Global dietary quality study highlights the challenges to encourage healthy eating

On a scale of 0 to 100 that indicates how well people stick to recommended diets, where 0 is poor nutrition (think heavy consumption of sugar and processed meat) and 100 is the recommended balance of fruits, vegetables, legumes/nuts and whole grains, most countries would score around 40.3. Globally, that represents a small but significant gain of 1.5 points between 1990 and 2018, researchers at Tufts University’s Friedman School of Nutrition Science and Policy report today in the journal health food.

The study, one of the most comprehensive estimates of global diet quality to date – and the first to include findings in both children and adults – highlights the challenges worldwide to promoting healthy eating. Although global gains have been modest, there have been notable differences between countries, with nutritious options rising in popularity in the United States, Vietnam, China and Iran, and less so in Tanzania, Nigeria and Japan.

“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 meats, sugar-sweetened beverages and sodium,” says lead author Victoria Miller , a visiting scholar from McMaster University in Canada, who began this study as a postdoctoral fellow with Dariush Mozaffarian, Dean of Policy and Jean Mayer Professor of Nutrition at the Friedman School, and senior author of the paper.

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Nutritional quality in detail

Poor nutrition is a leading cause of disease and is responsible for 26% of preventable deaths worldwide. While interventions and strategies to support healthy eating are urgently needed, little is known about disparities in diet quality across demographics such as age, gender, education or proximity to urban areas – useful information for targeted public health campaigns.

Miller and colleagues bridged this gap by measuring global, regional, and national eating habits among adults and children in 185 countries, based on data from over 1,100 surveys from the Global Dietary Database, a large, collaborative compilation of data on the world’s food and nutrient consumption. The researchers’ primary outcome was the 0 to 100 scale known as the Alternative Healthy Eating Index, a validated measure of diet quality.

Regionally, averages 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. 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 countries with the lowest scores were Brazil, Mexico, and the United States and Egypt.

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Among adults, women were more likely to eat than men and older adults more than younger adults worldwide.

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.”

Victoria Miller, lead author

“On global average, nutritional quality was also better in younger children, but then deteriorated as children got older,” she 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 there are some study imperfections to consider, including measurement errors in dietary data, incomplete availability of surveys in some countries, and a lack of information on some important dietary considerations, such as: B. the intake of trans fats. However, the results provide important benchmarks for comparison as new information is added to the Global Dietary Database.

Making politics out of data

The researchers say that the scale and detail of the health food The study allows nutrition researchers, public health officials and policy makers to better understand trends in food intake, which can be used to set goals and invest in actions that promote healthy eating, such as eating healthy food. B. Promoting meals consisting of 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,” says Mozaffarian. “This suggests that policies that provide incentives and rewards for healthier food, such as health care, employer wellness programs, government nutrition programs, and agricultural policies, have a significant impact on improving nutrition in the United States and around the world.” world.”

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

This research was supported by Grants from the Bill and Melinda Gates Foundation and the American Heart Association. Full information on authors, funders and conflicts of interest is available in the published paper.


Magazine reference:

Mueller, V., et al. (2022) Global nutrition quality in 185 countries from 1990 to 2018 shows large differences by nation, age, education and urbanity. health food.

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