Summer 2015

Global Diet Quality on the Decline

Bad choices outpace healthy changes

By Katherine Pett, N16

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Illustration: Alex Nabaum

A first-of-its-kind study assessing global dietary patterns in 187 countries found that diets worldwide are getting worse.

Using dietary surveys from 1990 and 2010 that were representative of more than 90 percent of adult diets around the world, researchers assessed how individual nations’ diets changed over time. Seventeen key foods and nutrients served as a proxy for total diet quality. Healthy foods included whole grains, fruit and vegetables, while unhealthy items included sugar-sweetened beverages and those high in sodium.

What researchers discovered was concerning. Overall, healthy food intake increased in high- and middle-income countries, but so did consumption of unhealthy food, with the latter trend outpacing healthy changes.

“People in high-income countries, and increasingly middle-income countries, are among the biggest consumers of unhealthy foods,” said first author Fumiaki Imamura, Ph.D., N09, a senior investigator at the Medical Research Council Epidemiology Unit of the University of Cambridge.

On the other hand, people in poorer regions like Sub-Saharan Africa are eating fewer healthy foods than they did two decades ago.

“If we don’t step up efforts to improve the current food supply, we could see the same turn toward nutrient-poor, processed foods as we’ve seen in China, India and other middle-income countries where we saw the largest increases in consumption of unhealthy foods,” Imamura says.

Some patterns were consistent throughout regions of the world. In general, older people eat more healthfully than young adults, and women eat better than men.

The variety of ways that diets are changing indicates that there is no one-size-fits-all approach to improving global nutrition, said Dariush Mozaffarian, M.D., Dr. P.H., senior author on the study and dean of the Friedman School. “Poor diet quality is now the number one cause of poor health in the U.S. and the world, causing enormous suffering and costing trillions of dollars,” he said. “These new findings can be used to inform policies and prevention efforts aimed at improving dietary patterns to reduce these burdens.”

The study, published in the March issue of The Lancet, was funded by the Bill & Melinda Gates Foundation.

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