Global trends in dietary quality
Authors: Ian R Hambleton, Christina Howitt, Angela M C Rose, T Alafia Samuels, Nigel Unwin
Journal: The Lancet Global Health (2015)

The systematic assessment of dietary quality by Fumiaki Imamura and colleagues (March, 2015)1Imamura F Micha R Khatibzadeh S et al.Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment.Lancet Glob Health. 2015; 3: e132-e142Summary Full Text Full Text PDF Scopus (475) Google Scholar examined global consumption of healthy and unhealthy foods. The investigators describe this study as the most recent and robust source of data about dietary patterns, recommending its use for policy development. Barbados, where we live and work, topped the list of highest consumers of ten “more healthy items”. Because this finding is highly discordant with our own observations, we were keen to identify and review the sources of data used by the authors. Identification of the data sources was not straightforward. In the supplementary tables of two previous publications,2Powles J Fahimi S Micha R et al.Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide.BMJ Open. 2013; 3: e003733Crossref Scopus (582) Google Scholar, 3Micha R Khatibzadeh S Shi P et al.Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys.BMJ. 2014; 348: g2272Crossref PubMed Scopus (367) Google Scholar we found reference to an unpublished “nationally representative” survey of 280 Barbadian adults. Data were provided by an unspecified “corresponding member”, although in the list of collaborators, none are from Barbados. We believe that we have traced the source of these data to a subset of participants in the Barbados National Cancer Study,4Sharma S Cao X Harris R Hennis AJ Leske MC Wu SY for the Barbados National Cancer Study GroupDietary intake and development of a quantitative food-frequency questionnaire for the Barbados National Cancer Study.Public Health Nutr. 2007; 10: 464-470PubMed Google Scholar a case-control study of breast and prostate cancer. Of the 280 adults in the study subset, 35% are cases, which is hardly nationally representative. Our experience highlights two crucial issues. The first is the difficulty in identifying the data, and who provided them, on which the estimates are based; the second is the use of data without the involvement of local researchers. By their nature, global estimates will always be works in progress. Critical review by local researchers is essential. However, as we and others5Byass P de Courten M Graham WJ et al.Reflections on the global burden of disease 2010 estimates.PLoS Med. 2013; 10: e1001477Crossref PubMed Scopus (77) Google Scholar have noted, this process is hindered by a lack of transparency in the presentation of data sources and methods. We declare no competing interests. Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessmentConsumption of healthy items improved, while consumption of unhealthy items worsened across the world, with heterogeneity across regions and countries. These global data provide the best estimates to date of nutrition transitions across the world and inform policies and priorities for reducing the health and economic burdens of poor diet quality. Full-Text PDF Open Access