How supportive is the global food supply of food-based dietary guidelines? A descriptive time series analysis of food supply alignment from 1961 to 2013

Chloe Clifford Astbury; Emilie Aguirre; Katherine Cullerton; Pablo Monsivais; Tarra L Penney

doi:10.1016/j.ssmph.2021.100866

How supportive is the global food supply of food-based dietary guidelines? A descriptive time series analysis of food supply alignment from 1961 to 2013

SSM Popul Health. 2021 Jul 6:15:100866. doi: 10.1016/j.ssmph.2021.100866. eCollection 2021 Sep.

Authors

Chloe Clifford Astbury^{1

2}, Emilie Aguirre^{3

4}, Katherine Cullerton⁵, Pablo Monsivais⁶, Tarra L Penney^{1

2}

Affiliations

¹ Global Food Systems and Policy Research, School of Global Health, Faculty of Health, York University, 4700, Keele St., Toronto ON, M3J 1P3, Canada.
² Global Strategy Lab, Faculty of Health, York University, Canada.
³ University of Chicago Law School, Chicago, USA.
⁴ Harvard Business School, Cambridge, USA.
⁵ School of Public Health, University of Queensland, Australia.
⁶ Department of Nutrition & Exercise Physiology, Washington State University, USA.

Abstract

Background: FAO/WHO have encouraged national governments to create food-based dietary guidelines (FBDGs) to support healthy diets. However, little is known about the extent to which food supply composition aligns with FBDGs, thereby structurally supporting or undermining population-level adherence. It is also unclear how this alignment has evolved over time. The aim of this study was to determine to what extent the global food supply aligns with FBDGs, and to examine historical trends.

Methods: Descriptive time series analysis of food supply alignment (FSA), 1961-2013. FSA was characterised as a ratio dividing country-level food supply data by FBDG across four food groups: fruit and vegetables (FV); sugar (SU); fish and seafood (FS); and red and processed meat (RP). FBDG data was collected from guidance produced by international bodies, and from countries with published FBDGs. The food supply was estimated using yearly FAOSTAT data. A population-weighted average of this ratio was created for all countries included in the analysis, and stratified by region and country income.

Findings: FBDGs from 89 countries were included. Of those, 80% had country guidelines for FV, 34% for SU, 44% for FS, and 21% for RP. FSA (1.0 = perfect alignment) based on global guidelines showed a higher supply than recommended for FV (1.2), SU (1.2) and RP (1.1). FSA based on country guidelines showed a lower supply than recommended for FV (0.9) and a higher supply than recommended for SU (2.3), RP (2.3) and FS (1.4). FSA also showed substantial differences in levels and trends across region and country income.

Interpretation: As of 2013, food supplies were not aligned with national and international FBDGs and misalignment persisted across five decades with subtantial variation in trends based on geography and country income. The long running nature of these trends suggest that the transition toward sustainable and healthful food systems represent a signifiant global challange. Additionally, acknowledging the degree of misalignment between macro-level structural factors, such as the composition of the food supply, in relation to national or global food policy aims may further aid efforts for population level adherence.

Keywords: Determinants of health; Dietary guidelines; Food environment; Food supply; Global health; Structural.