Egg Nutrition Center Blog

Diet Quality Characterized in 187 Countries

Hand with plate and globe

New global data show that while consumption of “healthy” food items increased in many countries, consumption of “unhealthy” items worsened across the world.

A study in The Lancet Global Health examined 20-year trends in diet patterns from around the world based on over 300 diet surveys estimated to represent 89% of adults worldwide (Imamura, 2015). The Global Burden of Diseases Nutrition and Chronic Diseases Expert Group co-author Dr. Dariush Mazaffarian noted the importance of examining “healthy” food patterns separately from “unhealthy” food items, in order to fully inform policies and priorities (online interview).

In examining diets, the research team noted that ‘’national diet quality based on healthy versus unhealthy items was largely masked when only overall diet patterns were considered.”   Therefore, diet trends were characterized separately for 10 “healthy” items, for 7 “unhealthy” items, and then a combined pattern for all 17 items.

The “healthy” pattern scored consumption of: fruits, vegetables, beans and legumes, nuts and seeds, whole grains, milk, total polyunsaturated fatty acids, fish, plant omega-3s and dietary fiber.

The “unhealthy” pattern scored consumption of: unprocessed red meats, processed meats, sugar-sweetened beverages, saturated fat, trans fat, dietary cholesterol, and sodium.

In light of the recent acknowledgement by the US Dietary Guidelines Advisory Committee (DGAC, 2015) that scientific evidence has evolved to the point in which dietary cholesterol is not a nutrient of concern for overconsumption, it would be informative to know whether results from this global diet study change if dietary cholesterol is removed from the “unhealthy” pattern score.

Results of the current study showed:

“[O]lder adults had better dietary patterns than did younger adults…women also had better dietary patterns than men…”

 “Higher national income was associated with better quality for the healthy dietary pattern…and with much worse quality for the unhealthy dietary pattern.”

In concluding remarks, the authors noted

“Increases in unhealthy patterns are outpacing increases in healthy patterns in most world regions. In view of the disease burden associated with suboptimum diet quality, these findings emphasise the need to better elucidate the societal, policy, and food industry determinants of these differences and trends, and to implement policies to address these inequities and improve diet quality globally.”

This study illustrates the importance of considering patterns of foods consumed rather than overall single diet quality scores, single food approaches, or single nutrient assessments. That’s good advice when considering diet globally, locally, and also individually. A summary article and global map of diet quality is available at the Medical Research Council.

References Citations

F Imamura, R Micha, S Khatibzadeh, S Fahimi, P Shi, J Powles, D Mozaffarian, on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). “Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment.” The Lancet Global Health. March 2015. (3):e132-e142.

Scientific Report of the 2015 Dietary Guidelines Advisory Committee. February 2015.

photo2-150x150 Barbara Lyle, Ph.D. is President of B Lyle, Inc. a nutrition consulting and innovation firm, and guest blogger for the Egg Nutrition Center.


Views expressed by the author may not be those of the Egg Nutrition Center.

Author: Barbara Lyle, Ph.D.