Madam
We appreciate the comments and insights shared by Dr Darmon. We are gratified to know we agree about the fundamental message our paper(Reference Katz, Doughty and Njike1) purported to deliver, that selecting more nutritious foods in given categories does not inevitably cost more.
Dr Darmon refutes our claim that no prior studies had examined price differentials based on overall nutritional quality(Reference Katz, Njike and Rhee2) within given food categories. She is correct in global context. However, pricing is a matter of policies and politics, and thus is highly culture-specific. We should more precisely have said we could find no prior studies specifically addressing this issue in the USA. The references provided by Dr Darmon relate to studies in the UK(Reference Cooper and Nelson3), France(Reference Darmon, Caillavet and Joly4), Canada(Reference Ricciuto, Ip and Tarasuk5) and Australia(Reference Giskes, Van Lenthe and Brug6). And even so, these citations show that while some prior work has been done in this area, the relevant literature is surprisingly limited for a topic so often discussed. We nevertheless convey a mea culpa for failing to explicate our ethnocentric focus more decisively.
More importantly, we quite agree that too few studies have examined the issue, and concur as well about the challenges related to variable definitions of food categories and variable measures of overall nutritional quality.
Price is well established as an important barrier to more healthful eating; our paper does not refute that. The extent to which enhanced knowledge of the overall nutritional quality of available products would allow consumers in the USA and around the globe to navigate to better nutrition in many food categories without incurring a financial penalty is a matter of timely importance, deserving more dedicated attention.
