The Alternative Healthy Eating Index produced regional means ranging from 30.3 (out of 100) in Latin America and the Caribbean to 45.7 in South Asia. Child scores were lower than adult scores in Central and Eastern Europe, Central Asia, the Middle East and North Africa, and high-income countries. Scores were higher among women and more educated individuals. Diet quality increased modestly between 1990 and 2018 globally, except in South Asia and sub-Saharan Africa.