Global trends indicate increasing consumption of dietary sodium and fiber in middle-income countries: A study of 30-year global macrotrends.

According to the Global Burden of Disease Study, 3 million deaths were attributable to high sodium intake and low intake of whole grains. With the rapid evolution of the food industry, we hypothesize that dietary intake of sodium has increased and that dietary intake of whole grains or fibers has decreased because of easier access to highly processed food. Country-level data on dietary factors and country income levels from 1990 to 2018 were collected from 3 public databases. The trend of dietary intake was modeled using the linear mixed model accounting for random effects of individual countries. The country-level differences in dietary factors between males and females were calculated, and the trends were also modeled accounting for the random effects of countries. Both males and females consumed increasing amounts of dietary sodium from 1990 to 2018 in high-income, middle- to high-, middle-, and low-income countries. Dietary fiber intake increased in low-to-middle, middle-, and middle-to-high income countries for both men and women over the past 3 decades. Men tend to consume more sodium and less fiber and whole grains in their diets than women, the trend of which is statistically significant in middle-income countries. Over the past 3 decades, the macrotrend of dietary sodium has increased around the globe. To reduce the sodium intake level, nutrition policy should emphasize sodium reduction, especially in high-income, middle- to high-income, middle-income, and low-income countries.