Nutrient profiling and food prices: what is the cost of choosing healthier products?

Background The Health Star Rating (HSR) is a front-of-pack label designed to help Australian consumers identify healthier packaged foods. Price is an important determinant of food choice and yet no previous studies have examined the relationship between HSR and price. In the present study, we investigated whether (i) healthier packaged food products, as determined by HSR, are more expensive than less healthy alternatives and (ii) products displaying the HSR are more expensive than similar products that do not. Methods Prices of three packaged foods categories (breakfast cereals, cereal-based bars and fruit juices) and nutrient data (to calculate HSR) were obtained from shopping receipts of approximately 1600 Australians between June 2014 and September 2016. Associations between HSR and price [per energy ($/100 kJ) and per unit ($/100 g)] for products of comparable package sizes were assessed by linear regression and the results are presented as differences in average price over the theoretical maximum range of HSR from 0.5 to 5 stars. Results The HSR of products was not consistently related to price. Small positive associations were observed for juice ($0.08/100 mL; P = 0.03) and for cereal-based bars ($0.04/100 kJ; P = 0.02). No other associations between HSR and price were observed (P ≥ 0.23). Products that displayed the HSR were no more expensive on average than products that received a similar HSR but did not display the HSR (P ≥ 0.16). Conclusions In summary, the findings of the present study suggest that healthier packaged food products were not consistently more expensive than less healthy products and also that price is unlikely to be a barrier for consumers to use the HSR to select healthier packaged foods.