PER DAY (USD)
B) COST CONTRIBUTION (PERCENTAGE SHARE OF TOTAL COST) OF EACH FOOD GROUP IN A HEALTHY DIET BY REGION IN 2017
Central Asia Eastern Asia South-eastern Asia Southern Asia Western Asia
To gauge a degree of affordability, the cost of each of the three diets described for these analyses (see Box 11) needs to be compared with a standard of income or expenditures. Our analysis uses the following three standards.
1. International poverty line: The first measure of affordability compares the cost of each diet with 63 percent of the international poverty line of USD 1.90 PPP per day, which is equal to USD 1.20 (see Figure 28). The 63 percent accounts for a portion of the poverty line that can be credibly reserved for food, based on observations that the poorest people in low-income countries spend, on average, 63 percent of their incomes on food (World Bank Global Consumption Database).55* It is assumed that a minimum of 37 percent of expenditures must be reserved for non-food expenditures, such as housing, transport, education and health, and farm inputs.51,52,53,54
In reality, 37 percent of expenditures is a conservative assumption. For instance, non-food expenditures may have a higher share in high-income countries.
2. Average daily food expenditures in each country: The second measure of affordability compares the cost of each diet with average daily food expenditures in each country. The national average per capita food expenditures used in this measure of affordability is calculated by Herforth et al.
(2020)40 based on data from ICP, and is expressed using ratios or percentages. Ratios are defined as the cost of a diet divided by average country food expenditures: ratios above 1 indicate that a diet is unaffordable as its cost exceeds average food expenditures in a given country (see Figure 29).
Alternatively, the cost of a diet can be expressed
as a percentage of average food expenditures in a given country: a diet is unaffordable for values greater than 100 percent (see Table in Box 13 and Figure A5.3).
3. Estimated income distribution: The third measure of affordability compares the cost of each diet with the estimated income distribution in a given country, using income distributions from the World Bank PovcalNet interface.57** Specifically, a diet is considered unaffordable when its cost exceeds the 63 percent of the average income in a given country, following the same rationale behind the first measure of affordability. This third measure of affordability provides estimates on the percentage of people for whom the cost of a specific diet is unaffordable. Percentages are then multiplied by the 2017 population in each country, to arrive at the estimated number of people who cannot afford a given diet in a given country (see Table 8 and table in Box 13). Since income distributions estimated by the World Bank are not available for year 2017, income distributions in year 2018 are used that are based on household surveys across 164 economies (see Annex 3 for a full description of the methodology and data sources).
Out of the 170 countries included in this analysis, information on the percentage and number of people who are not able to afford the diets is available on 143 countries. Furthermore, to provide a range to these estimations, lower- and upper-bound estimates of this measure of affordability are computed and presented in Annex 3 (Table A3.3). The cost and affordability of the three diets are shown in Table A3.2 (Annex 3).
Global maps showing ranges of affordability are presented in Figure A5.3 (Annex 5) for the 143 countries analysed.
BOX 12