The U.S. ranks number one in many things (most of them unseemly), but one thing for which we don’t rise to the top is healthy eating. No shocker there. But a report from Oxfam America, an organization that has made global health one of its top priorities, now quantifies and ranks the best countries in the world when it comes to eating healthy. And, sorry to say, the U.S. doesn’t even make the top 20.

Oxfam’s report, which relies on the organization’s Good Enough To Eat Index, outlines several key factors that contribute to a country’s overall ranking. Put into basic questions, these are: 1) Do people have enough to eat?; 2) Can people afford to eat?; 3) Is the food of good quality?; and 4) What is the extent of unhealthy outcomes of people’s diets? According to these metrics, the Good Enough To Eat Index ranks The Netherlands as the best place to eat and Chad as the worst.

The data offers intriguing, if disappointing, insights. Beginning stateside, the U.S. ranks number one in food cost and food price inflation volatility — meaning pretty much everyone can afford to be full, and the cost to do so doesn’t fluctuate very much. Unfortunately, the food most people can afford is patently unhealthy. Thanks in part to one-third of the population being overweight or obese, the U.S. ranked 120th out of 125 countries in measures of diet influencing health. American diets contain high levels of fat, salt, and sugar compared to many of the produce- and protein-heavy diets of Western European countries, which all but swept the top 20 places, save for Australia’s taking 8th.

What shot the Netherlands up to its first place rank — and the dozen-plus other European countries beneath it — was the country’s accessibility to affordable produce. It also has lower diabetes levels and greater nutritional diversity than many of its rivals. “However,” the report states, “the Netherlands scores poorly on the obesity measure — almost one in five of its population (19 percent) have a body mass index of more than 30.” Many countries in the top 12 also show high rates of obesity.

At the other end of the list are the worst-performing countries. Many reside in Africa, including the worst place to eat: Chad. Chadians face such great dietary obstacles because the country has outrageously high food costs (the highest, in fact), yet the food is of deplorable quality. Many citizens don’t have access to clean drinking water or foods that nourish the body, such as lean proteins and fresh fruits and vegetables. One in three children is underweight in Chad.

The gaps between the highest-ranked countries and the lowest-ranked are striking, and they indicate a vast misappropriation of global food resources, according to Oxfam’s Max Lawson. “Basically, if you arrive from Mars and design a food system, you probably couldn't design a worse one than what we have today on Earth," Lawson told NPR’s, The Salt. "There is enough food overall in the world to feed everyone. But 900 million people still don't have enough to eat, and 1 billion people are obese. It's a crazy situation."

The balance is tenuous, Lawson explains. Western countries with a lot of wealth tend to have a lot of wealth inequality. This puts poverty in direct parallel with diet, as the cheapest food options in the U.S. are packed with salt, preservatives, and fat. Fresh produce is expensive and doesn’t keep.

"People think that hunger is inevitable, but that's just not true. There is enough food in the world to ensure that nobody goes to bed hungry,” Lawson told NPR. “Even in countries with famines, there's still often enough food. Someone is hoarding it, or it hasn't been distributed.”