Affordable supermarket purchases from dollar stores are not sabotaging typical American nutritional habits, according to research findings
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A new study published in the Journal of the Academy of Nutrition and Dietetics has shed light on the relationship between dollar store food purchases and overall diet quality. Researchers from Tufts University in Boston analysed food purchasing data from 183,000 U.S. households between 2008 and 2020.
The study used the Healthy Eating Index (HEI) to track the healthfulness of household food purchases. This index measures diet alignment with national guidelines on a 100-point scale. The team found that households with substantial purchases at dollar stores had an average HEI score of 46.3, similar to those with moderate or no purchases.
However, the study also revealed that the overall healthfulness of diets among dollar store shoppers is only modestly lower due to their balanced shopping patterns. As Dr. Wenhui Feng, a professor at Tufts University School of Medicine, emphasised, "While dollar store offerings tend to be less healthy, the overall diets of families who shop there are not drastically harmed because of compensatory purchasing behavior elsewhere."
The rise in dollar store food purchases—from 3.4% to 6.5% of household calories over the period—was especially notable among lower-income, female-headed, rural, and non-Hispanic Black households. Despite the prevalence of calorie-rich, processed, and less nutritious items sold in dollar stores, shoppers appear savvy, balancing these purchases with healthier items from traditional grocery stores and clubs like Costco.
Dr. Marie-Pierre St-Onge, a professor of nutritional medicine at the Columbia University Irving Medical Center, stated that most of what dollar stores sell is ultra-processed foods, which are higher in salt and additives that aren't necessarily healthy. However, she also noted that even if the issue of food access is solved, nutritional inequality may still exist due to consumer preferences and economic constraints.
Dr. Feng suggested that families may be purchasing certain items at dollar stores for affordability while buying healthier items at other grocery stores. She also noted that improving the offerings of dollar stores could be a great step towards addressing the issue of food access and health.
St-Onge expressed concern about the rapid growth of dollar stores, particularly in low-income and rural areas, where they often serve as one of the few nearby retail options for food access. She emphasised that food accessibility is a nuanced issue that requires work beyond just stopping the expansion of dollar stores.
Veer Patel, MD, an emergency medicine doctor at Maimonides Medical Center and a member of the our website Medical Unit, was not involved in the study. He noted that while the study provides valuable insights, it's important to remember that individual dietary choices can vary greatly, and the study's findings should be considered in the broader context of an individual's overall diet and lifestyle.
In summary, the study found that while dollar store foods are less nutritious on average, the overall healthfulness of diets among dollar store shoppers is only modestly lower due to their balanced shopping patterns. This nuanced finding challenges assumptions that dollar store purchasing alone substantially harms diet quality.
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