If you’re hungry right now hopefully you aren’t in Chad, the worst country on earth for eating, according to a new report Tuesday from Oxfam.
Tallying up data from 125 countries around the world, the Oxfam report reveals some surprising findings about which countries make for the best eating. Atop the list proudly sits the Netherlands. France and Switzerland tie for second place, but the United States doesn’t even make the top 20.
The report looks not only at food security and access to calories, but includes metrics like the cost of food, the nutritional quality of food, access to safe drinking water, and unhealthy eating habits.
This last metric—unhealthy eating measured via the prevalence of diabetes and obesity—is what undoes the U.S., which scores highly on other metrics like nutritional diversity and the cost of food. According to Oxfam’s data, the U.S. is tied with Egypt and Saudi Arabia for the title of second most obese country on the list, behind Kuwait.
The five worst countries on earth for eating, according to Oxfam, are Yemen, Madagascar, Angola, Ethiopia and Chad, where calories tend to be both expensive and nutritionally bland, and where access to safe drinking water is scant. One-in-three children is Chad is underweight. Yemen is the only country outside of sub-Saharan Africa in the bottom ten worst performers.
The bigger picture that emerges out of the report is that both sides of the list—the best and worst places to eat on earth—are connected.
“The food system is global. Policies and practices in countries like the Netherlands and the United States do have an impact,” Oxfam Senior Researcher Deborah Hardoon told TIME. “We know that there is enough food in the world and yet still one in eight people go hungry today.”
The report blames lack of investment in small-scale agriculture in the developing world, unbalanced trade agreements, biofuel production that diverts crops from food to fuel, and the impact of climate change on food production.
The problem is not as simple as rich people in rich countries leaving too little for the poorest of the poor: The U.S. isn’t elbowing Chad away from the macaroni at the dinner table. In rich countries, like the U.S., obesity and diabetes tend to be disproportionately common among the poor. In effect, it is the poor, whether in the Netherlands, France, Ethiopia or Chad, who bear the brunt of dysfunction in the global food economy, Hardoon said.
“It demonstrates a broken system,” she said.