Agricultural production, commodity marketing and food consumption patterns have changed significantly over the past 30 years the world over, as have national epidemiological profiles. Many countries are now experiencing epidemics of non-communicable diseases (NCDs), while some simultaneously have large burdens of childhood undernutrition. Little is known about how the changing availability of different kinds of foods may be related to both undernutrition and NCDs. Combining data for 124 countries over the period 1980-2009, this study uses random effects models to explore associations between dietary energy availability and dietary quality, on the one hand, and nutrition and health outcomes, on the other. The analysis suggests that increased total dietary energy availability over the study period was associated with lower rates of chronic child undernutrition (stunting) but increased rates of mortality from ischaemic heart disease (IHD), which is an important element of the NCD burden.