Abstract 17: Global diet quality among adults in 187 countries

Abstract

Background: Global quality and trends over time of dietary patterns, a priority for reducing chronic diseases, are unknown. Methods: We evaluated age- and sex-specific energy-adjusted consumption, derived from 325 national surveys covering 88.7% of the global adult population, of 17 key foods and nutrients in 187 countries in 1990 and 2010. Diet patterns were assessed by two distinct scales, one based on higher intakes of healthful items (higher intakes=higher scores), and the other on lower intakes of unhealthful items (lower intakes=higher scores), by country, age, sex, and national income. Results: In 2010, global diet patterns varied substantially ( Figure ). African and South Asian nations had low scores based on more healthful items, but high scores based on fewer unhealthful items. In contrast, Western countries had moderate scores based on healthful items and very poor scores based on unhealthful items. This distinction between more healthful items and fewer unhealthful items was largely masked if we aggregated the two pattern scores, which were weakly correlated ( r =-0.08). By age and sex, women and older adults had higher scores based on either healthful or unhealthful items ( p <0.05). Compared to low-income countries, high-income countries had higher scores based on more healthful items (+4.4 [95% uncertainty interval: 3.8, 5.0]), but substantially lower scores based on fewer unhealthful items (-28.1 [-27.3, -28.9]). From 1990 to 2010, most regions improved their diets based on more healthful items (global average=+2.2 [2.0, 2.4]), except for poorest nations; conversely, nearly all regions worsened their diets based on fewer unhealthful items (-2.5 [-2.8, -2.2]), with marked heterogeneity across global regions. Conclusions: Diet quality varies substantially worldwide, with important differences by higher intakes of healthier foods vs. lower intakes of unhealthy foods. The findings emphasize distinct, nation-specific policy priorities for increasing healthful and decreasing unhealthful foods.