Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies . The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020 . English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs . Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs . Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3% . HIC have higher consumption of discretionary foods, while results were mixed for LMIC . Grains and dairy were consumed below recommendations in both HIC and LMIC . Consumption of animal proteins (> 30 %), particularly red meat, exceeded the recommendations . Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country ’ s guidelines . Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.