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Worldwide, consumption of healthy foods such as
fruit and vegetables has improved during the past
two decades, but has been outpaced by the increased
intake of unhealthy foods including processed meat
and sweetened drinks in most world regions,
according to the first study to assess diet quality
in 187 countries covering almost 4.5 billion adults,
published in The Lancet Global Health journal, and
funded by the Medical Research Council and the Bill
and Melinda Gates Foundation.
Improvements in diet
quality between 1990 and 2010 have been greatest in
high-income nations, with modest reductions in the
consumption of unhealthy foods and increased intake
of healthy products. However, people living in many
of the wealthiest regions (eg, the USA and Canada,
Western Europe, Australia and New Zealand) still
have among the poorest quality diets in the world,
because they have some of the highest consumption of
unhealthy food worldwide.
In contrast, some
countries in sub-Saharan Africa and some countries
in Asia (eg, China and India) have seen no
improvement in their diet quality over the past 20
years.
The authors warn that
the study presents a worrying picture of increases
in unhealthy eating habits outpacing increases in
healthy eating patterns across most world regions
and say that concerted action is needed to reverse
this trend.
Led by Dr Fumiaki
Imamura from the Medical Research Council
Epidemiology Unit opens in new window at the
University of Cambridge in the UK, a team of
international researchers analysed data on the
consumption of 17 key food items and nutrients
related to obesity and major non-communicable
diseases (eg, cardiovascular disease, diabetes, and
diet-related cancers) in countries around the world,
and changes in diets between 1990 and 2010.
This analysis was
performed by the Global Burden of Diseases Nutrition
and Chronic Diseases Expert Group (NutriCoDE),
chaired by Dr Dariush Mozaffarian, senior author on
the paper and dean of the Friedman School of
Nutrition Science and Policy at Tufts University.
NutriCoDE is an ongoing project assessing dietary
information from more than 300 dietary surveys
across the world and UN Food and Agriculture
food-balance sheets, covering almost 90% of the
global adult population.
The international team
examined three different diet patterns: a favourable
one based on 10 healthy food items (fruit,
vegetables, beans and legumes, nuts and seeds, whole
grains, milk, total polyunsaturated fatty acids,
fish, omega-3s, and dietary fibre); an unfavourable
one defined by seven unhealthy items (unprocessed
meats, processed meats, sugar-sweetened drinks,
saturated fat, trans fat, dietary cholesterol, and
sodium); and an overall diet pattern based on all 17
food groups. The researchers calculated a diet score
for each pattern and assessed differences by country,
age, sex, and national income, with a higher score
indicating a healthier diet (range 0-100).
The findings reveal that
diet patterns vary widely by national income, with
high-income countries generally having better diets
based on healthy foods (average score difference
+2.5 points), but substantially poorer diets due to
a higher intake of unhealthy foods compared with
low-income countries (average score difference -33.0
points). On average, older people and women seem to
consume better diets.
The highest scores for
healthy foods were noted in several low-income
countries (eg, Chad and Mali) and Mediterranean
nations (eg, Turkey and Greece), possibly reflecting
favourable aspects of the Mediterranean diet. In
contrast, low scores for healthy foods were shown
for some central European countries and republics of
the former Soviet Union (eg, Uzbekistan,
Turkmenistan, and Kyrgyzstan).
Of particular interest
was that the large national differences in diet
quality were not seen, or were far less apparent,
when overall diet quality was taken into account as
previous studies have examined.
“By 2020, projections
indicate that non-communicable diseases will account
for 75% of all deaths. Improving diet has a crucial
role to play in reducing this burden”, says Dr
Imamura. “Our findings have implications for
governments and international bodies worldwide. The
distinct dietary trends based on healthy and
unhealthy foods, we highlight, indicate the need to
understand different, multiple causes of these
trends, such as agricultural, food industry, and
health policy. Policy actions in multiple domains
are essential to help people achieve optimal diets
to control the obesity epidemic and reduce
non-communicable diseases in all regions of the
world.”
According to Dr
Mozaffarian, “There is a particularly urgent need to
focus on improving diet quality among poorer
populations. If we do nothing, undernutrition will
be rapidly eclipsed by obesity and non-communicable
diseases, as is already being seen in India, China,
and other middle-income countries.”
See also
Study suggests humans are slowly but surely losing
intellectual and emotional abilities (26/11/2012)
For more information
“Dietary
quality among men and women in 187 countries in 1990
and 2010: a systematic assessment” by Imamura et
al, is published in The Lancet Global Health.
Medical Research Council
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