Overcoming Barriers to Healthy Eating: A Brief Shopping List

By Lianne Jacobs
Woman with shopping list at grocery store to overcome barriers to healthy eating - Vitality

Throughout the past two decades, Americans’ diets have improved slightly, but there is still plenty of room for improvement.  According to a new study in JAMA that looked at 44,000 Americans’ eating habits from 1999 to 2016, while we are eating nearly 3% fewer highly-processed foods with added sugars, we are still eating too many refined grains, starchy vegetables, and saturated fat.[1]  The study also noted that these outcomes were worse for adults over age 50, racial minorities, and those who were less educated and poor. These insights provide us with a valuable grocery list of action items to help democratize healthy food access and consumption.

Coming to a store near you: Access means making healthy food readily available and affordable

There is consistent evidence to suggest a positive relationship between access to healthy food and healthy eating behaviors.[2-3] Unfortunately, food deserts confront many living in low-income neighborhoods, communities of color, and rural areas. This is a major issue that needs to be addressed, ideally with the collaboration of the private and public sectors, to facilitate access to healthy choices in the first place. This is further exacerbated by the high cost of healthy options, which leads to a reliance on cheaper options that are energy-rich and nutrient-poor, contributing not only to issues such as obesity, but also nutrient deficiencies as well.  Twice as many individuals in fair or poor health cite cost as a significant motivation for choosing less healthy food compared with healthier options.[4]

Too good to be true: Things are not always as they seem – that needs to change for food labeling

Food labeling, with its opacity and misdirection, establishes a further stumbling block for consumers.  A food label that says “reduced sodium” may sound healthy but can be applied as long it has 25% less sodium than the full-sodium version of the same product.  Thus, the “reduced sodium” version may still have too high levels of sodium.  It is no surprise then that despite our best efforts, we aren’t eating as healthy as we should be. The onus lies on both manufacturers and the Food and Drug Administration to ensure that everyone understands precisely what they are eating and whether it is healthy.

Offering low, low prices: A Vitality case study – the power of access and incentives

At Discovery, Vitality members receive up to 25% in cash back for their healthy food purchases as part of the HealthyFood program.  Not only does this benefit make healthy food more accessible, but Vitality-approved purchases are typically highlighted in stores providing members with clear prompts as to what is healthy (assessed by nutrition and health experts) versus what may simply be marketed as healthy or – even worse – “healthier.” The efficacy of increasing access and consumer clarity has been validated by multiple studies. HealthyFood program rebates of 10% and 25% were associated with an increase in the proportion of healthy food and a decrease in the ratio of less desirable total food expenditure.[5]  There was an increase in the net consumption of fruits, vegetables and whole grains, and members were also less likely to consume unhealthy items like foods high in sugar and salt, fried foods, processed meats and fast foods.[6]

Checking out: Adding it all up

As we peruse the aisles of our local grocery stores each week, we are confronted with choices. In some instances, we have a profuse number of healthy options, in others all too few. In all cases, decisions need to be made quickly. Does this seem healthy? Can I afford it? Is this the only fresh produce the store has? While a robust solution for the issues of access, affordability and transparency will require a coordinated effort across public, private and non-government organizations, there are tangible action steps that can be taken to ensure the healthier choice is simpler. Given the central role that good nutrition plays in good health more broadly, this is a shopping list that is worth saving.



Lianne Jacobs, Product Analyst, has a master’s degree in Public Health from Yale University.  She is the only indoor cycling instructor who can’t ride a bike.  She enjoys traveling the world, laughing at her own jokes, and tricking her husband into eating baked goods made with hidden vegetables.


[1] https://jamanetwork.com/journals/jama/article-abstract/2751719

[2] http://thefoodtrust.org/uploads/media_items/grocerygap.original.pdf

[3] https://www.ncbi.nlm.nih.gov/pubmed/18977112

[4] https://foodinsight.org/wp-content/uploads/2018/05/2018-FHS-Report-FINAL.pdf

[5] https://www.rand.org/pubs/external_publications/EP51391.html

[6] https://www.rand.org/pubs/external_publications/EP20130001.html#related


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