Income Levels and Continents

Overview

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into caloric prices using USDA Food Composition tables. We classified products into 21 specific food groups. We
then tasked with utilizing nationally representative surveys of retail nutritionally similar products (Table 1). For part of our analysis, we
beverages pertaining to 176 countries. Supplemental Table 1 provides 1. Starchy staples, consisting of 9 categories of cereals and
and Supplemental Table 2 provides meta-data on the survey frame used generally low in micronutrients and high-quality protein. These
ICP price data with consumer price data, since appropriate rice price 2. Vegetal foods, consisting of vitamin A–rich fruits and vegetables,
Supplemental Tables 1–10 are available from the “Supplementary data” link in
Table 1. These calorie shares were then used as weights in an index
Abbreviations used: ASF, animal-sourced food; FIC, fortified infant cereal; principally from rice (49%) and wheat (35%), followed by coarse grains
GDP, gross domestic product; HAZ, height-for-age z score; ICP, International (12%) and potatoes (3%). The ICP data for India includes 26 types
TABLE 1 The type and number of standardized food products in the International Comparison Program price database
Dark green leafy vegetables 11 Spinach, cassava leaves, pumpkin leaves, bean leaves
grains, and 3 potato products, and the median price in each food group Analysis
As the denominator in the RCPs, this starchy staple index has several STATA v14 (StataCorp). We analyzed population-weighted mean RCPs
use of the median price (rather than the minimum or average price) geographical maps, the RCPs were binned into 4 categories: cheap
flour). Supplemental Table 3 reports the value of this starchy staple Next, we conducted a robust regression analysis using the rreg
international dollars per 1000 kcal. This cost varies from a mean of RCPs for different foods are associated with dietary indicators and
index. As with the starchy staple approach, selecting multiple products in Table 1. These indicators were available for over 50 low- and
food group. For all food groups, we measured a ratio of the average also map well into various food groups in Table 1. However, food
Child diets (children 6–23 mo), % consumed in past 24 h
Women’s diets, % consumed in past 7 d
Female literacy (women 15+ y), % 136 80.9 ± 22.1 (15.1–99.9)
Female labor force participation (18–65 y), % 161 53.2 ± 15.5 (14.6–86.5)
as adjusted regressions that include the per capita gross national Table 2 reports summary statistics on RCPs for the full sample,
<−1); to employing the least squares regressor instead of the robust fruit, vegetables, and ASF categories are moderately expensive
regressor; and to the inclusion of different sets of RCPs as explanatory on average (RCPs of 4–8), with dark green leafy vegetables a
FIGURE 2 (A–C) Global variation in the RCPs of vitamin A–rich fruits and vegetables, pulses, and fortified infant cereals in 176 countries,
1. The statistics reported are population-weighted means of the RCPs for each income or regional group, shaded according to the brackets
Price variations across regions and income groups 2A). Dark green leafy vegetables were expensive in most regions,
across products, income levels, and regions (Figures 1 and 2). leaves), were relatively cheap. Other vegetables and fruits
typically classified into the very cheap and moderately cheap (Figure 4A and B). India, however, was a notable outlier
more expensive than soft drinks, on average. In contrast, sugary and statistically significant at the 5% level for 7 of 9 food
Table 3 reports robust regression results for associations Supplemental Table 4 reports analogous results for con-
Table 3 also reports the mean consumption prevalence for pattern of coefficient signs and magnitudes was generally similar
the consumption prevalence for oils/fats and sugar-rich sweets. Table 4 reports associations between RCPs for sugar, soft drinks,
were statistically significant at the 5% level; were negative, as using unadjusted and adjusted models. The unadjusted models
3.2 robust (with both coefficients still significant at the 0.1% level),
26.6 for oil/fats and salty snack RCPs (Supplemental Table 5) and to
0.28 least squares regressions (Supplemental Table 6). Furthermore,
Table 5 reports tests of associations between child stunting and
RCP coefficients were still significant at the 5% level in the
adjusted model. Supplemental Table 7 specified models with
26.0 remained robustly statistically significant. Supplemental Table

Methods (brief)

cognitive development in early childhood, particularly animal- We used ICP data to measure the ratio of the price of 1 calorie of a
parison Program (ICP) survey (25). The ICP is a worldwide initiative or generic inflation.
A key mandate of the ICP is to survey prices of highly standardized related data on the edible portions of different foods (27). In practice,
which formed part of a global list of widely consumed products, whilst and individual dietary diversity to classify specific foods in the ICP
2011 ICP report (25). After excluding beverages and condiments with (Table 1):
ICP price data with consumer price data, since appropriate rice price 2. Vegetal foods, consisting of vitamin A–rich fruits and vegetables,
ICP price data is the high degree of standardization of food and beverage choline, vitamin B-12, and, in the case of dairy, insulin-like growth
products: ICP definitions of food products refer to quantity, quality, factor-1 and calcium. This broad group also includes processed
GDP, gross domestic product; HAZ, height-for-age z score; ICP, International (12%) and potatoes (3%). The ICP data for India includes 26 types
WHO for 2011 (30). We estimated unadjusted regressions, as well Food price variation in the global sample
as adjusted regressions that include the per capita gross national Table 2 reports summary statistics on RCPs for the full sample,
(31). These regression samples were substantially smaller than the sources of calories are oil/fats and sugar, both of which are
larger sample used in the descriptive analysis since some countries were cheaper sources of calories than starchy staples (i.e., RCP <1),
income countries and regions, and very expensive in low- the relatively small sample, RCPs were significant predictors
24 h among children 12–23 mo old and the log of the the small sample contributed to imprecision, so fewer own
these foods, as well as mean RCPs in this sample of low- and (indeed, Pearson correlations between children’s and women’s
limited by only having data for 1 round of the ICP (2011), since comparative risk assessment of burden of disease and injury attributable
earlier ICP rounds did not release the price data of individual to 67 risk factors and risk factor clusters in 21 regions, 1990–2013: a

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Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised