Unhealthy food is too cheap, healthy food is too expensive!

Fruit and vegetables are healthy, inferior meat and sausage products, ready meals and sugar bombs are unhealthy. When it comes to price, it is usually the case that healthy food is expensive and unhealthy food is cheaper. However, due to the price increases in recent years and the small adjustments to the social welfare rate, it is likely to be even more difficult for people with limited financial resources to ensure a healthy diet, especially as the sharp rise in energy costs must also be met from the budget.

A study by the Robert Koch Institute*, among others, suggests that food poverty is real. According to this, "children and adolescents in the poverty risk group (...) are significantly more likely to have impaired health than their peers in the middle and, above all, the high income group, and their health behaviour is less favourable".

UBTaktuell: How expensive is it to eat healthily in this country? How easy is it?

Prof. Dr Tina Bartelmeß: In Germany, the assessment of a diet as healthy is usually based on whether it meets the recommendations of specialist organisations, for example the recommendations of the German Nutrition Society** (DGE). According to these recommendations, it is particularly healthy to include a large proportion of fruit and vegetables in your daily diet. It is precisely these foods that have recently been subject to significant price increases on the German market. There are not many studies on this, but the 2003 income and consumer sample shows that the cost of a healthy, wholesome diet was 43.46 euros per person per week, while the cost of an average diet was only 29.86 euros. This must be seen against the background of price trends and inflation: Food prices rose by 13.7 per cent between 2022 and 2023 alone. In relation to the budget of recipients of citizen's income in 2023 (€40.25 per week), this shows that a healthy diet that contains sufficient macro- and micronutrients to cover needs and prevent diet-related diseases cannot be realised on a low budget. Energy-dense but nutrient-poor foods are comparatively inexpensive, which means that a nutritionally unfavourable food selection is usually associated with lower costs.

How could this be countered?

Due to the price increases in recent years and the small adjustments to the social assistance rate, it is currently likely to be even more difficult for people with limited financial resources to ensure a healthy diet, especially as the sharp rise in energy costs must also be met from the budget. Monitoring food prices as a reference for the dynamic adjustment of standard social assistance rates and one-off payments could make a healthy diet possible. Another food policy measure would be a reduction in VAT on fruit and vegetables, which would increase the affordability of these foods. An increase in the VAT rate for unhealthy foods, such as low-quality meat and sausage products or products with a high sugar content, could also steer diets in a healthier direction overall. Another important aspect is school catering. Certification according to DGE standards for school catering has not been implemented throughout Germany. Cost reductions for socially disadvantaged pupils are often not utilised because the necessary information does not reach the parents or the application process is overwhelming. Low-threshold information provision and support services to overcome bureaucratic hurdles would be helpful.

What are the consequential costs of unhealthy eating?

Both children and adults with a low socio-economic status, for example, consume more sugary soft drinks and meat and sausage products and less fruit and vegetables than people with a higher socio-economic status. As a result, the prevalence of overweight and obesity is significantly higher in the lower social classes. The prevalence of other diet-related illnesses such as type 2 diabetes mellitus, high blood pressure and cardiovascular diseases as well as mental health problems is also higher. The average life expectancy at birth is also lower in low-income groups: the difference between the lowest and highest income groups is 4.4 years for women and 8.6 years for men. The social inequality in the chances of realising a balanced and sustainable diet with low consequential costs for the environment goes hand in hand with a higher risk of illness and premature death in favour of the lower classes.

Can you explain why this issue is being ignored politically?

There is a lack of representative surveys that take a multidimensional view of food poverty. Previous descriptions usually only take into account differences in nutritional behaviour according to socio-economic characteristics. According to this approach, people living in poverty are more likely to engage in risky and less health-promoting behaviour, which goes hand in hand with their attitudes and knowledge. Health and nutrition policy attention is therefore usually focused on improving the skills of socio-economic, so-called "vulnerable" groups in the hope that they will minimise their risk behaviour. A more comprehensive consideration of nutritional behaviour in poverty and its reasons and conflicting objectives, for example in relation to other, temporarily more important household expenditure than expenditure on healthy food, has not yet been undertaken. This is also reflected in the political attention. What remains unconsidered is that this perpetuates and reinforces various forms of stigmatisation in connection with food poverty. This in turn impairs the social, cultural and psychological dimensions of nutrition for those affected, which can have an additional impact on the health and well-being of people affected by poverty.