Economics of eating for oral and overall health

The COVID-19 pandemic and the Russia-Ukraine war have led to significant global economic disruptions, sharply increasing food prices. In January 2023, food inflation in Canada was at 10.4% – this was the highest level over the past 40 years.¹ This surge affected all major food groups, including fresh produce, baked goods, dairy, and meats (Fig.1).^1,2 Specifically, fruits and vegetables saw price increases of up to 12%.¹ Despite a moderation in food price growth to 2.7% year-over-year by July 2024, this rate still exceeds the general inflation rate of 2.5%. Factors driving these increases include extreme weather, global supply chain issues, geopolitical instability, high energy costs, and a weakened Canadian dollar.³

Fig. 1

Given the close link between whole foods and health, these persistent high food prices have significant implications for nutrition and oral health. As the cost of groceries increases, Canadians may be compelled to cut back on essential, nutrient-rich foods that benefit oral health and overall health. For instance, higher prices for fresh fruits, vegetables, and dairy products can lead to reduced consumption of foods that provide essential vitamins and minerals necessary for healthy teeth and gums.⁴ A decline in the intake of these nutrient-dense foods – and often at the expense of consuming higher amounts of foods with added sugars – might contribute to an increased risk of tooth decay and gum disease while also negatively impacting overall well-being.

Moreover, the ongoing high costs are influencing consumer behaviours and dining habits. Many Canadians adjust their spending by seeking discounts, using coupons, and opting for value meals. A survey by Lightspeed Commerce revealed that Canadians are also noticing higher restaurant prices and shrinking portion sizes, leading to reduced tipping and altered dining practices.⁵ Despite these changes, many Canadians continue to dine out, though restaurant operators are struggling to balance menu prices with consumer spending.⁵ These shifts in consumer behaviour, driven by high food prices, further underscore the potential impact on dietary choices and nutritional intake, highlighting the need for consumers to balance eating healthy and the associated costs of different foods.

The evidence supports the relationship between diet and oral health, including periodontal health.^6-11 Key nutrients and food components of interest known to positively modulate periodontal health and/or healing after sanative therapy include calcium, vitamins C and D, protein, polyunsaturated fatty acids, flavonoids and fibre. Moreover, a recent special issue and accompanying editorial further highlight this relationship.¹²

Thankfully, there are some strategies to help us purchase foods that support our oral and overall health while being mindful of financial costs. Of note are the helpful online resources that Health Canada and Dietitians of Canada provide to assist consumers in eating healthy on a budget.^13-16 Let’s consider three strategies to reduce costs associated with purchasing foods that support health. These strategies are also summarized in Figure 2.

Fig. 2

Make more meals at home. This strategy requires effort and is time intensive but there are benefits that you can feel good about, in addition to saving money. Having control over ingredients in your meals and what isn’t added (think salt) can support you in consuming meals that meet your nutrient needs for vitamins minerals, and protein while lowering intakes of saturated fat and added sugars. Planning meals can be part of your weekly routine. Have a list of meals that you and others you eat with can prepare and/or enjoy together and rotate through the options. Consideration of seasonal availability of fruits and vegetables can also be helpful to reduce costs. There are many different apps that can also assist with menu planning and generate the associated shopping list. When preparing meals, consider whether you can make extra portions to provide leftovers for the next day or freeze them and keep them on hand for when you are crunched for time. Frozen stews and chilis can work well.

Buy frozen fruits and vegetables more often. Purchasing fresh fruits and vegetables can be costly, yet Canada’s Food Guide recommends that half of each meal be made up of these whole foods. This is where purchasing frozen fruits and vegetables can help cut costs without compromising freshness and nutrient content. Within the resources of Canada’s Food Guide is an article that states the ten reasons to buy frozen vegetables and fruits.¹⁶ Further cost reductions can be achieved by purchasing larger “bulk” quantities, and there is often a store brand or no-name option that is less expensive. Frozen fruits and vegetables are frozen very soon after harvest, which preserves nutrient quality for consumers while also providing a rich source of flavonoids.

