The paper by Banks et al1 was music to my ears. As someone who has been jousting with a tendency towards obesity since my teenage years I am not only well aware of the ‘healthy food costs too much’ argument so beloved by patients, but the counter arguments. The one that seems to confound people most of all is ‘why don't you just eat less of what you can afford to buy?’ I have not yet had a sensible answer to this: generally there is a knotting of brows for a few seconds as though I were speaking in tongues, before moving on to some other issue.
It seems to me that there are two main problems to be overcome in quashing the ‘healthy is expensive’ argument. First the cheapness of less healthy options: the often quoted discount ready-made lasagne, for example. Second is the idea that a diet is not healthy unless it contains a liberal sprinkling of exotic fruit and veg. We are surrounded by images of blueberries with our breakfast cereal, pak choi in our ‘10-minute’ supper, and kiwi fruit at just about any time of day. These images are propagated by magazines and diet clubs alike. Is it any wonder people think they can't afford it?
Last year one of Britain's leading supermarkets introduced menus that cost around £50 per week for a family of four. In some quarters this came under fire for such mundanities as toast for breakfast. There is nothing wrong with toast for breakfast. In many Mediterranean countries (whose diet is seen as the gold standard) it is common to skip breakfast altogether in favour of elevenses, or to take little more than bread and coffee.
By all means try to curb the purveyors of cheap, unhealthy options, but more importantly let us push a sensible, achievable alternative.
- © British Journal of General Practice 2012