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

Authors: Victoria Miller, Patrick Webb, Frederick Cudhea, Peilin Shi, Jianyi Zhang, Julia Reedy, Josh Erndt‐Marino, Jennifer Coates, Dariush Mozaffarian, Global Dietary Database, Murat Baş, Jemal Haidar, Suhad Abumweis, Anand Krishnan, Puneet Misra, Nahla Chawkat Hwalla, Chandrashekar Janakiram, Nur Indrawaty Liputo, Abdulrahman O. Musaiger, Farhad Pourfarzi, Iftikhar Alam, Karin DeRidder, Céline Termote, Anjum Memon, Aida Turrini, Elisabetta Lupotto, Raffaela Piccinelli, Stefania Sette, Karim Anzid, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Tamene Taye Asayehu, Francis Oduor, Julia Boedecker, Lilian Aluso, Johana Ortíz‐Ulloa, J.V. Meenakshi, Michelle Alessandra de Castro, Giuseppe Grosso, Anna Waśkiewicz, Umber S. Khan, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Marga C. Ocké, Zohreh Etemad, Mohannad Al Nsour, Lydiah M. Waswa, Eha Nurk, Joanne E Arsenault, Patricio López‐Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Carukshi Arambepola, Carla Lopes, Mílton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana Lindström, Suvi Μ. Virtanen, Cristina Palacios, Eva Roos, Imelda Angeles‐Agdeppa, Josie Desnacido, Mario V. Capanzana, Anoop Misra, Ilse Khouw, Swee Ai Ng, Edna Gamboa Delgado, Mauricio Caballero, Johanna Otero, Hae‐Jeung Lee, Eda Köksal, Idris Guessous, Carl Lachat, Stefaan De Henauw, Ali Reza Rahbar, Alison Tedstone, Androniki Naska, Angie Mathee, Annie Ling, Bemnet Tedla, Beth Hopping, Brahmam Ginnela, Catherine Leclercq, Charmaine Duante, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Colin D. Rehm, Coline van Oosterhout, Corazon Cerdeña, Debbie Bradshaw, Dimitrios Trichopoulos, Dorothy Gauci, Dulitha Fernando, Elzbieta Sygnowska, Erkki Vartiainen, Farshad Farzadfar, Gábor Zajkás, Gillian Swan, Guansheng Ma, Ayla Gülden Pekcan, Hajah Masni Ibrahim, Harri Sinkko, Heléne Enghardt Barbieri, Isabelle Sioen, Jannicke Borch Myhre, Jean‐Michel Gaspoz, Jillian Odenkirk, Kanitta Bundhamcharoen, Keiu Nelis, Khairul Zarina, Lajos Biró, Lars Johansson, Laufey Steingrímsdóttir, Leanne M Riley, Mabel Yap, Manami Inoue, Maria Szabo, Marja‐Leena Ovaskainen, Meei‐Shyuan Lee, Mei Fen Chan, Melanie Cowan, Mirnalini Kandiah, Ola Kally, Olof Jonsdottir, Pam Palmer, Péter Vollenweider, Philippos Orfanos, Renzo Asciak, Robert Templeton, Rokiah Don, Roseyati Yaakub, Rusidah Selamat, Safiah Md Yusof, Sameer Al‐Zenki, Shu-Yi Hung, Sigrid Beer‐Borst, Suh Wu, Widjaja Lukito, Wilbur C. Hadden, Wulf Becker, Xia Cao, Yi Ma, Yuen Lai, Zaiton Hjdaud, Didier Garriguet, Jennifer Ali, Ron Gravel, Tina Tao, Lennert Veerman, Shashi Chiplonkar, Mustafa Arıcı, Ngoan Tran Le, Demosthenes B. Panagiotakos, Yanping Li, Antonia Trichopoulou, Noël C. Barengo, Anuradha Khadilkar, Veena Ekbote, Noushin Mohammadifard, Irina Kovalskys, Avula Laxmaiah, Harikumar Rachakulla, Hemalatha Rajkumar, Indrapal I Meshram, Avula Laxmaiah, Nimmathota Arlappa, Hemalatha Rajkumar, Licia lacoviello, Marialaura Bonaccio, Simona Costanzo, Yves Martin‐Prével, Katia Castetbon, Nattinee