Global Plant-Based Food Intakes by Country Wealth and Socioeconomic Status: Findings from the Global Dietary Database

Abstract

Abstract Objectives Given the major interest in plant-based foods (PF) for global diets, we aimed to characterize inequalities in intakes of fruits, vegetables (non-starchy, potatoes, other starchy), legumes, grains (refined, whole), and nuts/seeds by country wealth and population socioeconomic status (SES). Methods PF intakes were derived from the Global Dietary Database, including 1144 national and subnational surveys from 1980 through 2015 covering 97.5% of the world's population. A Bayesian hierarchical prediction model combined stratum-specific individual-level intakes with survey-level and time-varying country-level (GDP, FAO's food balance sheets) covariates to estimate mean intakes and 95% uncertainty intervals jointly stratified by country (n = 185), year (1990–2015), sex, age (all ages, 20 age groups), urban-rural residence, and education (low, middle, high). Results Using the World Bank's country wealth categories, fruit intake, in 2015, was much higher in high-income (HIC) (120 g/d) and upper-middle income countries (UMIC) (107 g/d) compared with low (LIC) (72 g/d) and lower-middle income countries (LMIC) (68 g/d); and within nations, generally higher with higher education and in urban areas, except for HIC where it was higher for rural residents. Average intakes of non-starchy vegetables (148–153 g/d) and legumes (22–25 g/d) were similar by country wealth; highest vegetable consumption was among those of higher education in LIC. Legume consumption was highest among those of higher education in LIC and LMIC. Average refined and whole grain intakes were highest in HIC (128 and 42 g/d) and lowest in LIC (46 and 11 g/d), with notable heterogeneity by education; refined grains were highest with lower education in HIC and UMIC, whereas whole grains were highest with higher education. Findings on other PF, and over time will be presented. Conclusions Such global data provide novel evidence for substantial variation in PF intakes by country wealth, further linked to population SES, and can inform potential health impacts and country-specific nutrition policy priorities. Funding Sources Gates Foundation.