- The researchers investigated how global dietary patterns changed between 1990 and 2018.
- They found that diets became modestly healthier by 2018.
- They concluded that dietary recommendations should be based on localized nutrition data.
Data shows that poor diets are responsible for about 26% of global preventable mortality. Existing evidence suggests that different foods and nutrients have synergistic and complementary effects when consumed together.
While what constitutes an optimal dietary pattern is largely Well established and validated, it remains unclear how common it is consumed globally.
Previous studies have been limited to small subsets of countries and generally did not included those under 25 years of age.
Studies investigating the dietary patterns of various countries across a broader age range could improve dietary guidelines and recommendations.
Researchers recently analyzed global, regional, and national dietary patterns and trends among adults and children from 185 counties.
They found that between 1990 and 2018, diets became slightly healthier, although the extent of this varied by country.
“In general, healthy diets have become more affordable as countries get richer,” Dr Boyd SwinburnProfessor of Epidemiology and Biostatistics at the University of Aukland, who was not involved in the study, said Today’s medical news.
“Also, the globalization of food means that the variety of whole foods has increased, which is good. But the countervailing forces of ultra-processed foods replacing whole foods and growing wealth inequalities are creating unhealthy diets,” Dr Swinburn added.
The study appears in Natural food.
The researchers collected nationally and subnationally representative survey data on individual-level dietary intake along with biomarker surveys.
In total, they collected data from 1,248 dietary surveys from 188 countries. Among the surveys, 73.9% included data from children aged 0 to 19 years and 64.5% from adults aged 20 years or older.
The researchers obtained data on individual-level dietary intake of up to 53 foods, beverages, and nutrients along with demographic data, such as age, gender, education, and urban or rural residence.
The researchers used the Alternative Healthy Eating Index (AHEI) to define a healthy diet. Victoria Miller, Ph.D.a researcher at the PHRI Population Health Research Institute and a visiting scientist at Tufts University, one of the study’s authors. MNT:
“The AHEI recommends that people eat plenty of fruits, vegetables, whole grains, nuts and legumes, polyunsaturated fats and omega-3 fats, and limited amounts of red and processed meat, sugar-sweetened beverages and sodium.”
In the end, the researchers ranked the diets on a scale of 0 to 100, with 0 being a poor diet and 100 being an optimal diet.
They found that between 1990 and 2018, the global AHEI score increased modestly by 1.5 points, from 38.8 in 1990 to 40.3.
They also found that in 2018 only ten countries representing less than 1% of the world’s population had dietary scores of 50 or higher. These included Vietnam, Iran, Indonesia, and India, with average scores of 54.5.
Meanwhile, the countries with the lowest scores included Brazil, Mexico, the United States and Egypt, with scores ranging from 27.1 to 33.5.
The researchers noted that the mean AHEI scores in 2018 for children and adults were similar, ranging from 38.2 to 42. However, in most regions, those younger than 5 years and those older than 75 years tended to have the highest AHEI scores.
Additionally, they wrote that, globally, children tended to consume fewer fruits, non-starchy vegetables and omega-3s from seafood than adults. However, they also consumed more sodium and polyunsaturated fat than adults.
The researchers further found that higher education attainment was associated with a higher AHEI score in most regions, except the Middle East, North Africa, and Sub-Saharan Africa, where they found no difference.
When asked how these findings could improve dietary choices around the world, Dr. Miller said:
“Our findings are useful in informing the design and implementation of future research and national policies to improve diet quality. Although South Asia and sub-Saharan Africa had the highest dietary quality in 2018, consumption of fruits, vegetables, legumes/nuts, omega-3 fats from seafood, and polyunsaturated fats were far from optimal in these regions. Policies to increase intake of produce, seafood and vegetable oils will have the greatest impact on diet quality in these countries.”
“In Asia and Latin America and the Caribbean, we found that red/processed meat and sodium increased over time, and policies focused on reducing intake of these foods and nutrients will greatly improve diet quality,” he added. .
“Low consumption of unhealthy foods and nutrients, such as sugary drinks, red/processed meat, and sodium, led to higher diet quality in many countries, including Vietnam. In the US, a two-pronged approach to increasing healthy foods (fruits, vegetables, vegetable oils) and reducing unhealthy foods (sugary beverages, sodium) is needed to improve diet quality,” he noted.
Dr Marco Springmanna senior researcher on environment and health at the University of Oxford, who was not involved in this study, also said MNT:
“The study also highlights that there has been little progress in improving diets around the world. This should be a wake-up call to policymakers who routinely dismiss the need for progressive food policies as interfering too much with the market.”
“Without clear policy measures that empower citizens to make healthy and sustainable dietary choices, we risk another decade without progress in improving diets and the health and environmental impacts associated with them,” he added.
The researchers concluded that their findings highlight the need for specific national and subnational policies to improve nutrition.
When asked about the limitations of the study, Dr Swinburn said: “The data on diets are notoriously challenging. There is always massive underreporting: About 20% of calories under optimal data collection conditions are never reported.”
“However, by taking a narrow approach like this, you start to see patterns that can tell you very useful things about underlying changes over time and differences between populations,” he added.
Rob M. van Dam, MDProfessor of Exercise and Nutritional Sciences at the Milken Institute School of Public Health, George Washington University, also said MNT: “The limitation of these findings is that the survey instruments and the precision of the data varied between countries.”
“Furthermore, the diet quality indices used in the study were developed in high-income countries to prevent chronic disease, but may be less suitable for low-income countries where nutrient deficiencies are common,” he added.
Salim Yusuf MD, D. Phil, Distinguished Professor of Physiology and Pharmacology at McMaster University, who was not involved in the study, agreed that the data-driven guidelines may not apply to most other regions of the world. He pointed out that malnutrition is a challenge for many, in addition to obtaining an adequate variety of food. He added that cultural habits, taste and cost also influence what people eat.
