The High Cost of Healthy: How Grocery Prices Shape American Diets and Health

Rising grocery prices are forcing most Americans to shift toward ultraprocessed foods, leading to increased health risks and exacerbating existing disparities, particularly among underserved communities. | Image Credit: Jammy Jean - stock.adobe.com

The escalating cost of groceries, particularly healthy options, is forcing a critical shift in American diets toward more affordable, often ultraprocessed alternatives, sparking concerns about widening health disparities.¹

The Price of Healthy Eating

About 90% of US adults say the price of healthy food has grown over the past few years, with more than 69% who say higher prices are impacting their overall diets, according to findings from a Pew Research Center survey.¹ Recently, Americans are experiencing sticker shock at the grocery store amid trends of obesity levels rising, waves of diet trends hitting, and social media suggestions exploding in popularity, along with the proliferation of food delivery options.

Notably, Americans eat at home far more commonly than they order takeout or delivery or eat at restaurants, based on the Pew Research Center survey conducted from February 24 to March 2, 2025, among 5123 US adults. Researchers found about 9 in 10 Americans eat home-cooked meals at least a few times a week, compared with 17% ordering takeout or delivery and 12% eating at restaurants frequently.

An estimated 7 in 10 Americans say the increased cost of healthy food in recent years has made it more difficult to maintain a healthy diet. A larger share of lower-income adults than upper-income express this view (77% vs 54%).

The price index for food away from home rose 0.3% in May, based on the consumer price index summary from the US Bureau of Labor Statistics.² The index for full service meals rose 0.3% over the month and the index for limited service meals also increased 0.3%. The food away from home index rose 3.8% over the last year. The index for full service meals rose 4.2%, and the index for limited service meals rose 3.5% over the same period.

High grocery prices lead to various challenges, including food insecurity, which is the household-level economic and social condition of limited or uncertain access to adequate quality of food.³ Factors like income, employment status, race/ethnicity, and disabilities can influence food security and determine whether it remains a long-term issue or temporary. Food insecurity is classified as a national public health crisis because inadequate access to nutritious food can harm the health of many Americans and worsen existing food and nutritional insecurity, as well as other social factors affecting health.

Unpacking Ultraprocessed Food Consumption

As grocery prices increase, many American households find themselves unable to buy healthy or healthier food options, pushing them toward ultraprocessed alternatives.⁴ Ultraprocessed foods are usually defined as ready-to-eat industrial products manufacturers create from food-derived ingredients combined with food additives through various industrial processes, and they design them to maximize industry profits. Individuals who rely on ultraprocessed foods are oftentimes nutritionally unbalanced, which further reveals the quality of the American diet and the body’s level of processing foods.

Americans pay 40% more for fruits and vegetables than they would in an ideally efficient market, which leads to decreased consumption, based on a study from the University of Warwick.⁵ High costs of healthy food constituted the biggest barrier to a healthier diet, 46% of respondents to a 2022 national Cleveland Clinic survey reported.⁶ Respondents also noted a lack of adequate time to prepare healthy meals (23%) and an unfamiliarity with healthy ways of cooking (20%). Minority communities expressed issues in accessing healthy foods, with about 20% of Black Americans finding it hard for them to access stores that sell healthy food compared with 15% of White Americans.

Greater exposure to ultraprocessed foods carries higher risks of all-cause mortality, cardiovascular disease–related mortality, common mental disorder outcomes, overweight and obesity, and type 2 diabetes.⁷ Asthma, gastrointestinal health, some cancers, and intermediate cardiometabolic risk factors remain potential additional impacts from ultraprocessed food consumption.

Individuals with a 10% increase in the proportion of ultraprocessed foods they consume face a 12% increase in overall cancer risk and an 11% increase in breast cancer risk, based on research from a large cohort study.⁸ Consumption of ultraprocessed foods also increases colorectal cancer risk. Ultimately, ultraprocessed foods contain higher calorie counts or produce high glycemic responses, often increasing weight gain.

Systemic Health Gaps, Policy Solutions Beyond Personal Choice

Black adults in the US who consumed significant amounts of ultraprocessed foods faced a 55% increased risk of high blood pressure compared with White adults who ate a similar amount of ultraprocessed foods, based on research presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference.⁹

Black adults in the top 25% of all participants for total ultraprocessed food consumption were 55% more likely than White adults to have incident hypertension. Interestingly, men and adults who had less education, had lower levels of physical activity, and household income below $35,000 annually consumed more ultraprocessed foods.

