While the consumption of healthy foods such as fruits and vegetables has improved worldwide over the last two decades, it is still being outpaced by the increasing consumption of unhealthy foods including sweetened drinks and processed meats.
A recent study published in The Lancet Global Health journal took a look at the diet quality of 4.5 billion adults in 187 countries. The authors claim 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.
The study was led by Dr. Fumiaki Imamura from the Medical Research Council Epidemiology Unit at the University of Cambridge in the United Kingdom. A team of international researchers analyzed data on the consumption of 17 key food items and nutrients related to obesity and major non-communicable diseases such as cardiovascular disease, diabetes, and diet-related cancers as well as changes in diets between 1990 and 2010.
The team examined three different diet patterns:
A favorable one based on 10 healthy food items - fruits, vegetables, beans and legumes, nuts and seeds, whole grains, milk, total polyunsaturated fatty acids, fish, omega-3s, and dietary fibre;
An unfavorable one defined by seven unhealthy items - unprocessed meats, processed meats, sugar-sweetened drinks, saturated fat, trans fat, dietary cholesterol, and sodium;
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.
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.
People living in many of the wealthiest regions - the United States 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.
Some countries in sub-Saharan Africa and some countries in Asia - China and India - have seen no improvement in their diet quality over the past 20 years.
Diet patterns vary widely by national income, with high-income countries generally having better diets based on healthy foods , but substantially poorer diets due to a higher intake of unhealthy foods compared with low-income countries. On average, older people and women seem to consume better diets.
The highest scores for healthy foods were noted in several low-income countries such as Chad and Mali, and Mediterranean nations such as Turkey and Greece, possibly reflecting favorable 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 - 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 - including healthy and unhealthy foods - was examined.
"By 2020, projections indicate that non-communicable diseases will account for 75% of all deaths, says Dr. Imamura. Improving diet has a crucial role to play in reducing this burden. 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."
"There is a particularly urgent need to focus on improving diet quality among poorer populations, added Dr. Mozaffarian. 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."
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