Healthy diets are affordable but often displaced by other foods in Indonesia

Abstract

• In places where healthy diets are affordable, other factors may contribute to poor diets. • We use Indonesia as a case study for analyzing economic and behavioral barriers to consumption of healthy diets. • In Indonesia, healthy diets are affordable but not chosen. • Consumption of unhealthy discretionary foods is high for households of all incomes. • Nutrient and food group adequacy are low for households of all incomes. New methods for modeling least-cost diets that meet nutritional requirements for health have emerged as important tools for informing nutrition policy and programming around the world. This study uses the cost of a healthy diet to inform targeted nutrition programming in Indonesia. We combine detailed retail prices and household survey data from Indonesia to describe how reported consumption and expenditure patterns across all levels of household income diverge from least cost healthy diets using items from nearby markets. We examine regional price variations, identify households with insufficient income for healthy diets, and analyze the nutrient adequacy of reported consumption patterns. We find that household food spending was sufficient to meet national dietary guidelines using the least expensive locally available items for over 98% of Indonesians, but almost all households consume substantial quantities of discretionary foods and mixed dishes while consuming too little energy from fruits, vegetables, and legumes, nuts, and seeds. Households with higher incomes have higher nutrient adequacy and are closer to meeting local dietary guidelines, but still fall short of recommendations. These findings shed new light on how actual food demand differs from least-cost healthy diets, due to factors other than affordability, such as taste, convenience, and aspirations shaped by marketing and other sociocultural influences.