Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment.
Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment.
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DOI：
10.1016/s2214-109x(14)70381-x
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发表时间：
2015-03
影响因子：
34.3
通讯作者：
Mozaffarian, Dariush
中科院分区：
文献类型：
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作者：
Imamura, Fumiaki;Micha, Renata;Khatibzadeh, Shahab;Fahimi, Saman;Shi, Peilin;Powles, John;Mozaffarian, Dariush
健康的饮食模式是减少非传染性疾病的全球优先事项。然而，世界范围内的饮食模式及其随时间的趋势都没有得到很好的确定。我们的目标是在国家和地区范围内研究饮食模式的全球变化（或趋势），并评估年龄，性别，国民收入和饮食模式类型的异质性。在这项系统性评估中，我们按地区、国家、年龄和性别评估了1990年和2010年全球关键膳食项目（食物和营养素）的消费量。消费数据来自325项调查（71.7%具有全国代表性），覆盖全球88.7%的成年人口。两种类型的饮食模式进行了评估：一个反映了更多的消费量的10个健康的饮食项目和其他基于较少的消费量的7个不健康的饮食项目。每个饮食因素的平均摄入量被分为五分之一，每个五分之一被分配一个有序的分数，分数越高，相当于更健康的饮食（范围0-100）。饮食模式进行了评估分层线性回归，包括国家，年龄，性别，国民收入和时间作为探索性变量。从1990年到2010年，基于健康食品的饮食在全球范围内有所改善（提高了2.2个百分点，95%不确定性区间（UI）为0.9至3.5），而基于不健康食品的饮食则有所恶化（-2.5，-3.3至-1.7）。2010年，健康模式的全球平均得分为44.0（SD 10.5），不健康模式的全球平均得分为52.1（18.6），国家之间的相关性较弱（r=-0statist08）。平均而言，老年人的饮食比年轻人好，女性比男性好（p<0.0001）。与低收入国家相比，高收入国家基于健康项目的饮食更好（+2统计5点，95% UI 0.3至4.1），但基于不健康项目的饮食则要差得多（-33.0，-37.8至-28.3）。世界各地区的饮食及其趋势差异很大。例如，这两种饮食模式在高收入国家都有所改善，但在非洲和亚洲的一些低收入国家却有所恶化。中等收入国家基于健康项目的饮食模式改善最大，但基于不健康项目的饮食模式恶化最大。世界各地健康食品的消费有所改善，而不健康食品的消费则有所恶化，各区域和国家之间存在差异。这些全球数据提供了迄今为止世界各地营养转变的最佳估计，并为减少饮食质量差的健康和经济负担的政策和优先事项提供了信息。比尔和梅林达盖茨基金会和医学研究理事会。
Healthy dietary patterns are a global priority to reduce non-communicable diseases. Yet neither worldwide patterns of diets nor their trends with time are well established. We aimed to characterise global changes (or trends) in dietary patterns nationally and regionally and to assess heterogeneity by age, sex, national income, and type of dietary pattern. In this systematic assessment, we evaluated global consumption of key dietary items (foods and nutrients) by region, nation, age, and sex in 1990 and 2010. Consumption data were evaluated from 325 surveys (71·7% nationally representative) covering 88·7% of the global adult population. Two types of dietary pattern were assessed: one reflecting greater consumption of ten healthy dietary items and the other based on lesser consumption of seven unhealthy dietary items. The mean intakes of each dietary factor were divided into quintiles, and each quintile was assigned an ordinal score, with higher scores being equivalent to healthier diets (range 0–100). The dietary patterns were assessed by hierarchical linear regression including country, age, sex, national income, and time as exploratory variables. From 1990 to 2010, diets based on healthy items improved globally (by 2·2 points, 95% uncertainty interval (UI) 0·9 to 3·5), whereas diets based on unhealthy items worsened (−2·5, −3·3 to −1·7). In 2010, the global mean scores were 44·0 (SD 10·5) for the healthy pattern and 52·1 (18·6) for the unhealthy pattern, with weak intercorrelation (r=–0·08) between countries. On average, better diets were seen in older adults compared with younger adults, and in women compared with men (p<0·0001 each). Compared with low-income nations, high-income nations had better diets based on healthy items (+2·5 points, 95% UI 0·3 to 4·1), but substantially poorer diets based on unhealthy items (−33·0, −37·8 to −28·3). Diets and their trends were very heterogeneous across the world regions. For example, both types of dietary patterns improved in high-income countries, but worsened in some low-income countries in Africa and Asia. Middle-income countries showed the largest improvement in dietary patterns based on healthy items, but the largest deterioration in dietary patterns based on unhealthy items. Consumption 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. The Bill & Melinda Gates Foundation and Medical Research Council.