Eating a Healthy Diet: Is it affordable?

Food security, in the aftermath of pandemic related disruptions to both income and food supply, recent government policy to ban synthetic fertilizers and in the backdrop of skyrocketing cost of living is at the top of everyone’s mind.

Food insecurity, however, is hardly a new phenomenon in Sri Lanka, as our most distinguished and prolific historian K.M. Silva notes in “A History of Sri Lanka”, malnutrition was a pervasive problem among the poor in the country since the get-go.

Inadequate consumption of a high-quality diet is detrimental to generations of the family; undernourished mothers give birth to low-weight babies who they are unable to breastfeed sufficiently, and end up stunted (too short for their age), wasted (too thin for their height) or underweight.

In 2016, the Demographic and Health Survey found that 16% of newborns had a low birth weight and among children below the age of 5, 17% were stunted, 15% were wasted and 21% were underweight despite high levels of breastfeeding. This ties in to the fact that about 33% of women in reproductive ages (15-49 years) are anemic, which can affect the quality and quantity of breastmilk available to the newborn.

Malnutrition can lead to several health complications, and therefore, is desirable to avoid both individually and collectively as a country. Undernutrition, in particular, can be linked to inadequate household income, leading to an inability to purchase the required sources of foods to meet recommended dietary intake.

Food consumption patterns in Sri Lanka

Many studies have found that, Sri Lankans rely heavily on cheaper sources of food like rice and wheat flour for their caloric intake, rather than a balanced and healthy diet. A sample survey by the Hector Kobbekaduwa Agrarian Research and Training Institute (HARTI) in 2008/2009 found that Sri Lankans consume, on average, just 35 grams of meat & poultry and 36 grams of fish per day; much lower than the recommended dose of 90-120 grams per day. They also consume 425 grams of rice and wheat-based products, also less than the recommended intake.

In 1986, a study by Bogahawatte & Kailasapathy found an immediate requirement to boost the intake of proteins in the diets of the average Sri Lanka. Sri Lanka has arguably taken several strides forward in combatting malnutrition among its general populace since, yet, in 2013, a study by Arachchige & Jayawardena found that only 36.2% of the Sri Lankan adults attained the minimum Sri Lankan recommendation for protein; and a 25% of population did not consume any meat and pulses.

The Model

Therefore I decided to investigate, very simply, the cost of consuming a WHO/Health Ministry recommended diet . My sources of data are (i) spending patterns documented in the Department of Census and Statistics (DCS) Colombo Consumer Price Index (CCPI) basket of goods, (ii) retail prices from the DCS retail price bulletins and (iii) guidelines for a healthy diet from the Ministry of Health and the WHO which are given below.

The equation used in the calculation is as follows;

where “units” refer to grams, milliliters or individual units.

Certain food groups, like nuts, milk, yoghurt/curd and dried could not be included as their retail prices are not tracked by the DCS in its weekly tracker. Further, I am only able to include products that appear both on the CCPI basket of goods which has a spending share allocated to it, in order to account for spending patterns. The weekly data is only collected from the main markets in Colombo, therefore it is not fully representative for consumers outside of Colombo district.

The guidelines provide a lower bound and an upper bound (as indicated in the image above), which would capture the varied needs based on age, sex, level of activity, etc. Therefore I have calculated the cost for both the lower and upper bound – all other variations will lie between these 2 points.

Cost of eating a healthy diet in Colombo

Based on the model; as of last week, it would have costed between Rs. 387 – Rs. 612 per person, per day to consume what is deemed a healthy diet consisting of rice, bread, vegetables, fruits, meats, seafood, pulses, eggs, dairy products and nut oils.

The cost of the recommended diet has gone up by 3.4-3.7% in the 6 months since the start of the year 2021 – this is on top of a preceding year of inflation of 14.3-16.8% in 2020. Assuming a family of four – 2 adults and 2 adolescent children – the monthly cost of this recommended diet would vary between Rs. 46,482 – Rs. 73, 418 per month as of end June 2021.

* An average of weekly costs

For context, the median household income in the Colombo district is Rs. 70,000 according to the Household Income and Expenditure Survey 2016; meaning half of Colombo district households earn less than Rs 70,000 a month. The CCPI basket of goods indicates that approximately 1/3rd of household expenditure is on food, therefore a household earning less than Rs 70,000 a month would only spend about Rs. 23,333 on food, nowhere close to the amount needed to sustain the recommended, healthy diet.

Therefore, it seems that a healthy diet is not affordable to several households in Sri Lanka, particularly those who are on the left end of the income spectrum. Perhaps then, it is no surprise that malnutrition and related diseases are commonplace in Sri Lanka.

Perennial poverty is detrimental to ensuring satisfactory national nutritional outcomes, and sustained income loss resulting from the pandemic is a double whammy – how many more are worse off today as a result? How many were already vulnerable to begin with?

This is an important question to grapple with, particularly in formulating policies aimed at tackling food insecurity – since last year, the government reportedly spent Rs. 286 billion on providing a Rs. 5,000 cash handout to those affected by Covid. However, this handout is clearly woefully inadequate. The affordability of a healthy diet is essential to achieving better health and nutrition outcomes in Sri Lanka.

However, a handout-style dependency program is unlikely to lead to the drastic change required within Sri Lanka to ensure income and food security. As the Central Bank notes in its 2020 annual report (among several other recommendations), in addition to education the general population about healthy eating habits, enabling robust income generation opportunities for underserved communities and groups is paramount to ensure boosted income and food security.

Published by Rehana Thowfeek

I am an economics researcher by profession. I write here about things that interest me personally; current affairs, economy and politics.

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