Jitnarin, Yao-Te Hsieh, Sonia Olivares, Gabriela Tejeda, Aida Hadziomeragic, Amanda de Moura Souza, Wen‐Harn Pan, Inge Huybrechts, Alan de Brauw, Mourad Moursi, Maryam Maghroun, Augustin Nawidimbasba Zeba, Nizal Sarrafzadegan, Lital Keinan-Boker, Rebecca Goldsmith, Tal Shimony, Irmgard Jordan, Shivanand C. Mastiholi, Moses Mwangi, Yeri Kombe, Zipporah Bukania, Eman M. Alissa, Nasser Al-Daghri, Shaun Sabico, Martin Gulliford, Tshilenge S. Diba, Kyungwon Oh, Sanghui Kweon, Sihyun Park, Yoonsu Cho, Suad Al-Hooti, Chanthaly Luangphaxay, Daovieng Douangvichit, Latsamy Siengsounthone, Pedro Marques‐Vidal, Constance Rybak, Amy Luke, Nipa Rojroongwasinkul, Noppawan Piaseu, Kalyana Sundram, Donka Baykova, Parvin Abedi, Fariza Fadzil, Noriklil Bukhary Ismail Bukhary, Pascal Bovet, Sandjaja Sandjaja, Yu Chen, Norie Sawada, Shoichiro Tsugane, Lalka Rangelova, Stefka Petrova, Vesselka Duleva, Anna Karin Lindroos, Jessica Petrelius Sipinen, Lotta Moraeus, Per Bergman, Ward Siamusantu, L Szponar, Hsing‐Yi Chang, Makiko Sekiyama, Nagalla Balakrishna, Kalpagam Polasa, Sesikeran Boindala, Khanh Le Nguyen Bao, Jalila El Ati, Daniel Illescas-Zárate, Luz María Sánchez‐Romero, Ivonne Ramirez Silva, Juan Rivera Dommarco, Sı́món Barquera, Sonia Rodríguez‐Ramírez, Nayu Ikeda, Sahar Zaghloul, Anahita Houshiarrad, Fatemeh Mohammadi‐Nasrabadi, Morteza Abdollahi, Khun-Aik Chuah, Zaleha Abdullah Mahdy, Alison L. Eldridge, Eric L. Ding, Herculina Kruger, Sigrun Henjum, Anne C. Fernandez, Milton Fabian Suárez‐Ortegón, Nawal Al‐Hamad, Veronika Janská, Reema Tayyem, Parvin Mirmiran, Roya Kelishadi, Eva Warensjö Lemming, Almut Richter, Gert Mensink, Lothar Wieler, Daniël J. Hoffman, Benoı̂t Salanave, Cho‐il Kim, Rebecca Kuriyan-Raj, Sumathi Swaminathan, Saeed Dastgiri, Sirje Vaask, Tilakavati Karupaiah, Fatemeh Vida Zohoori, Alireza Esteghamati, Sina Noshad, Maryam Hashemian, Elizabeth Mwaniki, Elizabeth Yakes-Jimenez, Justin Chileshe, Sydney Mwanza, Lydia Lera Marques, Alan Martin Preston, Samuel Durán‐Agüero, Mariana Oleas, Luz Posada, Angélica Ochoa‐Avilés, Khadijah Shamsuddin, Zalilah Mohd Shariff, Hamid Jan Bin Jan Mohamed, Wan Manan, Anca Nicolau, Cornelia Tudorie, Bee Koon Poh, Pamela Abbott, Mohammadreza Pakseresht, Sangita Sharma, Tor A. Strand, Ute Alexy, Ute Nöthlings, Jan Carmikle, Ken Brown, Jeremy Koster, Indu Waidyatilaka, Pulani Lanerolle, Ranil Jayawardena, Julie M. Long, K. Michael Hambidge, Nancy F. Krebs, Aminul Haque, Gudrun B. Keding, Liisa Korkalo, Maijaliisa Erkkola, Riitta Freese, Laila Eleraky, Wolfgang Stuetz, Inga Þórsdóttir, Ingibjörg Gunnarsdóttir, Lluís Serra‐Majem, Foong Ming Moy, Simon Anderson, Rajesh Jeewon, Corina‐Aurelia Zugravu, Linda S. Adair, Shu Wen Ng, Sheila Skeaff, Dirce Maria Lobo Marchioni, Regina Mara Fisberg, Carol J. Henry, Getahun Ersino, Gordon Zello, Alexa Meyer, Ibrahim Elmadfa, Claudette Mitchell, David Balfour, Johanna M. Geleijnse, Mark Manary, Laetitia Nikièma, Tatyana El-kour, Masoud Mirzaei, Rubina Hakeem - Nature Food 2022 cited by 235

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.