1. The Cost of Nutrition in Asia
Derek Headey
d.headey@cgiar.org
Senior Research Fellow
Poverty, Health and Nutrition Division &
Myanmar Agricultural Policy Support Activity (MAPSA)
International Food Policy Research Institute (IFPRI)
1

2. Pre-lunch appetizers
• Poor diets a root cause of
undernutrition & overnutrition
• Healthy foods often perishable,
non-tradable and expensive
• Healthy diets expensive in Asia
• Policy implications?
• Raise incomes?
• Lower diet costs?
• Nutritional education?

3. What is a good diet?
• Broad agreement on principles, but
not necessarily on details
• Many countries have food-based
dietary guidelines (FBDGs):
• Diversity/balance across food groups
• High intake of fresh fruit/vegetables,
whole grains, legumes/nuts
• Low sodium, oils/fats, sugar, red meat
• First global reference diet released
this year: EAT-Lancet
• Decrease disease risk in adulthood
• However, infants & young children
benefit from animal-sourced foods:
• Stunting reduction
• Cognitive development

4. Food affordability or nutritional knowledge the key constraint?
Why should we care about dietary costs?
Diet affordability
(ratio of income to diet cost)
Dietary quality Cost of healthy diet
(fuzzy!)

5. Why should we care about market prices?
63%
87% 87%
69%
55%
76%
60%
81%
65%
37%
13% 13%
31%
45%
24%
40%
19%
35%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Sources of food consumption in rural Bangladesh
Own farm
Markets
• Even rural consumers mostly depend on markets for consumption

6. How expensive are (un)healthy foods?
• Can answer this question with relative caloric prices
• e.g. cost of 1 egg calorie relative to 1 starchy staple calorie
• Why price foods in caloric terms?
• Calories essential for survival, activity & averting hunger
• Why measure prices relative to staples?
• Measures cost of diet diversification in a comparable way
• Data: 2011 International Comparison Program (ICP)
• Prices for 657 standardized food products in 176 countries
• Series of maps:
• light = cheap relative to cereals
• dark = expensive relative to cereals
t u t/
[0,2]
(2,5]
(5,8]
(CPR>8]
No data

7. CPRs: vA-rich fruit/veg
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Cheapest Vitamin-A rich fruit/veg
Relatively cheap in most of Asia,
especially China

8. CPRs: Fortified infant cereals
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Fortified infant cereals (well known brand)
Very expensive in most of Asia

9. CPRs: Eggs
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Chicken eggs
Large variation in Asian egg prices:
Cheap in India, expensive in SE Asia

10. CPRs: Milk
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Fresh cow’s milk
Very expensive in
South-East Asia!

11. CPRs: Fish/seafood
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Cheapest fish
Only moderately expensive;
cheaper in China & Thailand

12. CPRs: Sugar
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Sugar
Cheap everywhere

13. What kinds of foods are cheap in Asia?
CPRs: Oils/fats
0 - 2
2 - 4
4 - 8
8 - 40
No data
Cheap everywhere
Oils

14. CPRs: Soft drinks
0 - 2
2 - 4
4 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Soft drinks (Coca-Cola)
Cheaper in China,
moderately expensive
elsewhere

15. CPRs: Potato chips
0 - 2
2 - 5
5 - 8
8 - 40
No data
What kinds of foods are cheap in Asia?
Potato chips
Cheap everywhere

16. Why are some foods expensive?
Less perishable More perishable
Less expensive
legumes/nuts, dried
fish & fruit
sugar, oils, soft
drinks, snack foods
More expensive
Fortified infant
cereals
Most fruit,
vegetables, milk,
eggs, meat, fresh fish
• Many fresh and nutrient-dense foods are perishable
• Limits opportunities for long-distance trade
• Prices mostly determined by local supply & productivity

17. How costly are healthy diets in Asia?
$1.90/day
Poverty line
• We used the same ICP price data to estimate cheapest daily
cost the EAT-Lancet diet …
Around 1 billion people cannot
afford EAT-Lancet in Asia

18. How costly are healthy diets in rural India?
• Use monthly data on prices & wages in rural India, 2001-11
• Diet costs rose from 2001, but wage growth faster
• Diet costs as share of wages fell by 5-6 points
• But ….
• Diets as a share of safety net (NREGA) wages rose
• Most rural Indians could not afford a healthy diet in 2011
Indicator Poverty headcount (%)
Rural population unable to afford $1.90/day
expenditures (World Bank poverty estimate)
24.8%
Rural population unable to afford $2.40 CoRD 44.9%
Rural population unable to afford $2.40 CoRD +
$0.63 non-food expenditures
63.8%

19. How costly are healthy diets in Myanmar?
• Use household survey data on prices and food expenditures
• Can compare patterns across income groups & regions
41% 43%
34%
57%
39%
34%
45%
33%
99%
58%
26%
13%
7%
0%
20%
40%
60%
80%
100%
National
Rural
Urban
Hills
DryZone
Delta
Coastal
Yangon
Q1-low
Q2
Q3
Q4
Q5-high
Regions Expenditure levels
Population share unable to afford recommended diet (%)

20. What should be done, where and when?
 Income growth is essential for the poor
 Incomes of the poor are a long way from meet diet costs
 Economic growth must be pro-poor (track with wages?)
 Safety nets can reduce dietary gaps in the short run
 But cash or food?
 Should food be staples or nutritious foods?
 Safety net programs should start costing nutritious diets!!!
 Investment in agriculture, and for agriculture
 Fresh nutrient-dense foods highly perishable, so limits to trade
 Diversification and productivity growth can drive down prices
 Essential to improve value chains for perishable foods
Policy implications

21. What about improving nutritional knowledge?
For poor populations
 Focus on young children and mothers
 Potentially combine with cash transfers (e.g. TMRI project)
For emerging middle classes, with rising incomes
 Nutrition education critical for obesity/NCD prevention
 Especially important for school-age populations:
 Forming life-long dietary habits
 Vulnerable to aggressive marketing, social pressures
 Focus on encouraging healthy diets and cooking practices
 Support with proactive legislation: e.g. food labelling
Major challenge: improve nutritional knowledge at scale!
Policy implications

22. • Big thanks to all my coauthors, from various publications
• Please email if interested: d.headey@cgiar.org
Headey, D.D., Alderman, H.H., 2019. The Relative Caloric Prices of
Healthy and Unhealthy Foods Differ Systematically across Income
Levels and Continents. The Journal of Nutrition.
Kalle Hirvonen, Yan Bai, Derek Headey, William A Masters. 2019.
“Affordability of the EAT–Lancet reference diet: a global Analysis.”
Lancet Global Health (forthcoming)
Kalyani Raghunathan, Derek Headey, Anna Herforth. 2019.
“Affordability of nutritious diets in rural India”. Forthcoming IFPRI
Discussion Paper
Mahrt, K., Mather, D., Herforth, A., Headey, D., 2019. Household
Dietary Patterns and the Cost of a Nutritious Diet in Myanmar.
Feed the Future Innovation Lab for Food Security, MSU Policy
Research Paper 135, East Lansing.
Note of thanks