"Eating Better For Less" by Allen Weiss, MD, MBA, President & CEO

Eating Better For Less

September 1, 2013 - “Eating Better for Less: A National Discount Program for Healthy Food Purchases in South Africa,” is the title of a recent paper published in the American Journal of Health Behavior, proving that diet quality can be improved by reducing prices of healthy foods. 

Behavioral economics may be the best road to a better diet.  For example, during the past four years over a quarter of a million middle class South Africans received a 25% rebate from their health insurance company when they purchased, in over 800 supermarkets, healthy foods as defined by international dietary guidelines. More fruits and vegetables were purchased along with whole-grain foods.  Simultaneously, consumption of processed meats, and foods high in added sugars, fats, and salt decreased.  

The participants’ buying patterns were assessed by grocery checkout scanners and showed an increase of 9% in healthy foods with a 6% decrease in less desirable foods. 

In Dubai, United Arab Emirates, the local government is offering a gram of gold for each kilogram (2.2 lbs.) of weight lost by overweight individuals.  At the current price of gold that is about $20 dollars per pound of weight.  One has to lose at least two kilograms to participate.  Clearly, this is the same idea of using a carrot (pun intended) rather than a stick.

By encouraging good dietary behavior, we can have a meaningful improvement in prevention—so much better and more effective than treating illness or the current sickness model which we now have in our nation. 

Americans, in general, do not want more taxes, which are no as effective in changing behavior as are rewards for doing the right thing.  A good example is the high tax levied on cigarettes.  About 19% of Americans still smoke, even though the cost of cigarettes continues to climb due to increased Federal and State taxes. 

An example of using rewards is France.  Pregnant smokers are paid to stop smoking, keep their pre-natal appointments, take their vitamins and otherwise be healthy during their pregnancy.  As a result, the babies and moms have better outcomes and there is a lower overall cost for healthcare.  

Even though we in America are not up to implementing a similar plan for encouraging consumption of healthier foods, we still have many current options which can be implemented immediately to improve on what we eat: 

• Planning ahead with meals so we buy only what we need and are not seduced in the supermarket by impulse items usually displayed at the end of the aisles and at the check-out counter.  Buying the right quantities is just common sense so we don’t waste perishable food or overeat because we have too much food on our plates.

• Healthy choices can be cheaper.  Reducing portion size, buying fewer high calorie foods and using more seasonal fresh fruits and vegetables not only saves money but is healthier and can help with weight loss.  

• Packing lunch is a great way to save time and money while controlling our intake.  Avoiding too much at lunchtime also helps avoid the sleepiness which is common after eating too big a meal.   

• Saving on protein meals by substituting inexpensive vegetarian sources such as beans, eggs, tofu, and legumes—rather than meats, fish, or poultry—is a good way to improve our diet and save on cost.  Avoiding pre-packaged foods is, in general, better for the diet; these food stuffs are usually loaded with salt, sugar, and fat. 

While we are not yet up to working with our insurance companies to share rewards and savings by being encouraged to make life style changes, we can at least learn from others.  In the meantime, the tips we are sharing are just plain common sense.   As Mark Twain states so eloquently, however, the “Problem with common sense, is that it is so uncommon.”

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.