RESUMEN
Benchmark diets using the most affordable locally available items to meet health and nutrition needs have long been used to guide food choice and nutrition assistance. This paper describes the result of recent innovations scaling up the use of such least-cost diets by UN agencies, the World Bank, and national governments for a different purpose, which is monitoring food environments and targeting systemic interventions to improve a population's access to sufficient food for an active and healthy life. Measuring food access using least-cost diets allows a clearer understanding of where poor diets are caused by unavailability or high prices for even the lowest-cost healthy foods, insufficient income or other resources to acquire those foods, or the use of other foods instead due to reasons such as time use and meal preparation costs, or cultural factors such as taste and aspirations. This paper reviews the data, methods and results that have led to official FAO and the World Bank adoption of cost and affordability metrics for global monitoring, and the parallel use of similar methods to guide interventions in country studies led by the World Food Programme with partner agencies across Africa, Asia and Latin America. We conclude by summarizing how increasing availability of food price data, matched to food composition and dietary requirements, allows analysts to use recently developed software tools for least-cost diet assessment to improve food access in a wide range of settings.
RESUMEN
A growing literature uses least-cost diets to evaluate how effectively a food system supports access to nutritious foods. We identify the cost of meeting nutrient requirements for whole households in rural Malawi from and the nutrient-level drivers thereof. From 2013 to 2017, we can identify a household least-cost diet only 60% of the time with an average cost of $2.32/person/day (2011 US$ PPP). We illustrate that larger households have more diverse nutrient needs and face a higher cost for 1000 calories of a sufficiently nutrient dense diet. Shadow price analysis shows riboflavin to be the costliest nutrient in the market. We use policy scenarios to understand what drives the infeasibility and high cost. Simulating the impact of selenium soil biofortification of maize results in a feasible diet 94% of the time at half the cost ($1.22/person/day on average) and eliminates the shadow price of copper. This is explained by insufficient selenium from sources low in copper such that under baseline conditions it is impossible to get enough selenium without too much copper. Even when feasible, to avoid copper, more higher cost foods enter the diet than would be otherwise needed to meet remaining nutrient requirements. Other value chain scenarios to increase the availability and lower the cost of nutrient-dense foods did not meaningfully change the diet cost results. Of direct relevance to Malawi, this study demonstrates more broadly how least-cost diet methods can be used to assess barriers to accessing an adequate diet and the potential impacts of policy options.