- freely available
Int. J. Environ. Res. Public Health 2019, 16(1), 32; https://doi.org/10.3390/ijerph16010032
2. Materials and Methods
- a single man [35–45-years-old]
- a single woman [35–45-years-old]
- a couple [man, woman; 35–45-years-old]
- a single woman [35–45-years-old] + 2 children [primary school boy, 10-years-old + secondary school girl, 14-years-old].
- a couple [35–45-years-old] + 2 children [primary school boy, 10-years-old + secondary school girl, 14-years-old].
- The household types are assumed to live in the capital city of each participant country. This point is particularly relevant in terms of the pricing of the items and the frequency in which people rely on the production of food for own consumption.
- All meals are prepared and eaten at home. All food is acquired, prepared and consumed in the most economical way possible. This means families are well-informed about prices and are able to shop in the most economic retailers that are accessible with public transport. However, we do not assume that people can always buy all their ingredients in the cheapest available supermarket. Hence, we allowed for a certain freedom of choice to shop within a range of cheap retailers.
- All household members are in good health and do not have specific dietary requirements. The reason for this assumption is not so much that this is the most common health condition, but rather that the cost of a diet varies depending on the kind and severity of health problems, each having different implications for the needs of the person affected.
- The ingredients should give families access to healthy, tasty and well varied meals. The food basket should be acceptable for citizens with different background characteristics provided that the healthy aspect is not compromised.
- Finally, we assume that the budget for food is allocated to each household member in accordance with her/his needs.
- For the first milestone, the national experts provided a clear description of the scientific basis (DRVs) of the national FBDG, the results of the last food consumption survey and the model of health education in their country.
- In the following step, in cooperation with a nutritionist, country teams translated the FBDG into a concrete list of food items, including the necessary amounts for each hypothetical household.
- For the third milestone, three different focus groups were organized in the capital city. Several focus group trainings were organized and instructions were developed by the coordinating team to make sure that the focus groups were conducted and analysed in a standardized way (cf. Annex 1 in ). The national partners recruited for each focus group 5–11 participants of active age (30–50), through a questionnaire for recruitment ensuring a mix of different family situations, and a variety of socio-economic backgrounds. Involving people with different backgrounds increases the variation of opinions, the quality of discussions (in terms of argumentation) and validity of the outcome [27,28,29]. The recruitment of different socio-economic backgrounds was measured based on three variables: activity status, level of education and burden of housing costs as a proxy for income. Because of the limited number of focus groups, it was difficult to make sure ethnic minorities were equally involved. Therefore, this pilot project aimed in the first place at capturing the dominant cultural patterns through FG discussions, acknowledging that more research is necessary to reveal the cultural variety within cities.Each focus group followed a predefined topic list, with an estimated time of three hours. The first half of the discussion was devoted to evaluating the broader theoretical framework (the assessment of needs and essential social roles) and the underlying assumptions we made (characteristics of the reference family), and the second half was used to discuss the acceptability, feasibility and completeness of the food basket, the kitchen equipment and the other non-physical functions of food—as well as the related purchasing patterns. For the purpose of this article, we only make use of the second part of the focus group discussions, which had an average duration of approximately 90 min. To facilitate the discussion, an illustrative weekly menu was developed by the nutritionist, in accordance with the proposed food basket.The results were analysed by the country teams in accordance with a common template of analysis. Each focus group was recorded, and, during the discussion, an assistant wrote down the various arguments in a structured template. For each topic a final column was completed with the overall conclusions and general remarks on interaction processes, proxemics and paralinguistic information. In literature they call this a micro-interlocutor analysis , which allows to focus on the group as well as on the individual data while taking into account group dynamics. The purpose of the focus groups was not to decide on specific quantities but rather to assess the nature, the origin and the construction of the arguments regarding why items are needed or not and what is acceptable and feasible within a given socio-cultural context.
- Next, the food baskets had to be adapted in function of feasibility and acceptability, based on the arguments put forward during focus group discussions. This was done in accordance with a common decision procedure that country teams had to follow to ensure that the healthy character of the diet was respected and to facilitate the consistency and robustness of the results across countries (cf. Annex 2 in ).
- The last milestone consisted of estimating the minimum feasible cost of the food basket. Again, several common assumptions were made. First of all, the food budget should represent the minimum resources that people need to get access to all essential food items. Further, people should have a minimum acceptable degree of freedom in the choice of shops and products. Thirdly, market prices are used, unless other purchasing patterns are common practice, but no sales prices are used. Another important guideline was that economies of scale in buying and preparing food should be taken into account. For the choice of shops to buy food, the national teams had to choose a few retailors or markets which were suggested by the participants in the focus groups. The retailers had to meet the following criteria: (1) they offer a wide variety of food items of acceptable quality at low prices, (2) the shops are well spread over the city, (3) the shops are well accessible by public transport. Being well spread over the country was another criterion that could be considered, as this could facilitate the future pricing of reference budgets developed for other regions.All countries priced the food baskets between March and April 2015 (exceptions are the food baskets for Luxembourg, Denmark and Slovakia which were priced in December 2014, July 2015 and October 2015, respectively). Prices were collected on the basis of a small-scale survey, carried out by researchers from each country team, making use of a standardised excel sheet (with the exception of Luxembourg, where the country team had access to the official price survey). To price pre-packaged food, the lowest price of suitable products had to be chosen. With regard to fresh food and food categories which contain a large variety of products, country teams had to follow a specific predefined pricing procedure, such that a weighted price could be estimated which takes into account the available range of relevant products. The food categories for which a weighted price procedure had to be used are the following: fresh fruit, canned fruit, fruit puree, frozen fruit, dried fruit, fresh vegetables, frozen prepared & unprepared vegetables, canned vegetables, fresh fish, frozen fish, canned fish, lean meat, fat meat, charcuterie and cheese.For instance, the cost of fresh fruit is based on a weighted average of all fresh fruit available in the shop, taking from each type of fruit the cheapest alternative of sufficient quality (e.g., the cheapest apple, the cheapest pear, etc.). The cheapest products are weighted 5/7, whereas the average weight of the more expensive items is given a weight of 2/7, while discarding the 10% most expensive fruits. This procedure aims to meet the dual objective of identifying the minimum cost to prepare healthy menus that still offer sufficient variation (see Annex 3 in  for the detailed instructions for assessing the cost of the food basket).
3.1. The Contents of the Food Basket
What Constitutes a Healthy Diet?
3.2. The Cost of the Food Baskets
Conflicts of Interest
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