Retail prices, environmental footprints, and nutritional profiles of commonly sold retail food items in 181 countries

Background: Transitions towards healthier, more environmentally sustainable diets would require large shifts in consumption patterns. Cost and affordability can be barriers to consuming healthy, sustainable diets. Objective: This study provides the first worldwide test of how retail food prices relate to empirically estimated environmental footprints and nutritional profile scores between and within food groups. Methods: We use 48,316 prices for 860 retail food items commonly sold in 181 countries during 2011 and 2017, matched to estimated carbon and water footprints and nutritional profiles, to test whether healthier and more sustainable foods are more expensive between and within food groups. Results: Prices, environmental footprints, and nutritional profiles differ between food groups. Within almost all groups, more expensive items have significantly larger carbon and water footprints. Associations are strongest for animal source foods, where each 10% increment in price is associated with 21 grams higher carbon footprint and 5 liters higher water footprint per 100kcal of food. There is no such gradient for price and nutritional profile, as more expensive items are sometimes healthier and sometimes less healthy depending on the food group, price range, and nutritional attribute of interest. Conclusions: Our finding that higher-priced items have larger environmental footprints is contrary to expectations that a more sustainable diet would be more expensive. Instead, we find that within each food group, meeting dietary needs with lower environmental footprints is possible by choosing items with a lower unit price. These findings are consistent with prior observations that higher-priced items typically use more resources, including energy and water, but may or may not be healthful as measured by nutrient profile scores.