TABLE 1.
Aspects of diet quality identified in global and national dietary recommendations and measured as risk factors in global diet-disease research.
| Construct | Dietary recommendation or risk factor | WHO healthy diet1 | National FBDGs2 | GBD risk factor3 | Measured in diet quality indexes designed for international use4 | Sustainable diets5 |
|---|---|---|---|---|---|---|
| Nutrient adequacy | Dietary diversity | x | x | (Some) | x | |
| Protection against NCDs | Fruits and vegetables | x | x | x | x | x |
| Whole grains | x | x | x | (Some) | x | |
| Legumes, nuts and seeds | x | (Some) | x | x | x | |
| Dietary fiber | x | x | x | (Some) | ||
| Fish | (Some) | (Omega-3) | (Some) | |||
| Dairy | x | (Some) | (Reduce) | |||
| PUFA | x | (Some) | ||||
| Increased risk of NCDs | Excess sugar | x | x | (SSB) | x | (The principle of limiting UPF intake relates to several risk factors closely associated with UPF intake) |
| Excess salt | x | x | x | x | ||
| Excess fat | x | x | (Some) | |||
| Excess saturated fat | x | x | (Some) | |||
| Trans fat | x | (Some) | x | (Some) | ||
| Processed meat | x | (Some) | x | (Some) | ||
| Excess red meat | x | (Some) | x | (Some) | x |
Abbreviations: AHEI, Alternative Healthy Eating Index; DASH, dietary approaches to stop hypertension; DQI-I, Diet Quality Index International; FBDG, food-based dietary guidelines; GBD, global burden of disease; GDQS, Global Diet Quality Score; HEI, Healthy Eating Index; IARC, International Agency for Research on Cancer; NCDs, noncommunicable diseases; MDS, Mediterranean diet score; SSB, sugar-sweetened beverages; UPF, ultraprocessed food.
An “x” denotes the dietary factor as a recommendation or risk factor included in the type of document noted.
Source: Adapted from Herforth, 2016 [24]
Recommendations and guidelines from WHO [[27], [28], [29], [30], [31]], other than risk factors (processed meats) from WHO IARC [32].
Summarized from the conclusions of Herforth et al. [33], a global review of FBDG for 93 countries.
Risk factors identified by the Global Burden of Disease Study [1,34] and the Global Dietary Database.
Diet quality indexes constructed for international use, from quantitative or semiquantitative data, including AHEI, HEI, DASH, DQI-I, GDQS, and MDS [[35], [36], [37], [38], [39], [40]]. An “x” means that the dietary risk factor is included in all of these indexes.
Source: FAO and WHO, 2019 [41].