Global Dietary Database Research Articles

Dietary inflammatory potential: a comprehensive approach to the inclusion of flavonoids

Abstract The Dietary Inflammatory Index (DII) has been widely used to estimate dietary inflammation. However, most studies do not consider the six classes of flavonoids (6F) included in the original DII. This study aimed to develop two new tools, the Complete-DIP (CDIP) and Short-DIP (SDIP), to estimate the Energy-adjusted Dietary Inflammatory Potential (DIP) in adults while exploring the benefit of including the 6F. An open-access reference population (RP) was created from the Global Dietary Database (GDD) to calculate DIP. CDIP considered 38 food parameters (FP), whereas SDIP excluded the 6F and considered 32 FP. CDIP and SDIP were estimated for 3501 participants aged 18-84 from the IAN-AF. FP intake z-scores were calculated using FPs from the RP. Centred percentiles were multiplied by the FP’s inflammatory effects (IE) to obtain FP-specific DIP, which were then summed to achieve the individual DIP. IE were retrieved from the literature. Lower DIP values indicated more anti-inflammatory diets. Linear regressions assessed the association between sociodemographic factors and diet quality (measured with the Healthy Eating Index (HEI)) with DIP. Pearson’s test evaluated the correlation between CDIP and SDIP. The mean and standard deviation for CDIP and SDIP were 0.00±2.17 and 0.02±1.74, respectively. Men had more pro-inflammatory diets than women using CDIP (β = 0.354[95%CI:0.209,0.499]), but this effect was not statistically significant when using the SDIP. Older adults had more anti-inflammatory diets than adults (CDIP: β=-0.668[95%CI:-0.850,-0.486]; SDIP: β=-0.548[95%CI:-0.529,-0.076]). Participants with lower diet quality (Q1 of HEI vs Q4) had higher DIP (CDIP: β = 2.309[95%CI:2.116,2.502]; SDIP: β = 2.185[95%CI:2.037,2.334]). A very strong correlation between the CDIP and the SDIP was observed (r = 0.94). Results suggest that CDIP and SDIP may be equally successful in estimating dietary inflammation. However, the advantage of adding the 6F to evaluate the DIP needs further research. Key messages • This study created two open-access energy-adjusted dietary inflammatory potentials (DIP), with and without flavonoids. • Results suggest that flavonoids may not be essential for accurate DIP estimations.

Global estimation of dietary micronutrient inadequacies: a modelling analysis

Inadequate micronutrient intakes and related deficiencies are a major challenge to global public health. Analyses over the past 10 years have assessed global micronutrient deficiencies and inadequate nutrient supplies, but there have been no global estimates of inadequate micronutrient intakes. We aimed to estimate the global prevalence of inadequate micronutrient intakes for 15 essential micronutrients and to identify dietary nutrient gaps in specific demographic groups and countries. In this modelling analysis, we adopted a novel approach to estimating micronutrient intake, which accounts for the shape of a population's nutrient intake distribution and is based on dietary intake data from 31 countries. Using a globally harmonised set of age-specific and sex-specific nutrient requirements, we then applied these distributions to publicly available data from the Global Dietary Database on modelled median intakes of 15 micronutrients for 34 age-sex groups from 185 countries, to estimate the prevalence of inadequate nutrient intakes for 99·3% of the global population. On the basis of estimates of nutrient intake from food (excluding fortification and supplementation), more than 5 billion people do not consume enough iodine (68% of the global population), vitamin E (67%), and calcium (66%). More than 4 billion people do not consume enough iron (65%), riboflavin (55%), folate (54%), and vitamin C (53%). Within the same country and age groups, estimated inadequate intakes were higher for women than for men for iodine, vitamin B12, iron, and selenium and higher for men than for women for magnesium, vitamin B6, zinc, vitamin C, vitamin A, thiamin, and niacin. To our knowledge, this analysis provides the first global estimates of inadequate micronutrient intakes using dietary intake data, highlighting highly prevalent gaps across nutrients and variability by sex. These results can be used by public health practitioners to target populations in need of intervention. The National Institutes of Health and the Dutch Ministry of Foreign Affairs.

How well global dietary intake estimates agree: a case of sodium consumption.