Individuals can alter their consumption of ultraprocessed foods on a personal level, but broad public policy changes are necessary for population-level impact.¹⁰ Communities with lower socioeconomic status offer fewer options when it comes to grocery stores, leading to unequal access to healthy foods like fresh fruits and vegetables. As such, experts say policy changes and incentive programs are crucial for overcoming disparities and inequalities.

Food banks and the Supplemental Nutrition Assistance Program (SNAP) are support systems for food-insecure families but are not tailored to target the complex factors of everyone.³ Advocates say policy makers should also be required to update SNAP benefits to better serve the needs and health of food-insecure individuals and households.

Interestingly, SNAP holders typically have the highest level of ultraprocessed food intake, likely due to these individuals’ higher risk of food insecurity, poverty, and poor health.¹¹ It is crucial for policies that increase access and affordability to less processed and unprocessed products to minimize obstacles to accessing alternatives to ultraprocessed food. SNAP participation further modified the association between food insecurity and ultraprocessed food consumption. This association was more pronounced for income-eligible and income-ineligible nonparticipants, and nonsignificant for SNAP participants.

Medical professionals should partake in screening patients for food insecurity, incorporate food insecurity education within appointments, and establish strategies for referring patients in need of community and government resources.³ Additional research should focus on better understanding prevalence, severity, and cost of food and nutrition insecurity as well as the impact this has on health care.

Bridging this gap requires comprehensive solutions, from updating SNAP benefits to encourage healthier choices to broad policy changes and incentive programs that improve access to fresh, less-processed foods in underserved areas. Ultimately, addressing this growing crisis demands a collaborative effort from policy makers, health care professionals, and communities to ensure all Americans have equitable access to the nutritious food essential for long-term health. 

References

1. Kikuchi E, Pula I, Yam E. Americans on healthy food and eating. Pew Research Center. May 7, 2025. Accessed June 18, 2025. https://www.pewresearch.org/science/2025/05/07/americans-on-healthy-food-and-eating/
2. Consumer price index summary. US Bureau of Labor Statistics. June 11, 2025. Accessed June 20, 2025. https://www.bls.gov/news.release/cpi.nr0.htm
3. Santoro C. Addressing food insecurity to improve physical, mental health outcomes. AJMC^®. November 28, 2024. Accessed June 23, 2025. https://www.ajmc.com/view/addressing-food-insecurity-to-improve-physical-mental-health-outcomes
4. Dunford EK, Miles DR, Popkin BM. Exploring disparities in the proportion of ultra-processed foods and beverages purchased in grocery stores by US households in 2020. Public Health Nutr. 2025;28(1):e85. doi:10.1017/S1368980025000606
5. Pancrazi R, van Rens T, Vukotić M. How distorted food prices discourage a healthy diet. Science Advances. 2022;8(13). doi:10.1126/sciadv.abi8807
6. Americans cite cost of heathy food as biggest barrier to a heart-healthy diet, according to Cleveland Clinic survey. News release. Cleveland Clinic; February 1, 2023. Accessed June 23, 2025. https://newsroom.clevelandclinic.org/2023/02/01/americans-cite-cost-of-heathy-food-as-biggest-barrier-to-a-heart-healthy-diet-according-to-cleveland-clinic-survey
7. Lane MM, Gamage E, Du S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ. 2024;384(8419):e077310. doi:10.1136/bmj-2023-077310
8. Fiolet T, Srour B, Sellem L, et al. Consumption of ultra-processed Foods and Cancer risk: Results from NutriNet-Santé Prospective Cohort. BMJ. 2018;360(360):k322. doi:10.1136/bmj.k322
9. Black adults in US who consume ultra-processed foods at greater risk for hypertension. American Heart Association. May 20, 2021. Accessed June 16, 2025. https://newsroom.heart.org/news/black-adults-in-u-s-who-consume-ultra-processed-foods-at-greater-risk-for-hypertension
10. Mahon SM. Here’s how to reduce our use of ultra-processed foods, as individuals and a society. Oncology Nursing Society. May 23, 2024. Accessed June 23, 2025. https://www.ons.org/publications-research/voice/news-views/05-2024/heres-how-reduce-our-use-ultra-processed-foods#google_vignette
11. Leung CW, Fulay AP, Parnarouskis L, Martinez-Steele E, Gearhardt AN, Wolfson JA. Food insecurity and ultra-processed food consumption: the modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP). Am J Clin Nutr. 2022;116(1):197-205. doi:10.1093/ajcn/nqac049