The World Health Organization states that a healthy diet can reduce the risk of suffering from 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 portions of vegetables or fruits per day, less saturated and trans fats, unsaturated fats of plant origin, less processed meat and less salt. These guidelines are publicly available in the media and form part of the curricula that are taught to most children in schools around the world. But do we listen?
A comprehensive study, and the first to include findings for children as well as adults, reviewed more than 1,100 different surveys about food and nutrient consumption levels in 185 different countries between 1990 and 2018. Friedman School of Nutrition Science and Policy at Tufts UniversityThey obtained survey data from the World Food Database, a large and collaborative set of data on people’s dietary behavior. They analyzed the quality of diets at the global, national and regional level to understand the changes that have occurred since 1990.
The researchers used a scale known as Alternative Healthy Eating Index, an approved measure of diet quality that ranks people’s meals from 0 to 100. With this system, 0 represents a poor diet that does not meet the World Health Organization’s dietary recommendations and is loaded with added sugar, salt and saturated fat and is deficient in fruits and vegetables. For a score of 100 on this scale, a person’s diet should contain the recommended balance of fruits, vegetables, legumes/nuts, and whole grains, have minimal added sugar and salt, and use modest amounts of fat, mostly unsaturated fats from vegetable origin.
The results are published in the journal nature foods, that the average regional diet quality ranged from 30.3 in Latin America and the Caribbean to 45.7 in South Asia. The average score of all 185 countries included in the study was 40.3, which is a paltry 1.5 increase since 1990. Only 10 countries, representing less than 1 percent of the world’s population, had scores over 50. Vietnam was the countries Which scored the highest scores in the world. Iran, Indonesia and India, the lowest scores were Brazil, Mexico, the United States and Egypt.
“Intake of legumes/nuts and non-starchy vegetables increased over time, but the overall improvement in diet quality was offset by increased intake of unhealthy ingredients such as red/processed meat, sugar-sweetened beverages, and sodium,” said study lead author Victoria. Miller, visiting scientist from McMaster University.
These findings seem to highlight the fact that we don’t really listen to WHO guidance. Although there has been little improvement globally in the past 30 years, it is clear that there are significant challenges to implementing healthy eating behavior in most countries. There was evidence that nutritious eating options were becoming more popular in the United States, Vietnam, China and Iran, but this trend was not present in other countries, such as Tanzania, Nigeria and Japan.
Globally, diets have been influenced by demographic factors, with adult women more likely to eat the recommended diets than adult men, and older adults eating more healthily than younger adults. In addition, young children had better nutritional quality than adolescents.
“On average around the world, diet quality was also higher among younger children but then worsened 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 and urban level. Globally and in most regions, more educated adults and children with more educated parents generally have higher nutritional quality.”
The researchers say that although the study has some limitations, the results provide key benchmarks for comparison as new information is added to the global nutritional database. In addition, their findings provide nutrition researchers, health agencies, and policy makers the opportunity to understand trends in dietary intake and take appropriate actions to encourage healthy eating in the future, such as promoting meals consisting of fresh produce, seafood and vegetable oils.
“We found that both a lack of healthy foods and a lot of unhealthy foods contribute to global challenges in achieving recommended nutritional quality,” said a study co-author. Dariush Mozaffarian. “This suggests that policies that incentivize and reward more healthy foods, such as health care, employer wellness programs, government nutrition programs, and agricultural policies, may have a significant impact on improving nutrition in the United States and around the world.”
The research team then plans to look at estimating how different aspects of poor diets contribute to major disease states around the world, as well as to model the effects of different policies and programs to improve diets at the global, regional and national levels.
This research was supported by Grants from the Bill & Melinda Gates Foundation and the American Heart Association.
by Alison BosmanAnd the Earth.com crew clerk