Global dietary data repositories are key components of nutrition surveillance. The two most comprehensive databases, the Global Dietary Database (GDD) and the Global Burden Disease (GBD), provide national dietary intake estimates but use different data sources and models to generate estimates. To explore the agreement between GDD and GBD estimates, we compared country-specific average daily sodium intakes in 169 countries over a 28-year period using descriptive statistics, the Bland-Altman method, and prevalence exceeding the intake reference level of 2.3g/day. We detected a staggering 36% difference between GDD and GBD estimates of global mean intakes (2.68 ± 0.74 vs. 3.88 ± 1.15g/day, respectively; p < 0.0001). As 104 (61.5%) countries reported to have over-consumed sodium by both databases, the development of standardized approaches for national dietary intake estimation is critical for monitoring global sodium intake in a systematic and comprehensive way and for implementing global strategies to reduce sodium intake.

Abstract 2212: Global cancers attributable to modifiable risk factors: Dietary factors of animal origin

Abstract Cancer is the leading cause of death worldwide. Modifiable risk factors including diet have been linked to a wide range of malignancies. We estimated the global cancer population-attributable fraction (PAF) to established and suspected dietary cancer risk factors according to the Human Development Index (HDI).Diet-cancer associations were selected from WCRF, GBD and IARC report. Dietary factors of animal origin include red meat, processed meat, fish and dairy products; cancers include nasopharynx, esophageal, stomach, colorectal, pancreatic, lung, prostate, breast cancer. Gender-specific PAF were calculated based on 1) the total and gender-specific 2022 country-specific population from World Bank; 2) the country-specific average daily dietary factors intake (g/day) for 2000-2005 from the Global Dietary Database; 3) relative risks from the meta-analyses and WCRF reports; 4) country-specific 2020 cancer incidence from WHO. Estimates were also stratified by Human Development Index (HDI).Table 1 provides the results. The PAF for red meat and processed meat was higher in high HDI countries, while that for low dairy product intake was higher in low HDI countries. According to results, changes in selected dietary factors can prevent cancer-related incidence, particularly depending on where development status of countries and access to the source of their intake. Table1: Population attributable fractions for incidence of cancer in 2020 by gender. Dietary factors and Related Cancers Relative risk (g/day) AF (N. global) – Both gender AF (N. global)- Female AF (N. global)- Male Red meat Nasopharynx(L) 1.35(100) 0.103(13750.2) 0.102(3734.9) 0.104(10015.3) Colorectal (S) 1.12(100) 0.040(78714.5) 0.040(33981.2) 0.041(44733.2) Pancreatic (L) 1.11(100) 0.037(27420.3) 0.036(8479.8) 0.037(18940.4) Lung (L) 1.22(100) 0.070(155986.9) 0.069(52442.6) 0.070(103544.4) Prostate(L) 1.04(100) 0.014(20665.6) - 0.014(20665.6) Effect on total cancers * 0.016(296537.5) 0.011(98638.5) 0.021 (197898.9) Processed meat Nasopharynx(L) 1.46(30) 0.164(22194.6) 0.154(5637.4) 0.173(16557.1) Esophagus(L) 1.3(100) 0.036(22654.9) 0.034(6345.8) 0.038(16309.2) Stomach(L) 1.21(50) 0.052(60325.8) 0.049(18161.7) 0.055(42164) Colorectal (S) 1.18(100) 0.023(45460.9) 0.021(18522.8) 0.024(26938.1) Pancreatic(L) 1.17(50) 0.043(21900.2) 0.040(9414.4) 0.046(12485.8) Lung (L) 1.14(50) 0.036(82762.9) 0.034(26023.9) 0.038(56739) Effect on total cancers * 0.014(255299.3) 0.010(84106) 0.018(171193.2) Dairy products Colorectal(S) 0.87(400) 0.092(180063.4) 0.091(77598.8) 0.093(102464.6) Breast (L) 0.95(200) 0.068(151960.9) 0.068(151960.9) - Prostate (L) 1.07(400) 0.016(24224.3) - 0.016(24224.3) Effect on total cancers * 0.019(356248.6) 0.026(229559.7) 0.013(126688.9) Fish Colorectal (L) 0.89(100) 0.022(44882.9) 0.022(18705.9) 0.024(26177) Effect on total cancers * 0.002(44882.9) 0.002(18705.9 0.003(26177) Mean (g/day) of global intake Processed meat (B=14.2/M=15.1/F=13.3), red meat (B=36.5/M=36.9/F=36), fish(B=23/M=22.1/F=23.8), dairy products(B=77/M=74.9/F=79)S=strong evidenceL=limited evidence*All cancers excl. non-melanoma skin cancer (B= 18094716/F=8751759/M=9342957) 1 Citation Format: Monireh Sadat Seyyedsalehi, Edward Giovannucci, Paolo Boffetta. Global cancers attributable to modifiable risk factors: Dietary factors of animal origin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2212.

