To compare the cost and affordability of two fortnightly diets (representing the national guidelines and current consumption) across areas containing Australia’s major supermarkets.

The Healthy Diets Australian Standardised Affordability and Pricing protocol was used.

Price data were collected online and via phone calls in fifty-one urban and inner regional locations across Australia.

Not applicable.

Healthy diets were consistently less expensive than current (unhealthy) diets. Nonetheless, healthy diets would cost 25–26 % of the disposable income for low-income households and 30–31 % of the poverty line. Differences in gross incomes (the most available income metric which overrepresents disposable income) drove national variations in diet affordability (from 14 % of the median gross household incomes in the Australian Capital Territory and Northern Territory to 25 % of the median gross household income in Tasmania).

In Australian cities and regional areas with major supermarkets, access to affordable diets remains problematic for families receiving low incomes. These findings are likely to be exacerbated in outer regional and remote areas (not included in this study). To make healthy diets economically appealing, policies that reduce the (absolute and relative) costs of healthy diets and increase the incomes of Australians living in poverty are required.

Low socio-economic groups (SEG) in Australia suffer poorer diet-related health than the rest of the population. Therefore, it is expected that low SEG are less likely to consume diets conforming to Australian Dietary Guidelines (ADG) than higher SEG. However, dietary intake of low SEG in Australia has not been synthesised methodically. This systematic scoping review aims to explore detailed dietary intake of low SEG in Australia in comparison to higher SEG.

A systematic search of peer-reviewed literature and websites, since 1999. Data were extracted, synthesised and analysed in relation to study populations, dietary assessment methods, food groups studied, socio-economic measures and dietary intake.

Australia.

Persons of any age and gender, differentiated by a socio-economic measure.

Results from thirty-three included studies confirmed that overall dietary nutritional value/quality tended to be lower in low SEG than higher SEG in Australia. However, findings were inconsistent across studies for all food groups or all socio-economic measures. Large variations were found between study metrics, definitions, dietary assessment methods, granularity of results and conclusions. Quantitative intakes of all ADG food groups by SEG were not reported in most studies and, where reported, were not comparable.

The review showed detailed dietary data are lacking to inform policy and practice and help develop targeted interventions to improve diet-related health of Australian low SEG. There is urgent need for regular, granular assessment of population dietary data to enable comparison of intake between SEG in the context of national food-based dietary guidelines in Australia.

To determine the reliability of streamlined data-gathering techniques for examining the price and affordability of a healthy (recommended) and unhealthy (current) diet. We additionally estimated the price and affordability of diets across socio-economic areas and quantified the influence of different pricing scenarios.

Following the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) protocol, we compared a cross-sectional sample of food and beverage pricing data collected using online data and phone calls (lower-resource streamlined techniques) with data collected in-store from the same retailers.

Food and beverage prices were collected from major supermarkets, fast food and alcohol retailers in eight conveniently sampled areas in Victoria, Australia (n 72 stores), stratified by area-level deprivation and remoteness.

This study did not involve human participants.

The biweekly price of a healthy diet was on average 21 % cheaper ($596) than an unhealthy diet ($721) for a four-person family using the streamlined techniques, which was comparable with estimates using in-store data (healthy: $594, unhealthy: $731). The diet price differential did not vary considerably across geographical areas (range: 18–23 %). Both diets were estimated to be unaffordable for families living on indicative low disposable household incomes and below the poverty line. The inclusion of generic brands notably reduced the prices of healthy and unhealthy diets (≥20 %), rendering both affordable against indicative low disposable household incomes. Inclusion of discounted prices marginally reduced diet prices (3 %).

Streamlined data-gathering techniques are a reliable method for regular, flexible and widespread monitoring of the price and affordability of population diets in areas where supermarkets have an online presence.

To undertake a systematic review to determine similarities and differences in metrics and results between recently and/or currently used tools, protocols and methods for monitoring Australian healthy food prices and affordability.

Electronic databases of peer-reviewed literature and online grey literature were systematically searched using the PRISMA approach for articles and reports relating to healthy food and diet price assessment tools, protocols, methods and results that utilised retail pricing.

National, state, regional and local areas of Australia from 1995 to 2015.

Assessment tools, protocols and methods to measure the price of ‘healthy’ foods and diets.

The search identified fifty-nine discrete surveys of ‘healthy’ food pricing incorporating six major food pricing tools (those used in multiple areas and time periods) and five minor food pricing tools (those used in a single survey area or time period). Analysis demonstrated methodological differences regarding: included foods; reference households; use of availability and/or quality measures; household income sources; store sampling methods; data collection protocols; analysis methods; and results.

‘Healthy’ food price assessment methods used in Australia lack comparability across all metrics and most do not fully align with a ‘healthy’ diet as recommended by the current Australian Dietary Guidelines. None have been applied nationally. Assessment of the price, price differential and affordability of healthy (recommended) and current (unhealthy) diets would provide more robust and meaningful data to inform health and fiscal policy in Australia. The INFORMAS ‘optimal’ approach provides a potential framework for development of these methods.