We know that, worldwide, 1 in 3 people grapple with various forms of malnutrition. But we don’t know what they’re eating. There is currently no data set that tells us about people’s diets and how that is affecting their health.
For years, this glaring gap has affected policies and programming. Now, a new initiative is attempting to fill in the blanks.
In the 2017 Global Nutrition Report, independent researcher Anna Herforth lays out the case for collecting data that capture diet quality. The quality of our diets is influenced by food safety, dietary diversity, the adequacy of macro and micronutrients and our diet’s ability to protect us from noncommunicable diseases.
“All are needed in all regions of the world, as bellwethers of malnutrition in all its forms,” Herforth writes in the report.
Herforth and researchers at the University of São Paulo are working with Gallup, the global polling agency, to introduce a section on diet quality into the agency’s annual World Poll, conducted across 145 countries.
Currently, practitioners have access to an indicator known as “minimum dietary diversity for infants and young children,” which USAID collects in its Demographic Health Surveys in 60 countries. This measures the proportion of children who ate food from four or more groups in the previous day, and corresponds to nutrient adequacy.
This is useful in recognizing the causes of chronic and acute malnutrition for children under 2, but it doesn’t capture the eating habits of the rest of the population. The new information coming from the Gallup World Poll will attempt to provide more insight.
“The overarching problem is that there is no comparable data across countries which is routinely collected. Globally comparable information on diet quality is needed to understand information trends that can help policy,” Herforth said.
She says it is hard to get the issue of healthy diets on the policy radar internationally, and a lack of data could be the reason. Without the numbers that show how many people do not have access to diverse and healthy diets, it is hard to put in place the correct policies to target malnutrition.
The Gallup module will use an indicator from the Food and Agriculture Organization that measures the minimum dietary diversity for women of reproductive age (MDD- W).
To develop the MDD-W indicator, women between the ages of 15 and 49 are asked whether they have consumed at least five out of 10 defined food groups the previous day or night.
“The proportion of women 15–49 years of age who reach this minimum in a population can be used as a proxy indicator for higher micronutrient adequacy, one important dimension of diet quality,” the FAO states in its publication, “Minimum Dietary Diversity for Women: A Guide to Measurement.”
The team will also develop new indicators to measure diet patterns that help stave off noncommunicable diseases.
Gallup is hopeful that, between them, these two indicators will provide the full picture of people’s diet quality worldwide.
Andrew Rzepa, managing consultant at Gallup, said research on the project will start next year.
“In order to take the indicators to every country, each of the 23 food groups have to be adapted for each of the 145-plus countries we plan to survey. We’ll start by creating a universal guide for undertaking the adaptation process. Following this, we will undertake quantitative and cognitive tests in the pilot survey in Brazil to determine how well the draft questionnaire is working,” he said.
John Hoddinott, a professor of food and nutrition at Cornell University, said the survey results will be helpful in determining who to reach, and how to focus policy.
According to him, increasingly, there is [a] belief and understanding that the nutrition of adolescent girls is very important. Malnourishment among women and their children have been correlated to the age of marriage and the number of children a woman has. “As the age of marriage is creeping up, the number of children is reducing, and these are both are good trends in countries like Bangladesh. To reach women before they have children is our last best shot at sharing knowledge and practice. This is one area where more data will be useful,” he said.
There are limitations to how much the data can tell us about the implication on malnutrition, due to the restricted sample sizes of the Gallup World Poll. But once the framework is globalized via Gallup, it will be made available publicly. Then the onus will be on individual countries to incorporate the indicators into their own national and regional surveys.
While the data won’t be as expansive as the household data conducted by individual countries, it will give a representative sample of the effect of diet quality on their nutrition status.
Even so, Rzepa is optimistic that the data can be used in many different ways. “We hope it can be a global public good,” he said.
“Once it’s available, the data will be hugely useful to frame conversation at the global, regional and individual country level. It will represent a paradigm shift from the data black hole that we have now.”
Correction Note: The article originally stated that the project will investigate the consumption of 10 food groups across 145 countries. The project will investigate 23 food groups, not 10.