Global Diets Haven’t Improved in 30 Years, Here’s Why

  • Diets have only improved by 1.5 points over the last 30 years as measured by the global Alternative Healthy Eating Index.
  • Certain groups of people were more likely to follow healthier eating habits than others.
  • Policy changes need to happen to approve affordability and accessibility to nutritious foods.

Globally, diets have not improved very much over the last 30 years a study in the journal Nature Food reports.

The study evaluated global, regional and national dietary patterns in both children and adults. It grouped participants further by age group, sex, education, and urbanicity to examine eating habits across 185 countries from 1990 to 2018. They measured diets primarily by the Alternative Healthy Eating Index, which scores dietary quality.

Researchers point out that poor diet quality is the leading cause of disease worldwide.

The Alternative Healthy Eating Index rates diets from 0 being the least healthy diet to 100 being the most healthy.

The scores for the diets looked at the amount healthier items like legumes, nuts, whole grains, seafood and non-starchy vegetables compared to less-healthy foods such as red or processed meat and sugar-sweetened beverages.

The regional mean scores ranged from 30.3 in Latin America and the Caribbean to 45.7 in South Asia.

For the entire globe Alternative Healthy Eating Index score was 40.3 in 2018. The mean global score increased just 1.5 points since 1990

The U.S. had one of the lowest scores at under 33.

Molly Rapozo, MS, RDN, Registered Dietician Nutritionist & Brain Health Coach at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA thinks that diets have not improved much because healthy choices are not always the most accessible choices for people in the communities to make.

She says, “While optimal dietary patterns have been established and validated, much work needs to be done to ensure healthy choices are the easiest choices.”

She also points out that, “Preventative nutrition services are not covered by insurance.”

Dual certified mindful eating coach, Susan Zilberman, who is certified through The Institute for the Psychology of Eating and Am I Hungry also brings up that dietary patterns are often rooted in families and cultures, which makes it harder for people to adopt new, healthier habits even though they know intellectually that they should.

“Simply telling a person to eat healthy food, or cut out certain foods because they are unhealthy, makes sense on an intellectual level, but it doesn’t take lifelong habits into account,” she says. “For most of us, eating is emotional. We celebrate with food, express love and caring by offering different dishes.”

The study found that certain groups of people were more likely to eat a healthier diet. In certain regions, adults scored substantially higher than children. Scores followed a U-shaped curve with the highest results among children under 5 and older adults.

Women were also more likely to eat healthily than men according to the research.

Rapozo generally agrees with this notion and cites the 2020 review examining nutritional behaviors and biological sex and cultural gender.

She says the study “provides insight on why women score higher globally.”

The 2020 study found that “Women manifest a more pronounced trust in healthy nutrition, greater engagement in controlling body weight, a higher tendency to eat in a group and in stressful situations, and they frequently experience frustration due to their own nutritional behaviors, which reflects higher social pressure and their attempts to reduce eating-related pleasure.”

Rapozo references the same study to discuss why men do not make food choices as health consciously as women. That study found men” prefer fatty meals with a strong taste and are directed mainly by the pleasure of consumption.”

She also notes that men are more likely to consume fast food.

Rapozo believes the way to improve diets is to “address the systemic causes” such as economic disparities that make accessing healthier foods more difficult.

According to Rapozo addressing the systemic causes includes steps to make nutrition and health care programs more accessible to the general population such as:

  • creating federal nutrition programs
  • increasing public health and nutrition education
  • more access to preventive health care

Rapozo also mentions a need for more research, business support and innovations, and federal coordination. These steps can help improve access and affordability of healthier foods.

Rapozo says expanding access and participation in federal nutrition programs and eliminating food insecurity would be particularly impactful.

Zilberman agrees and highlights the economic changes that need to happen to improve healthy eating.

She says, “The most important policy change is to make healthier eating opportunities available to all regardless of income. Policy changes are needed to incentivize healthier eating, and would include access to nutritious school lunches, and subsidies for groceries.”

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