Aging Increases Global Annual Food Greenhouse Gas Emissions up to 300 Million Tonnes by 2100.

The dietary preferences of the elderly population exhibit distinct variations from the overall averages in most countries, gaining increasing significance due to aging demographics worldwide. These dietary preferences play a crucial role in shaping global food systems, which will result in changed environmental impacts in the future such as greenhouse gas (GHG) emissions. We present a quantitative evaluation of the influence of population aging on the changes in GHG emissions from global food systems. To achieve this, we developed regional dietary coefficients (DCs) of the elderly based on the Global Dietary Database (GDD). We then reconciled the GDD with the dataset from the Food and Agriculture Organization of the United Nations (FAO) to calculate the food GHG emissions of the average population in each of the countries. By applying the DCs, we estimated the national food GHG emissions and obtained the variations between the emissions from aged and average populations. We employed a modified version of the regional integrated model of climate and the economy model (RICE) to forecast the emission trends in different countries based on FAO and GDD data. This integrated approach allowed us to evaluate the dynamic relationships among aging demographics, food consumption patterns, and economic developments within regions. Our results indicate that the annual aging-embodied global food GHG emissions will reach 288 million tonnes of CO2 equivalent (Mt CO2e) by 2100. This estimation is crucial for policymakers, entrepreneurs, and researchers as it provides insights into a potential future environmental challenge and emphasizes the importance of sustainable food production and consumption strategies to GHG emission mitigations associated with aging dietary patterns.

Harmonising dietary datasets for global surveillance: methods and findings from the Global Dietary Database.

The Global Dietary Database (GDD) expanded its previous methods to harmonise and publicly disseminate individual-level dietary data from nutrition surveys worldwide. Analysis of cross-sectional data. Global. General population. Comprehensive methods to streamline the harmonisation of primary, individual-level 24-h recall and food record data worldwide were developed. To standardise the varying food descriptions, FoodEx2 was used, a highly detailed food classification and description system developed and adapted for international use by European Food Safety Authority (EFSA). Standardised processes were developed to: identify eligible surveys; contact data owners; screen surveys for inclusion; harmonise data structure, variable definition and unit and food characterisation; perform data checks and publicly disseminate the harmonised datasets. The GDD joined forces with FAO and EFSA, given the shared goal of harmonising individual-level dietary data worldwide. Of 1500 dietary surveys identified, 600 met the eligibility criteria, and 156 were prioritised and contacted; fifty-five surveys were included for harmonisation and, ultimately, fifty two were harmonised. The included surveys were primarily nationally representative (59 %); included high- (39 %), upper-middle (21 %), lower-middle (27 %) and low- (13 %) income countries; usually collected multiple recalls/ records (64 %) and largely captured both sexes, all ages and both rural and urban areas. Surveys from low- and lower-middle v. high- and upper-middle income countries reported fewer nutrients (median 17 v. 30) and rarely included nutrients relevant to diet-related chronic diseases, such as n-3 fatty acids and Na. Diverse 24-h recalls/records can be harmonised to provide highly granular, standardised data, supporting nutrition programming, research and capacity development worldwide.

How prices and income influence global patterns in saturated fat intake by age, sex and world region: a cross-sectional analysis of 160 countries

ObjectiveWhen considering proposals to improve diets, it is important to understand how factors like price and income can affect saturated fat (SF) intake and demand. In this study, we examine...

Do Global Dietary Nutrient Datasets Associate with Human Biomarker Assessments? A Regression Analysis

