Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity
Victoria Miller, Patrick Webb, Frederick Cudhea, Peilin Shi, Jianyi Zhang, Julia Reedy, Josh Erndt‐Marino, Jennifer Coates, Dariush Mozaffarian, Global Dietary Database, Murat Baş, Jemal Haidar, Suhad Abumweis, Anand Krishnan, Puneet Misra, Nahla Chawkat Hwalla, Chandrashekar Janakiram, Nur Indrawaty Liputo, Abdulrahman O. Musaiger, Farhad Pourfarzi, Iftikhar Alam, Karin DeRidder, Céline Termote, Anjum Memon, Aida Turrini, Elisabetta Lupotto, Raffaela Piccinelli, Stefania Sette, Karim Anzid, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Tamene Taye Asayehu, Francis Oduor, Julia Boedecker, Lilian Aluso, Johana Ortíz‐Ulloa, J.V. Meenakshi, Michelle Alessandra de Castro, Giuseppe Grosso, Anna Waśkiewicz, Umber S. Khan, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Marga C. Ocké, Zohreh Etemad, Mohannad Al Nsour, Lydiah M. Waswa, Eha Nurk, Joanne E Arsenault, Patricio López‐Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Carukshi Arambepola, Carla Lopes, Mílton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana Lindström, Suvi Μ. Virtanen, Cristina Palacios, Eva Roos, Imelda Angeles‐Agdeppa, Josie Desnacido, Mario V. Capanzana, Anoop Misra, Ilse Khouw, Swee Ai Ng, Edna Gamboa Delgado, Mauricio Caballero, Johanna Otero, Hae‐Jeung Lee, Eda Köksal, Idris Guessous, Carl Lachat, Stefaan De Henauw, Ali Reza Rahbar, Alison Tedstone, Androniki Naska, Angie Mathee, Annie Ling, Bemnet Tedla, Beth Hopping, Brahmam Ginnela, Catherine Leclercq, Charmaine Duante, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Colin D. Rehm, Coline van Oosterhout, Corazon Cerdeña, Debbie Bradshaw, Dimitrios Trichopoulos, Dorothy Gauci, Dulitha Fernando
Abstract
Evidence on what people eat globally is limited in scope and rigour, especially as it relates to children and adolescents. This impairs target setting and investment in evidence-based actions to support healthy sustainable diets. Here we quantified global, regional and national dietary patterns among children and adults, by age group, sex, education and urbanicity, across 185 countries between 1990 and 2018, on the basis of data from the Global Dietary Database project. Our primary measure was the Alternative Healthy Eating Index, a validated score of diet quality; Dietary Approaches to Stop Hypertension and Mediterranean Diet Score patterns were secondarily assessed. Dietary quality is generally modest worldwide. In 2018, the mean global Alternative Healthy Eating Index score was 40.3, ranging from 0 (least healthy) to 100 (most healthy), with regional means ranging from 30.3 in Latin America and the Caribbean to 45.7 in South Asia. Scores among children versus adults were generally similar across regions, except in Central/Eastern Europe and Central Asia, high-income countries, and the Middle East and Northern Africa, where children had lower diet quality. Globally, diet quality scores were higher among women versus men, and more versus less educated individuals. Diet quality increased modestly between 1990 and 2018 globally and in all world regions except in South Asia and Sub-Saharan Africa, where it did not improve.