Background Poor diets pose a threat to all forms of malnutrition and diet-related noncommunicable diseases (NCDs). Data on dietary patterns are scarce in South Asia.

Objectives We sought to describe overall diet quality, intake of foods and food groups, and eating occasions among adults in rural South Asia.

Methods Data were from five districts across Bangladesh (n=2,802 individuals), India (n=1,672), and Nepal (n=1,451). The Global Diet Quality Score (GDQS) application was used to measure intake of foods on the previous day, with each food tagged to an eating occasion. Diet quality and the risk of diet-related noncommunicable diseases (NCDs) were described using GDQS total (0–49), GDQS positive (0–32) and GDQS negative (0–17) metrics for overall, healthy, and unhealthy food intake respectively.

Results Diet quality was low, with similar scores across countries for GDQS total (17-19 depending on country), GDQS positive (7–8) and GDQS negative (10–12), indicating low intake of healthy foods as the main contributor to poor diets. Over 90% of adults had levels of GQDS scores associated with moderate/high risk for diet-related NCDs, with the proportion at high risk in Bangladesh being 2-3x higher than other countries. Across sites, intake of refined grains (white rice), sweets (sugar, biscuits), and white tubers (potatoes) was common. One-third of adults did not eat breakfast in Nepal, and snacking was twice as common in males (63%) versus females (33%) in Bangladesh.

Conclusions These findings highlight the need to improve diets in rural South Asia and may help inform interventions targeting food intake patterns.

The authors have declared no competing interest.

We acknowledge all funders who supported this research through their contributions to the CGIAR Trust Fund: www.cgiar.org/funders/.

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The protocol, informed consent forms, and study questionnaires were approved by the Institutional Review Boards (IRB) of the International Food Policy Research Institute in Washington, DC, USA; the Institute of Health Economics, University of Dhaka, Bangladesh; Centre for Media Studies, Delhi, India; and the National Health Research Council, Kathmandu, Nepal.

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