The Cost-Effectiveness of the Whole30

The Cost-Effectiveness of the Whole30

Alternative title: a health economist goes on a diet

New year.  Empty fridge.  Expanded waistline.  After a November and December of over-indulging I decided to multi-task two items on my to-do list: get healthy and figure out how much it costs to get healthy.

Costs

How much does it cost to eat healthy?

 There’s a general acceptance that the healthier the food, the more expensive it is.  I fill my cart with fruits, vegetables, and proteins and am always shocked to see the prices at the grocery store checkout counter.  I often wonder that if I’m balking at these prices to feed my husband and I, how can busier, larger families with lower incomes afford to eat well?

There’s been numerous studies connecting socio-economic status to obesity.  The problem isn’t just cost and availability of high quality healthy foods, however. Unhealthy eating is also tied to education, location, stress, marketing of unhealthy products, and access to overall healthcare (FRAC.org has a good overview of the literature connecting income and food insecurity in the US: https://frac.org/initiatives/hunger-and-obesity/why-are-low-income-and-food-insecure-people-vulnerable-to-obesity/).  Even though obesity and poor health aren’t just about the cost of food, surely it’s a factor.  A 2013 meta-analysis covering 27 articles across 10 countries found that healthier eating costs about $1.50 per day more than the least healthy diets (https://www.hsph.harvard.edu/news/press-releases/healthy-vs-unhealthy-diet-costs-1-50-more/).  While this seems trivial compared to the costs of poor health, an extra $550 per year per person for an already struggling family is still significant. 

This is all comparing the costs of normal healthy eating and bad fast-food eating.  What about the costs of some of these ultra-healthy diets and weight-loss programs.  Can gluten-free be affordable?  Can the paleo diet be affordable and healthy?  What about the Whole30?  I’ve decided to find out more how much an extremely healthy diets costs.

Effects

Is a diet worth the costs?

 I decided base my costing experiment around the Whole30, the trendy new diet (or way of life for some) based on kickstarting healthy eating habits and “resetting” your health over a 30 day period.

The Whole30 is basically nothing fun: No added sugar, no grains, no alcohol (the hardest part), no dairy, no legumes, no artificial additives (no Diet Pepsi!).  The creators claim that 96% of participants lose weight without counting calories.  So, even though this is restrictive eating, I can live with a month of vegetables and meat, if I don’t need to count calories.  Plus bacon is still allowed.

Part of what drew me to the Whole30 were the outrageous claims around the diet: “It’s so much bigger than just food.  It’s a paradigm shift the likes of which you may only experience a few times in your whole life,” write the authors to the Whole30: The 30-Day Guide to Total Health and Food Freedom.  My whole life?

Starting with food, the Whole30 claims the diet will improve sleep, energy levels, mood, attention span, body composition, motivation, self-confidence, self-efficacy, and quality of life. “Yes, the Whole30 eliminates cravings, corrects hormonal imbalances, fixes digestive issues, improves medical conditions, and strengthens the immune system.” 

Can a month of healthy eating really have such resounding effects?  The book asks that we “keep reading with an open mind.”  So I will.  And I’ll measure.

Methodology

Over the next month I’m going to try to determine the cost of the Whole30 and its effects.  Not only will I be counting pennies (but not calories) but I’m also going to be tracking a slew of health indicators which correspond to the Whole30 claims. 

• Sample Size: N=1
• Baseline:
  • Cost: I did a two week baseline to estimate my costs of everyday eating and then referenced my bank statements to attain my average my weekly grocery costs for 2015 (excluding vacations and the month of December)
  • Effect: I’ve measured my baseline: weight, energy levels, overall health (EQ5D), blood pressure, cholesterol, mood, anxiety levels, attention span, job performance, productivity, crankiness when I don’t eat every 2 hours, mindful eating, amount of binge eating. I tried to attach as many of these as I could to a standardized, quantitative metric (e.g. health status=EQ5D), weight) and have made up others (e.g. crankiness, my own 1-5 scale)
• Intervention:
  • Costs are the sum of 1) cost of eating at home (sum of the ingredients, usually divided by two to account for my husband) 2) cost of eating out and 3) the estimated cost of a free meal (work events, friends’ houses)

I’ll update this post based on my interim results and endline results.