All countries have a rising burden of diet-related disease from the consumption of unhealthy foods. About three billion people around the world cannot afford the diverse foods needed for a healthy diet. This chapter aims to extend previous work on diet cost and affordability to address the hidden costs of meal preparation inside the home. Costs of a basic meal based on market prices for the most affordable items are estimated in 168 countries. Also, the hidden costs of meal preparation are considered, taking account of environmental or social externalities from the production and distribution of food, as well as the health externalities involved in food consumption. The data shown here reveal that even the simple raw ingredients for a basic plate are often unaffordable for the poorest, and the added cost of time and fuel can make such meals prohibitively expensive. Results suggest two main avenues for policy action. First, governments should use the information on the least costly way to meet dietary standards to inform poverty lines and provide targeted assistance so as to ensure that citizens can acquire safe and nutritious items in sufficient quantities for an active and healthy life, using locale-appropriate safety nets. Second, food policies should recognize the hidden costs of meal preparation that often put healthier, more sustainable diets out of reach. Overcoming the hidden barriers to preparation of healthy meals will require support for helpful forms of food processing that preserve or enhance nutritional values, while taking action to limit potentially harmful forms of ultra-processing associated with diet-related disease. Food-based safety nets and improvements in the food environment can make healthy diets affordable for all people at all times, to help every country reach global development goals.
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