On a scale of 0 to 100 of how well people adhere to recommended diets, with 0 being a poor diet (think excessive consumption of sugar and processed meats), and 100 representing the recommended balance of fruits, vegetables, legumes/fruits dry and whole grains, most countries would score around 40.3. Globally, this represents a small, but significant, 1.5-point increase between 1990 and 2018, researchers from Tufts University’s Friedman School of Nutrition Science and Policy report in “Nature Food.”
The study, one of the most comprehensive estimates to date of global diet quality – and the first to include results from children and adults – highlights the challenges that exist around the world in promoting healthy eating. Although global gains were modest, there was notable variation across countries, with nutritious options most popular in the US, Vietnam, China and Iran, and less so in Tanzania, Nigeria and Japan.
“Intake of legumes/nuts and non-starchy vegetables has increased over time, but overall improvements in diet quality have been offset by increased intake of unhealthy components, such as red/processed meat, sugary drinks and sodium,” says lead author Victoria Miller, a scientist at McMaster University in Canada and lead author of the paper.
The quality of the diet in detail
Poor diet is one of the leading causes of disease, responsible for 26% of preventable deaths worldwide. Although interventions and policies to support healthy eating are urgently needed, little is known about differences in diet quality according to demographic criteria such as age, gender, education or proximity to urban areas, useful information to guide public health campaigns.
Miller and colleagues addressed this gap by measuring global, regional, and national dietary patterns among adults and children in 185 countries, drawing on data from more than 1,100 World Health Organization surveys. World Dietetic Database, a large collection of data on food and nutrient consumption levels around the world. The main result of the researchers was the scale from 0 to 100 known as Alternative Healthy Eating Indexa validated measure of diet quality.
At the regional level, the averages ranged from a low of 30.3 in Latin America and the Caribbean to a high of 45.7 in South Asia. The average score of the 185 countries included in the study was 40.3. Only 10 countries, representing less than 1% of the world’s population, scored above 50. The highest scoring countries in the world were Vietnam, Iran, Indonesia and India, and the lowest scoring were Brazil, Mexico, the United States and Egypt.
Globally, among adults, women were more likely to follow recommended diets than men, and older adults more than young people.
Women were more likely to follow recommended diets than men
“Healthy eating was also influenced by socioeconomic factors, such as educational level and urbanity,” says Miller. “Globally and in most regions, more educated adults and children with more educated parents generally had higher overall dietary quality.”
“On average across the world, diet quality was also higher among younger children, but then worsened as children got older,” he adds. “This suggests that early childhood is an important time for intervention strategies to encourage the development of healthy food preferences.”
The researchers note that some limitations of the study need to be taken into account, such as measurement errors in the dietary data, incomplete survey availability in some countries, and lack of information on some important dietary considerations, such as trans fat intake. . However, the results offer key benchmarks for comparison as new information is added to the World Dietary Database.
Turn data into policies
The scientists say the scale and detail of the ‘Nature Food’ study allow nutrition researchers, health agencies and policymakers to better understand trends in dietary intake that can be used to set goals and invest in actions that promote healthy eating, such as promoting meals made up of produce, seafood, and vegetable oils.
“We found that both a shortage of healthy foods and an excess of unhealthy foods contributed to global challenges in reaching recommended dietary quality,” says Mozaffarian. “This suggests that policies that incentivize and reward more healthy foodas in healthcare, employer wellness programs, government nutrition programs, and agricultural policies, can have a substantial impact on improving nutrition in the United States and around the world.”