Global diet quality has not improved in the past 30 years •

The World Health Organization states that a healthy diet can reduce our risk of developing non-communicable diseases and conditions such as obesity, high blood pressure, heart disease, stroke, diabetes and cancer. A healthy diet should include at least five servings of vegetables or fruit per day, fewer saturated and trans fats, more unsaturated fats of plant origin, less processed meat, and less salt. These guidelines are publicly available in the media and form part of the curriculum taught to most children in schools around the world. But are we listening?

A comprehensive study, including results for children and adults for the first time, has now reviewed more than 1,100 different food and nutrient consumption surveys in 185 different countries between 1990 and 2018. The researchers, from the Friedman School of Nutrition Science and Policy at Tufts University, obtained the survey data from the Global Dietary Database, a large, collaborative compilation of data on people’s dietary behaviors. They analyzed diet quality at global, national and regional levels to understand the changes that have occurred since the 1990s.

Researchers used a scale known as the Alternative Healthy Eating Index, a validated measure of diet quality that ranks people’s diets from 0 to 100. In this system, 0 represents a poor diet, not meeting WHO dietary recommendations, overloaded with added sugars, salt, and saturated fat, and deficient in fruits and vegetables. To score 100 on this scale, a person’s diet must contain the recommended balance of fruits, vegetables, legumes/nuts, and whole grains, contain minimal added sugar and salt, and use modest amounts of fat, primarily unsaturated fats of plant origin.

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The results published in the journal health food, showed that regional average diet quality ranged from just 30.3 in Latin America and the Caribbean to 45.7 in South Asia. The average score for all 185 countries included in the study was 40.3, a paltry increase of 1.5 since 1990. Only 10 countries, representing less than 1 percent of the world’s population, had scores above 50. The countries with the highest scores in the world were Vietnam, Iran, Indonesia, and India, and the worst performers were Brazil, Mexico, the United States, and Egypt .

“Intakes of legumes/nuts and non-starchy vegetables increased over time, but overall improvements in diet quality were offset by increased intake of unhealthy components such as red/processed meat, sugar-sweetened beverages and sodium,” said the study’s lead author , Victoria Miller, a visiting scholar from McMaster University.

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These results seem to underscore the fact that we don’t really listen to WHO guidelines. Although there has been a small improvement globally over the past 30 years, there are clearly significant challenges in implementing healthy eating behaviors in most countries. There was evidence that nutritious eating options had become more popular in the United States, Vietnam, China and Iran, but this trend was not seen in other countries such as Tanzania, Nigeria and Japan.

Diets around the world have been influenced by demographic factors, with adult women consuming recommended diets more often than adult men and older adults eating healthier than younger adults. In addition, young children had better nutrition than teenagers.

“On global average, nutritional quality was also better in younger children, but then deteriorated as children got older,” Miller said. “This suggests that early childhood is an important time for intervention strategies to encourage the development of healthy food preferences.”

“Healthy eating has also been influenced by socioeconomic factors, including educational attainment and urbanity. Globally and in most regions, better educated adults and children with better educated parents generally had higher overall diet quality.”

The researchers say that while the study has some limitations, the results provide important benchmarks for comparison as new information is added to the Global Dietary Database. In addition, their results offer nutrition researchers, public health officials and policy makers the opportunity to understand trends in food intake and take appropriate actions to promote healthy eating in the future, e.g. B. Promoting meals made from fresh produce, seafood and vegetable oils.

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“We found that both too little healthy food and too much unhealthy food contribute to global challenges in achieving recommended dietary quality,” said study co-author Dariush Mozaffarian. “This suggests that policies that promote and reward healthier food, such as in healthcare, employer wellness programs, government nutrition programs, and agricultural policies, have a significant impact on improving nutrition in the United States and around the world.” can have.”

Next, the research team plans to assess how different aspects of poor nutrition contribute to major disease states around the world, as well as to model the impact of different nutritional improvement policies and programs at global, regional and national levels.

This research was supported by Grants from the Bill and Melinda Gates Foundation and the American Heart Association.

Through Alison Bosman, Staff writer

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