Abstract
Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million), micronutrient deficiencies (2 billion), and overweight or obesity (2.1 billion). We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.
Highlights
Assuring all people have access to sufficient and healthy food remains one of the world’s pressing challenges
National per capita daily energy availability (PCDEA) has increased steadily since 1961, except in South Asia, where it did not begin to increase substantially until 1981, and sub-Saharan Africa, where it did not begin to increase substantially until 1985 (Fig 1A)
We found that the Micronutrient Density Index (MDI) has improved over the past 50 years in most regions, but it has declined in sub-Saharan Africa
Summary
Assuring all people have access to sufficient and healthy food remains one of the world’s pressing challenges. Undernourishment (hunger) has been declining but remains very high at about 11% of the global population [1]. Poor quality diets can lead to micronutrient deficiencies, especially in populations with low total food intake. Such “hidden hunger” can cause pregnancy complications and child growth failure, increase susceptibility to disease, and impair cognitive development [2]. An increasing part of the world population consumes excessive amounts of food, which is associated with increased incidence of obesity and risk of diabetes and heart disease [3]. To improve access to healthy foods and reduce undernutrition and overnutrition, it is essential to understand how the food supply relates to these changing forms of malnutrition
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