Choose plant-based protein foods and grains more often: Plant protein can generally be less expensive than animal sources, particularly if comparing whole foods rather than processed foods. For whole food sources of plant protein, think of peas, beans and lentils, with common examples being chickpeas and a variety of beans such as lima, black, kidney or soybeans, and red or green lentils. A main tenet of Canada’s Food Guide is “ trying to choose protein foods that come from plants every day”.¹⁷ Some of the reasoning behind this messaging is that these protein foods tend to have a healthier fat profile (less saturated fat, more polyunsaturated fatty acids) while also making meaningful contributions to fibre intake. Canadians tend not to meet guidance around fibre intake, so increasing the intake of legumes can help increase fibre intake and thereby favourably influence the gut microbiome. Choosing whole-grain foods such as whole-grain breads and cereals can also help increase fibre intake. 

Oral Health welcomes this original article.

References

1. Statista. Food price inflation in Canada. Accessed September 5, 2024, from https://www.statista.com/topics/9659/food-price-inflation-in-canada/#topicOverview
2. Statistics Canada. Monthly average retail prices for selected products. Accessed September 5, 2024, from https://www150.statcan.gc.ca/t1/tbl1/en/cv.action?pid=1810024501
3. Forbes Advisor. Food inflation: How it affects your finances. Accessed September 5, 2024, from https://www.forbes.com/advisor/ca/personal-finance/food-inflation/#:~:text=Many%20
4. Bank of Canada. What drives up the price of groceries? Accessed September 5, 2024, from https://www.bankofcanada.ca/2024/07/what-drives-up-the-price-of-groceries/
5. CTV News. Canadians feel the pinch at grocery store as food inflation ticks higher for first time in nearly a year. Accessed September 5, 2024, from https://www.ctvnews.ca/business/canadians-feel-the-pinch-at-grocery-store-as-food-inflation-ticks-higher-for-first-time-in-nearly-a-year-1.6940172#:~:text=
   Overall%2C%20food%20
6. Martinon P et al. Nutrition as a key modifiable factor for periodontitis and main chronic diseases. Journal of Clinical Medicine. 2021;10:197.
7. Woelber JP et al. Dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy – a systematic review. Nutrients. 2023;15:1538.
8. Iwaski M et al. Relations of ascorbic acid and alpha-tocopherol to periodontal disease. J Dental Research. 2012;91:167-172.
9. Dodington DW et al. Higher intakes of fruits and vegetables, beta-carotene, vitamin C, alpha-tocopherol, EPA, DHA are positively associated with periodontal healing after nonsurgical periodontal therapy in nonsmokers but not in smokers. Journal of Nutrition. 2015;145;2512-2519.
10. O’Connor JLP et al. Poor dietary intake of nutrients and food groups are associated with increased risk of periodontal disease among community-dwelling older adults: a systematic literature review. Nutrition Reviews. 2020;78:175-188.
11. Nielsen SJ et al. Dietary fiber intake is inversely associated with periodontal disease among US adults. Journal of Nutrition. 2016;146:2530- 2536.
12. Woelber JP and Vach K. Healthier smile: the role of diet and nutrition in the prevention and therapy of caries, gingivitis, and periodontitis. Nutrients. 2023;15:4319.
13. Government of Canada. Healthy eating on a budget. Accessed September 5, 2024, from https://food-guide.canada.ca/en/tips-for-healthy-eating/healthy-eating-budget/
14. Dietitians of Canada. UnlockFood. Accessed September 5, 2024, from https://www.unlockfood.ca/en/default.aspx
15. Dietitians of Canada. Learn more about the benefits of healthy eating on a budget. Accessed September 5, 2024, from https://www.unlockfood.ca/en/Articles/Budget/
16. Government of Canada. 10 reasons to buy frozen fruits and vegetables. Accessed September 2, 2024 from, https://food-guide.canada.ca/en/cooking-skills/10-reasons-buy-frozen-vegetables-fruits
17. Government of Canada. Eat a variety of healthy foods each day. Accessed September 5, 2024, from https://food-guide.canada.ca/en/

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About the Authors

Pierson Fritz is a second-year student in Rotman Commerce at the University of Toronto. He has an interest in understanding consumer behaviour in relation to health-related choices. 

Wendy Ward is a Professor in the Department of Kinesiology and holds a Senior Research Fellowship in the Faculty of Applied Health Sciences at Brock University. Her team’s overall research goal within the Nutrition, Bone and Oral Health Research Group is to develop dietary strategies that help protect against osteoporosis and related fractures while also understanding the complex relationships with other health conditions such as periodontal disease.