2.5: National and house­hold surveys in the global assess­ment of food security and diet quality by age and sex

Where feasible, it is preferable to use quantitative food con­sump­tion data collected at the indi­vidual level to assess the distrib­ution of usual intakes of both food and nutri­ents in different popu­lation groups within a country. In this way, the adequacy of the nutri­ent intakes at the popu­lation level can be evaluated using the methods described in Chapter 8b. Such quantitative data from food con­sump­tion surveys collected at the indi­vidual level can be accessed from the FAO/WHO GIFT platform.

However, currently, quantitative national food con­sump­tion data collected at the indi­vidual level are only avail­able for a few low‑ and middle-income coun­tries. Therefore, to fill this gap, alternative global databases based on infor­mation synthesized from FBS, HCES surveys, and indi­vidual-level surveys (where possible) have been compiled. Such databases are aimed at modeling worldwide indi­vidual intakes of foods and nutri­ents by age, sex and physiological status. Examples of these global databases include the Global Dietary Database (GDD) and a database devel­oped by the Institute for Health Metrics and Evaluation (IHME) discussed briefly below. For more discussion of these global databases, see Chapter 3.

The GDD database pro­vides modeled data in 188 coun­tries for 55 dietary factors including 14 foods, 7 beverages, 15 macro­nutri­ents, 19 micro­nutri­ents, and two indices of carbohydrate quality. The FoodEx2 categorization system is used to standardize the description and classification of foods into food groups. Modeled data are provided by country, year of primary data collection, age across the life span, sex, education level, urban or rural residence, and pregnancy or nursing status. The GDD modeled estimates can also be used to compile global patterns of healthy and unhealthy diets together with indi­cators such as the Healthy Eating Index and the Mediterranean Diet Score, Minimum Dietary Diversity for Women (MDDW) and for Infant and Young Child Feeding (IYCF). See Chapter 8c for more details of these indi­cators.

The IHME initiative database aims to provide rigorous and comparable measurements of the world's most impor­tant health problems and evaluates strategies used to prevent them. IHME uses FAO Food Balance Sheet estimates, national product sales, household surveys, and data based on 24 hr recalls (considered the gold standard). Datasets created by IHME are stored in the IHME data catalogue known as the Global Health Data Exchange and can be freely downloaded from the IHME website. The IHME initiative provides modeled data by country, age, sex and year, based on primary data collected in 204 coun­tries and 87 indi­cators, including 15 dietary indi­cators (9 foods and 6 nutri­ents). These dietary indi­cators are included in the Global Burden of Diseases (GBD), a worldwide observational epidemiological study that tracks the progress within and between coun­tries of the changing health challenges (Lim SS et al. 2012; GBD 2017 Diet Collaborators). For example, Qiao et al. (2022) investigated the global burden of non-communicable diseases attributable to dietary risks from 1990‑2019. They reported that a high intake of sodium and low intake of whole grains and fruits were leading dietary risks for deaths and disability-adjusted life-years (DALYs) worldwide, especially in devel­oping coun­tries and among males. Their findings highlight the need to raise public awareness of interventions and improve dietary practices aimed to reduce the disease burden caused by dietary risk factors. Data from the GBD study are also used to monitor progress in coun­tries at the national and subnational level towards meeting the United Nations 33 health-related Sustainable Devel­opment Goals. Key research papers based on the global health estimates from the analysis of GBD data are published each year in a special issue of The Lancet.