Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Adults from Henan province

Abstract Objectives: Food price is a determining factor in food choices. However, its relationship with diet quality is unclear in Chinese adults. This study aimed to examine daily energy-adjusted dietary cost (CNY/2000kcal) concerning diet quality in northeast central Chinese adults. Design: Cross-sectional study. The food consumed by 680 Chinese adults from Henan province during the year 2020 was recorded by 24-h dietary recalls. Three dietary quality indices, namely the nutrient-rich foods (NRF) index, the mean adequacy ratio (MAR), and the energy density (ED), were adopted. Daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying 2000. Setting: Three communities in Zhengzhou city, Henan province, China. Participants:A total of 680 adults were recruited from Henan as the subjects. Results: Subjects who closely adhered to the NRF9.2, MAR, and ED paid daily ¥8.92, ¥13.17, and ¥14.34 more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Furthermore, adjusted linear regression analysis revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with a change of 0.494 units (P< 0.001), 0.003 units (P<0.001), and -0.018 units (P<0.001) in the NRF9.2, MAR, and ED, respectively. Conclusion:Higher energy-adjusted diet costs were associated with higher-quality diets. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets by regulating food and diet costs.