BackgroundTo assess the state and trends of global nutrition, our best tools are nationally representative assessments using human biomarker assays, yet these are expensive and logistically challenging. We instead often rely on more easily produced global nutrient datasets—measures of nutrients provided by the diet—as a proxy for nutritional intake and deficiency, due to their greater geographic and temporal coverage. However, the accuracy of global nutrient datasets is questionable. ObjectiveWe aimed to test whether estimates of inadequate dietary intake derived from existing global nutrient datasets reliably associate with biophysical deficiency. DesignWe performed linear regressions of estimates of inadequate dietary nutrient intake derived from three global nutrient datasets—Global Dietary Database, Global Nutrient Database, and Global Expanded Nutrient Supply (GENuS) model—against the existing suite of nationally representative biomarker survey data for three key nutrients of global concern in two vulnerable demographic groups: zinc, folate, and vitamin A in females of childbearing age; and zinc and vitamin A in children younger than 5 y. ResultsWe found significant associations (P < 0.1) for only 3 of 22 regressions between global nutrition datasets and biophysical deficiency: zinc for females of childbearing age from GENuS and Global Dietary Database, and zinc for children under 5 y from GENuS. Folate and vitamin A show no reliable relationship between nutrient datasets and independent biomarker surveys. Applying the successful models for zinc to the accompanying full datasets yield estimates of global zinc deficiency of 31%–37% for these demographic groups. ConclusionsWe found that few estimates of nutritional inadequacy from global dietary datasets are associated with more direct measures of biophysical deficiency from biomarker studies. Researchers and policymakers must be cautious when applying global nutrient datasets to questions of global health and use them for limited applications.

Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries

Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.

P17-039-23 Global, Regional, and National Consumption of Sugar-Sweetened Beverages in Children and Adolescents Between 1990 and 2018: New Findings From the Global Dietary Database

P17-039-23 Global, Regional, and National Consumption of Sugar-Sweetened Beverages in Children and Adolescents Between 1990 and 2018: New Findings From the Global Dietary Database

PTFS06-06-23 Discrepancies in Intake Estimates for Select Dietary Factors in Two Dietary Databases: Global Burden of Disease and Global Dietary Database

PTFS06-06-23 Discrepancies in Intake Estimates for Select Dietary Factors in Two Dietary Databases: Global Burden of Disease and Global Dietary Database

P14-011-23 Testing the Agreement of the EAT-Lancet Diet and Dietary Intakes From Two Databased: Global Dietary Database and Global Burden of Disease Database

P14-011-23 Testing the Agreement of the EAT-Lancet Diet and Dietary Intakes From Two Databased: Global Dietary Database and Global Burden of Disease Database

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.

The Global Association between Egg Intake and the Incidence and Mortality of Ischemic Heart Disease-An Ecological Study.

The relationship between egg consumption and ischemic heart disease (IHD) remains controversial as there is still no clear answer regarding the relationship, with research limited to a few geographical regions. In the current study, we conducted a longitudinal analysis of the association between egg intake and IHD incidence (IHDi) and mortality (IHDd) using 28 years of international data from 1990 to 2018. Egg intake (g/day/capita) by country was obtained from the Global Dietary Database. Age-standard IHDi and IHDd rates per 100,000 subjects in each country were obtained from the 2019 Global Burden of Disease database. The analysis included a total of 142 countries with populations of at least one million, for which all data were available from 1990 to 2018. Eggs are consumed worldwide, and regional differences in consumption are also shown. Utilizing IHDi and IHDd as objective variables and egg intake as an explanatory variable, the analysis was conducted using linear mixed models, which controlled for inter- and intra-country variation from year to year. The results showed a significant negative association between egg intake, and IHDi (-0.253 ± 0.117, p < 0.05) and IHDd (-0.359 ± 0.137, p < 0.05). The analysis was carried out using R 4.0.5. The results suggest that adequate egg intake might suppress IHDi and IHDd on a global scale.

Machine learning-based colorectal cancer prediction using global dietary data

BackgroundColorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. Active health screening for CRC yielded detection of an increasingly younger adults. However, current machine learning algorithms that are trained using older adults and smaller datasets, may not perform well in practice for large populations.AimTo evaluate machine learning algorithms using large datasets accounting for both younger and older adults from multiple regions and diverse sociodemographics.MethodsA large dataset including 109,343 participants in a dietary-based colorectal cancer ase study from Canada, India, Italy, South Korea, Mexico, Sweden, and the United States was collected by the Center for Disease Control and Prevention. This global dietary database was augmented with other publicly accessible information from multiple sources. Nine supervised and unsupervised machine learning algorithms were evaluated on the aggregated dataset.ResultsBoth supervised and unsupervised models performed well in predicting CRC and non-CRC phenotypes. A prediction model based on an artificial neural network (ANN) was found to be the optimal algorithm with CRC misclassification of 1% and non-CRC misclassification of 3%.ConclusionsANN models trained on large heterogeneous datasets may be applicable for both younger and older adults. Such models provide a solid foundation for building effective clinical decision support systems assisting healthcare providers in dietary-related, non-invasive screening that can be applied in large studies. Using optimal algorithms coupled with high compliance to cancer screening is expected to significantly improve early diagnoses and boost the success rate of timely and appropriate cancer interventions.

Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity

Evidence on what people eat globally is limited in scope and rigour, especially as it relates to children and adolescents. This impairs target setting and investment in evidence-based actions to support healthy sustainable diets. Here we quantified global, regional and national dietary patterns among children and adults, by age group, sex, education and urbanicity, across 185 countries between 1990 and 2018, on the basis of data from the Global Dietary Database project. Our primary measure was the Alternative Healthy Eating Index, a validated score of diet quality; Dietary Approaches to Stop Hypertension and Mediterranean Diet Score patterns were secondarily assessed. Dietary quality is generally modest worldwide. In 2018, the mean global Alternative Healthy Eating Index score was 40.3, ranging from 0 (least healthy) to 100 (most healthy), with regional means ranging from 30.3 in Latin America and the Caribbean to 45.7 in South Asia. Scores among children versus adults were generally similar across regions, except in Central/Eastern Europe and Central Asia, high-income countries, and the Middle East and Northern Africa, where children had lower diet quality. Globally, diet quality scores were higher among women versus men, and more versus less educated individuals. Diet quality increased modestly between 1990 and 2018 globally and in all world regions except in South Asia and Sub-Saharan Africa, where it did not improve.

Legumes-A Comprehensive Exploration of Global Food-Based Dietary Guidelines and Consumption.

Despite the well-known human and planetary health benefits of legumes, consumption is often low. This scoping review aimed to evaluate the inclusion of legumes in global food-based dietary guidelines (FBDG), and to review consumption data against global food group classifications for legumes. The review of FBDG from 94 countries identified legume-based key messaging, the key terms used to define legumes, recommended serving size and frequency of consumption and the classification of legumes into food groups as depicted by food guides. The 2018 Global Dietary Database isolated consumption data of legumes and beans using individual-level, nationally representative dietary survey data for matched countries. Food-based dietary guidelines from 40/94 countries most often identified legumes utilising the term legumes, followed by beans (n = 13), pulses (n = 10), or as beans, peas and lentils (n = 5). The serving size recommendations for legume consumption varied widely, and there was no consistency in the suggested frequency of consumption. Median bean and legume consumption for countries with FBDG ranged from 1.2 g/d (Norway) to 122.7 g/d (Afghanistan). Classification of legumes into food groups varied, with 38% of countries categorising legumes in the protein-rich food group, 20% were in a group on their own and 15% were in the starchy staples group. In countries where legumes were together with either nuts or seeds had the greatest range in intake (11.6–122.7 g/day), followed by those that grouped legumes together with protein-rich foods (4.0–104.7 g/day), while countries that grouped legumes into two food groups, in an attempt to promote consumption, tended to have a lower consumption. Greater emphasis and perhaps repositioning of legumes in dietary guidelines may be required to encourage consumption for health, environmental and economic benefits.

The Power of Women: Does increasing women's parliamentary representation reduce intake of sugar-sweetened beverages among children and adolescents?

Consumption of sugar-sweetened beverages (SSBs) is associated with overweight and obesity in children and adolescents. Although existing research confirms the significance of economic and social factors as determinants of SSB intake, comparative studies on political factors and cross-national analyses are lacking. Research indicates that including women in the process of political decision-making promotes healthcare and child protection. This study examined how women's parliamentary representation influences children's and adolescents' SSB intake compared to adults. The study used cross-national food and beverage intake data from the Global Dietary Database. The outcome measurement was SSB consumption (g/day) for different population groups. We modeled SSB intake as a function of age groups, women's parliamentary representation at the national level (the independent variable), regime types (the contextual factor), and import tariffs on SSBs (the mediator) using country and time fixed effects regression models. 185 countries across three waves from 2005 to 2015. Different population groups. The impact of female representation on reducing SSB consumption is more prevalent in children and adolescents than in adults. Furthermore, the effect of women's parliamentary representation on SSB consumption among children and adolescents is conditional on a country's democratic status. Finally, the marginal effect decreases when import tariffs on SSBs are considered a link in a causal chain. No changes in adult SSB intake are statistically significant. The findings suggest that the presence of women in the legislature can have a substantial impact on child and adolescent health.

Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database

SummaryBackgroundDiet is a major modifiable risk factor for human health and overall consumption patterns affect planetary health. We aimed to quantify global, regional, and national consumption levels of animal-source foods (ASF) to inform intervention, surveillance, and policy priorities.MethodsIndividual-level dietary surveys across 185 countries conducted between 1990 and 2018 were identified, obtained, standardised, and assessed among children and adults, jointly stratified by age, sex, education level, and rural versus urban residence. We included 499 discrete surveys (91·2% nationally or subnationally representative) with data for ASF (unprocessed red meat, processed meat, eggs, seafood, milk, cheese, and yoghurt), comprising 3·8 million individuals from 134 countries representing 95·2% of the world population in 2018. We used Bayesian hierarchical models to account for differences in survey methods and representativeness, time trends, and input data and modelling uncertainty, with five-fold cross-validation.FindingsIn 2018, mean global intake per person of unprocessed red meat was 51 g/day (95% uncertainty interval [UI] 48–54; region-specific range 7–114 g/day); 17 countries (23·9% of the world's population) had mean intakes of at least one serving (100 g) per day. Global mean intake of processed meat was 17 g/day (95% UI 15–21 g/day; region-specific range 3–54 g/day); seafood, 28 g/day (27–30 g/day; 12–44 g/day); eggs, 21 g/day (18–24 g/day; 6–35 g/day); milk 88 g/day (84–93 g/day; 45–185 g/day); cheese, 8 g/day (8–10 g/day; 1–34 g/day); and yoghurt, 20 g/day (17–23 g/day; 7–84 g/day). Mean national intakes were at least one serving per day for processed meat (≥50 g/day) in countries representing 6·9% of the global population; for cheese (≥42 g/day) in 2·3%; for eggs (≥55 g/day) in 0·7%; for milk (≥245 g/day) in 0·3%; for seafood (≥100 g/day) in 0·8%; and for yoghurt (≥245 g/day) in less than 0·1%. Among the 25 most populous countries in 2018, total ASF intake was highest in Russia (5·8 servings per day), Germany (3·8 servings per day), and the UK (3·7 servings per day), and lowest in Tanzania (0·9 servings per day) and India (0·7 servings per day). Global and regional intakes of ASF were generally similar by sex. Compared with children, adults generally consumed more unprocessed red meat, seafood and cheese, and less milk; energy-adjusted intakes of other ASF were more similar. Globally, ASF intakes (servings per week) were higher among more-educated versus less-educated adults, with greatest global differences for milk (0·79), eggs (0·47), unprocessed red meat (0·42), cheese (0·28), seafood (0·28), yoghurt (0·22), and processed meat (0·21). This was also true for urban compared to rural areas, with largest global differences (servings per week) for unprocessed red meat (0·47), milk (0·38), and eggs (0·20). Between 1990 and 2018, global intakes (servings per week) increased for unprocessed red meat (1·20), eggs (1·18), milk (0·63), processed meat (0·50), seafood (0·44), and cheese (0·14).InterpretationOur estimates of ASF consumption identify populations with both lower and higher than optimal intakes. These estimates can inform the targeting of intervention, surveillance, and policy priorities relevant to both human and planetary health.FundingBill & Melinda Gates Foundation and American Heart Association.

Economic determinants of differences in the composition of seemingly identical branded food products in the EU

This paper provides an econometric estimation of the economic determinants of differences in the composition of seemingly identical branded food products (DC-SIP) in the European Union. The DC-SIP issue has previously been referred to in the media as the “dual food quality” issue. The analyses in this paper are based on the results from the EU wide testing survey (European Commission, 2019a) in combination with economic data collected from different statistical sources (e.g. Eurostat, Eurobarometer, World Bank, Global Dietary Database). Econometric estimation—probit estimator—is performed on the combined dataset to identify drivers of DC-SIP quantitatively. The estimated results show that the difference in income levels between two Member States (MS) has a statistically significant positive effect on the probability that the versions of seemingly identical branded food products offered in these two MS are different. The estimation of this paper also shows that other factors—such as heterogeneous consumer preferences across MS, distance, price level, and product complexity—contribute to a firm’s incentive to offer different versions of seemingly identical branded food products in different MS. Further, specific characteristics of different product categories and country-specific factors are also found to impact the presence of DC-SIP between MS.