Abstract
Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.
Highlights
The obesity epidemic is becoming the greatest public health concern worldwide.Globally, current data suggest that 1307 million adults are overweight and 671 million are obese, and the number of cases in low- and middle-income countries (LMIC) are rapidly reaching those observed in high-income countries (HIC) [1]
This review synthesized the evidence from observational and intervention studies reporting the adherence to national food-based dietary guidelines (FBDGs) in individuals from both HIC and LMIC
This review found that a large proportion of individuals in both HIC and LMIC are not meeting national dietary guidelines
Summary
The obesity epidemic is becoming the greatest public health concern worldwide. Current data suggest that 1307 million adults are overweight and 671 million are obese, and the number of cases in low- and middle-income countries (LMIC) are rapidly reaching those observed in high-income countries (HIC) [1]. Morbidity and mortality related to obesity have been shown to follow a socio-economic gradient, with higher rates of chronic non-communicable diseases (NCD) among those from lower socio-economic positions [2]. Along with other lifestyle behaviors, is an important risk factor for many. NCD, and a large number of dietary components have been shown to be socio-economically patterned [3–5]. Globalization has accelerated diet and lifestyle changes—as seen with the westernization of diet quality [6]
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