WHO Diet Advice Doesn’t Fit All: Global Realities Overlooked
The World Health Organization (WHO) urges everyone to eat more fruits and vegetables and get plenty of exercise. But for billions of people, these well-intentioned guidelines simply don’t match daily realities.
The High Cost of Healthy Eating in Low-Income Countries
Simon Fraser University professor Scott Lear, who leads cardiovascular prevention research, points out that WHO’s recommendations are built on assumptions from wealthy nations. In many low- and middle-income countries, the cost of eating healthy is staggering. For example, farmers may lose half their income if they eat what they grow instead of selling it. Meeting the WHO’s advice of five daily servings of fruits and vegetables could consume 50% of a family’s budget—a luxury few can afford.
Physical Activity: Not All Movement Is Equal
The WHO also suggests regular exercise, but this overlooks the reality for millions whose jobs are already physically demanding. Field workers, miners, and laborers spend hours doing strenuous tasks—far more than a gym session. Yet, their work is rarely seen as “healthy movement” in global guidelines.
Environment and Commute Matter
Daily life in lower-income countries often involves long, exhausting commutes on foot. Unlike a stroll in a leafy neighborhood, walking to work in a city like New Delhi means braving heavy pollution and unsafe conditions. The environment, type of work, and access to transportation all shape health in ways the guidelines don’t address.
The PURE Study: Real-World Data, Real-World Barriers
Lear’s work on the Prospective Urban Rural Epidemiology (PURE) study spans 28 countries and includes over 200,000 participants—most from low- and middle-income backgrounds. The research tracks not just diet and exercise, but also factors like air pollution, education, social isolation, and access to healthcare. The findings reveal that health risks and solutions look very different depending on where you live.
One Size Doesn’t Fit All
Lear admits his own perspective has changed over decades of research. “Early in my career, I thought everyone should eat the same foods and exercise more,” he says. “Now I see that’s a privilege of high-income countries. Real solutions must fit real lives.”
Global health guidelines work best when they reflect the realities of people everywhere—not just those in wealthy nations.
