The Global Diet Quality Project measures what the world eats

The Global Diet Quality Project measures what the world eats

The following article is excerpted from the findings of the newly released Global Diet Quality Project Report, Measuring what the world eats: Insights from a new approach.

Unhealthy diets are among the most significant risk factors for death and disability globally, but despite the direct links between diet quality and health and sustainable development, most countries lack routine, current and comparable data on what people eat.

With the release of the results of its first round of global surveys on diet quality, the Global Diet Quality Project – in collaboration with Gallup, Harvard University (Department of Global Health and Population) and the Global Alliance for Improved Nutrition (GAIN), along with several global stakeholders – is closing The critical gap in global diet quality data.

Results from the 41 countries surveyed in 2021 – detailed in a new report, Measuring what the world eats: Insights from a new approach – Offer a look at the ways in which diets around the world are unhealthy, where they are unhealthy, and in which populations.

Main results

The Diet Quality Questionnaire (DQQ) collects standard data for indicators of dietary adequacy and health protection against noncommunicable diseases across countries. It measures consumption of 29 food groups selected based on their relationship to nutrition and health, sustainability, and food-based dietary guidelines, and in line with United Nations indicators and recommendations.

Women’s Minimum Dietary Diversity (MDD-W) varies widely across countries and regions.

The DQQ data generates many indicators, including MDD-W, which is an indicator of the adequacy of the intake of micronutrients – vitamins and minerals the body needs – in a woman’s diet.

MDD-W varies greatly from 36% to 89% across the countries surveyed, including many countries that tend to bear the brunt of the deficiencies. The index tends to be higher among women in urban areas and among those who report having enough money to buy food.

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In most countries, less than half of people consume meals containing the five recommended food groups.

In 34 of the 41 countries surveyed, less than half of the population consumes meals containing all five food groups that are generally recommended for daily consumption in national food-based dietary guidelines worldwide.

Even in countries with the highest All-5 scores, more than a third of the population do not consume a diet that adheres to even the minimum dietary guidelines. All-5 scores are similar for women and men in most countries but tend to be somewhat higher among men and city dwellers.

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Countries where people consume more healthy foods often consume more unhealthy foods as well.

Diets can help protect against and increase the risk of non-communicable diseases. The World Health Organization (WHO) makes recommendations on healthy diets, which consist of nutritional factors that can protect health from non-communicable diseases and nutritional factors that may increase the risk of diet-related non-communicable diseases. In general, consuming a variety of fruits, vegetables, legumes, nuts, seeds, and whole grains is associated with meeting these recommendations. These are captured in a new indicator, NCD-Protection.

The higher the degree of protection against non-communicable diseases (0-9), the more recommendations are met. Protection against non-communicable diseases varies across countries, ranging from 2.5 in Sierra Leone to 4.9 in Mexico.

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On the other hand, consumption of sweet drinks, sweet foods, salty snacks, instant noodles, fast food, fried foods, red and processed meat is negatively associated with meeting the recommendations. The new indicator, NCD Risk, reflects the nutritional risk factors for NCDs.

The lower the NCD risk score (0-9), the more recommendations were met. In addition, the NCD risk score is a proxy indicator for ultra-processed food consumption. The lower the NCD risk score, the lower the proportion of dietary energy from ultra-processed foods. NCD risk scores range from 1.0 in Sierra Leone to 3.9 in Kazakhstan.

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Data across countries reveal that NCD protection tends to increase somewhat with national income, while NCD risk increases rapidly with national income. While poverty reduction is important to enable people to eat healthy diets, high incomes often bring with it unhealthy food consumption, and thus do not guarantee a healthy diet in general.


Findings in 41 countries detail in the report the potential of this data to monitor diet quality, in terms of diet adequacy and health protection from non-communicable diseases. Every country has positive and negative aspects of its diet.

It is more important than ever to measure what the world is eating. Measurement sparks and steering action. Based on this new data, urgent action is needed to tackle unhealthy diets – the major factor threatening human health, while also affecting the environment and economies of countries around the world.

Read the full report.


Anna Herforth, PhD, is the principal investigator for the Global Diet Quality Project, and co-director of the Food Price for Nutrition project, which has produced globally used indicators of the cost and affordability of a healthy diet. She is a research associate at the Harvard TH Chan School of Public Health.

T Bell, PhD, is a global nutrition scientist focused on helping achieve healthy, sustainable diets for all. His research seeks to understand what people eat and how it affects their health and our planet. He currently serves as a research consultant on the Knowledge Leadership Team for the Global Alliance for Improved Nutrition (GAIN), where he generates evidence to guide programs and mobilize knowledge related to global nutrition and food systems.

Gallup’s Julie Ray contributed to this article.

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