Assessing positive and negative features of diets is key to understanding the causes of poor health and nutrition outcomes. Identifying current diet patterns can help improve nutrition, especially in low- and middle-income countries where diets are rapidly changing due to urbanization, globalization, migration, and other factors. Measuring dietary patterns is thus key to inform nutrition programming, nutrition-sensitive agriculture policy and related interventions.
The Diet Quality Questionnaire (DQQ) is an internationally standardized survey instrument developed by Global Diet Quality Project, and funded by The Swiss Agency for Development and Cooperation and The Rockefeller Foundation, that works universally to capture local realities, that can be used to interpret diet quality within and across countries.
The country-adapted DQQ modules take just five minutes to implement and provides a host of information about diet patterns at the population level, capturing consumption information for 29 food groups, including both healthy and unhealthy foods. It can be used by any survey team with an interest in gathering information on diet quality. The availability of these low-burden tools is intended to facilitate and catalyze diet quality monitoring in countries, and across sectors.
The Gallup World Poll is already implementing the DQQ in 42 countries to assess diet quality, and aims to scale up implementation to all of the countries it surveys (about 140) by 2024. The DQ-Q is currently being adapted for more than 90 countries, with the support of USAID, The Rockefeller Foundation, and the European Union and BMZ through GIZ's Capacity for Nutrition (C4N). Country-specific diet-quality survey tools have been made available to 6 countries by mid-2022. These tools will enable the collection of dietary data that covers aspects of diet related to both undernutrition and diet-related noncommunicable diseases.
Population-level data obtained from the DQQ tool can be used to calculate numerous diet quality indicators, including the minimum dietary diversity for women, the corresponding food group diversity score, the Global Dietary Recommendation score, and the recently updated World Health Organization and UNICEF infant and young child feeding indicators.
Gallup, Harvard T.H. Chan School of Public Health, and the Global Alliance for Improved Nutrition (GAIN) have published a new report in October 2022 on diet quality entitled Measuring What the World Eats. It is the first report from the Global Diet Quality Project, with data based on the Diet Quality Questionnaire (DQQ).
Key messages
- Basic dietary diversity, diverse plant foods and ultra-processed foods are three indicators of diet – both, good and bad -- that are universally important across regions and countries, including those that are rapidly transitioning.
- There is a need to consistently collect comparable dietary quality data in the general adult population across countries worldwide.
- There is a need to enable thinktanks and policymakers to start using cross-country diet-quality monitoring data routinely, filling a decades-old gap in basic information about nutrition.
- Situations such as the recent COVID-19 pandemic show how vitally useful routinely collected data can be, on what people are eating, and how their diets shift because of shocks and over time.
- Unlike most other public health priorities such as HIV, smoking and obesity, there is no global monitoring system for diets.
- Understanding dietary patterns and trends in populations with tools like the DQ-Q, is a first step to inform actions to support and improve diet quality and track progress over time.
