However, in a cost of living analysis published yesterday in Health Affairs , the authors concluded that, at least for Washington state, it would cost $380 more per year to increase potassium intake as recommended in the latest Dietary Guidelines for Americans, 2010 . This doesn't even take into account increasing fiber, vitamin D & calcium, which were also recommended to improve our overall nutrition & health. On the other hand, more daily calories obtained from sugar and simple processed carbohydrates was associated with decrease in food costs.
The authors arrived at their conclusions by interviewing 2,000 adults and reviewing the cost & nutritional content of 1,300 who returned a printed questionnaire (which in and of itself could also lead to bias). Those who spent the most money on food got the closest to meeting DGA2010 recommendations for potassium, fiber, vitamin D & calcium. Those who spent the least were least likely to achieve the guidelines for all 4 nutrients while consuming the most in terms of added sugars and saturated fats.
As noted above, others have argued that food can be affordable if one doesn't require fresh, picked/harvested-same-day, all-natural, certified organic, pesticide-free, antibiotic-free, locally grown, cold-pressed, steel cut, hand-crafted products. And while the Mediterranean diet is likely the most studied and healthiest way of eating, it may conflict with ethnic & religious beliefs, not to mention personal palates. So while we may counsel all we want about healthy nutrition habits, we should also inquire into our patient's social situation as it may reflect upon their ability (and willingness) to eat in a healthy fashion. Unfortunately, it's already clear that the long-term costs of eating poorly (obesity, heart disease & diabetes) are even more expensive.