A global database of food and nutrient consumption.

In every region of the world, poor diet is a leading cause of both malnutrition and chronic diseases including diabetes, cardiovascular diseases and specific cancers. (1-3) In 2013, 38.3 million deaths occurred due to chronic diseases globally (70% of all deaths), with most of these deaths occurring in developing countries. (4) Anecdotal evidence and more formal evaluations in a limited number of countries suggest that changes in traditional eating patterns and a growing reliance on new types of foods are major drivers of these transitions. However, data on global patterns of dietary habits, as well as differences by population characteristics are not well established. An empirical assessment of dietary intakes is needed for evidence-based policy-making to address global health challenges. In most nations worldwide, assessment of dietary habits has been limited by the absence of robust data on individual dietary intakes that can be used in comparative studies. Up to now, most global analyses have evaluated only single dietary factors or have used data on crude household expenditure or national food supply estimates that do not adequately capture individualsu0027 actual consumption levels. (5,6) Moreover, types of foods consumed and diet-related diseases are often unevenly distributed within populations and it is therefore essential to collect data on specific demographic groups to understand the impact of diets on diseases. Furthermore, even when individual dietary intakes are available, these are rarely standardized or comparable across countries or time, due to differences in the data collection instruments and their intended use, in the design and administration of surveys, and in data processing and analysis. As part of our efforts for the 2010 Global Burden of Diseases study, we systematically identified the available data from national and subnational surveys of individual-based dietary intakes of key foods and nutrients worldwide, by age, sex, country and time (1980-2010). Our preliminary methods have been reported (7) and further details are available from the corresponding author on request. Briefly, we searched multiple electronic databases and used extensive personal communications with researchers and government authorities worldwide to identify and obtain nationally representative dietary intake surveys or, if these were unavailable, large subnational surveys. For countries without identified national or subnational individual-level dietary surveys, we searched for individual-level surveys from large cohort studies as well as other data sources on diet such as the World Health Organization (WHO) Global Infobase, the WHO STEPS database and household expenditure surveys. For trans-unsaturated fatty acids (trans-fats) and dietary sodium, we also searched for biomarker surveys measuring circulating or adipose trans-fat concentrations or 24-hour urinary sodium excretion. Finally, we used the comprehensive United Nations Food and Agricultural Organization (FAO) food balance sheets, (8) which provide country-level data on per capita food availability for major food groups in 187 countries and across the entire time period studied. For trans-fat, we also included industry estimates of nation-specific availability of partially hydrogenated oil, total oils/ fats and total packaged foods per capita from both retail and food-service establishments in 79 countries (Mark Stavro, Bunge LLC, personal communication, 23 May 2012). Due to the limited amount of relevant published data, most survey data were obtained by direct contacts with researchers and officials. By combining all these sources of information, including adjusted FAO data and industry estimates, our final estimates were derived from dietary information drawn from 187 countries. We included data from 325 dietary surveys and 145 urinary sample surveys. The total number of individuals sampled in each surveyed country ranged from several hundred to more than 10000. …