The following article is adapted from findings in the Global Diet Quality Project’s newly released report, Measuring what the world eats: Insights from a new approach.
Unhealthy diets are a top risk factor for death and disability globally, but despite the direct connections among diet quality, health and sustainable development, most countries lack routine, current and comparable data on what people eat.
With the release of the results from its first round of global surveys on diet quality, the Global Diet Quality Project — a collaboration of Gallup, Harvard University (Department of Global Health and Population) and the Global Alliance for Improved Nutrition (GAIN), along with many global stakeholders — bridges the critical gap in global diet quality data.
The findings from 41 countries surveyed in 2021 — detailed in a new report, Measuring what the world eats: Insights from a new approach — offer a lens into the ways diets around the world are unhealthy, where they are unhealthy, and among which populations.
The Diet Quality Questionnaire (DQQ) collects standardized data for indicators of dietary adequacy and protection of health against noncommunicable diseases (NCDs) across countries. It measures the consumption of 29 food groups that were selected based on their relationship to nutrition and health, sustainability, and food-based dietary guidelines, and in alignment with United Nations indicators and recommendations.
Minimum Dietary Diversity for Women (MDD-W) varies widely across countries and regions.
The DQQ data generate several indicators, including the MDD-W, an indicator of the adequacy of intakes of micronutrients — vitamins and minerals the body needs — in women’s diets.
The MDD-W varies widely from 36% to 89% across the countries surveyed, including many that tend to bear the highest burden of deficiencies. The indicator tends to be higher among women in urban areas and among those who report having enough money to afford food.
In most countries, less than half of people are consuming diets that contain all five recommended food groups.
In 34 out of the 41 countries surveyed, less than half of the population is consuming diets that contain all five food groups that are commonly recommended for daily consumption in national food-based dietary guidelines worldwide.
Even in countries with the highest score on the All-5 indicator, more than one-third of the population is not consuming a diet that even minimally adheres to dietary guidelines. Results for the All-5 indicator are similar among women and men in most countries but tend to be somewhat higher among men and in urban populations.
Countries where people are consuming more healthy foods are often consuming more unhealthy foods as well.
Diets can both help protect against and increase risk for NCDs. The World Health Organization (WHO) provides recommendations on healthy diets, consisting of dietary factors that can protect health against NCDs and dietary factors that may pose increased risk of diet-related NCDs. Overall, the consumption of a diversity of fruits, vegetables, pulses, nuts, seeds and whole grains is associated with meeting these recommendations. These are captured in a new indicator, NCD-Protect.
The higher the NCD-Protect score (0-9), the more recommendations have been met. NCD-Protect varies across countries, ranging from 2.5 in Sierra Leone to 4.9 in Mexico.
On the other hand, the consumption of sweet beverages, sweet foods, salty packaged snacks, instant noodles, fast food, deep-fried foods, and red and processed meat is negatively associated with meeting the recommendations. A new indicator, NCD-Risk, reflects dietary risk factors for NCDs.
The lower the NCD-Risk score (0-9), the more recommendations have been met. Additionally, the NCD-Risk score is a proxy indicator of ultraprocessed food consumption. The lower the NCD-Risk score, the lower the percentage of dietary energy from ultraprocessed food. NCD-Risk scores range from a low of 1.0 in Sierra Leone to 3.9 in Kazakhstan.
The data across countries reveal that NCD-Protect tends to increase somewhat with national income, while NCD-Risk increases quickly with national income. While poverty reduction is important to enable people to eat healthier diets, higher income often brings with it unhealthy food consumption and therefore does not guarantee overall healthy diets.
The findings on 41 countries detailed in the report demonstrate the potential of these data to monitor diet quality, in terms of both diet adequacy and protection of health against NCDs. Every country has positive and negative aspects to its diets.
It is more important than ever to measure what the world eats. Measurement sparks and guides action. Guided by these new data, urgent action is needed to tackle unhealthy diets — the main factor threatening human health, while also affecting the environment and economies in countries worldwide.