Patients with type 1 diabetes mellitus (T1DM) often need to modify their eating habits, but many youths with T1DM do not consume a healthful diet. To learn more about the challenges their parents may face in providing them with a more healthful diet, researchers set out to discover the availability of healthier food options and the price difference of the food items at stores frequented by families in northeastern Kansas and western Missouri.

Common barriers that clinicians hear as to why more nutritious diets are not provided include not knowing which foods to buy or prepare, not having the time, or not having enough money. To determine if a healthier diet really was more expensive, researchers from the University of Kansas Medical Center in Kansas City, Kansas, and Children’s Mercy Kansas City, in Kansas City, Missouri, recruited families with children aged 1-6 years, at least six months beyond his or her T1DM diagnosis, and on an intensive insulin regimen. A total of 23 families were included in the final results. During a home study visit, parents provided demographic information and details on the primary store at which they shop. Masters students in dietetics, who were blinded to the study questions, were dispatched to each of the stores to collect the lowest non-sale prices for 164 food items on the USDA Thrifty Food Plan (R-TFP) and a modified healthier version of the Thrifty Food Plan (H-TFP) to determine food prices for two standard shopping lists.

“Our results showed that a healthier market basket cost 18% more than the standard basket. Moreover, families can face barriers in finding specific healthier foods at their local stores,” lead author Susana R. Patton, PhD, CDE, Department of Pediatrics, University of Kansas Medical Center, said.

Small and independent markets were found to have a higher percentage of foods missing from the shopping lists compared with chain and big box stores. Consistent with parents’ perceptions, the H-TFP was more expensive than the R-TFP; average cost for the R-TFP was $324.71 versus $380.07 for H-TFP, a $57.62 difference. The greatest differences in cost were observed for proteins and grains.

Based on these results, the researchers suggest nutrition counseling strategies such as reframing food purchases in terms of nutrition per dollar, providing recipes and teaching families how to cook lower-cost substitutes for higher-priced foods, and providing information on local stores that offer a wide selection of healthful foods. However, the research in this study was somewhat narrow in its scope and the results may not extend to other populations. More research will be required to extend these conclusions more broadly.

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Eileen Leahy
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