This research examines how gender and economic development interrelate to predict healthy eating behaviors, and how all three interrelate to predict health outcomes. The consumption of fresh fruits and vegetables has been identified by international NGOS, policymakers, and health advocates as an important way to improve health outcomes. However, attempts to change population diets often take highly individualistic approaches, which may overlook structural factors that influence access to and availability of healthy food options, and systematic differences in the propensity to enact health behaviors among populations with similar levels of access and availability. In response, we examine nationally representative data from 31 middle- and high-income countries from the health module of the 2011 International Social Survey Programme. Following analyses from multilevel gamma and linear regression models, we draw two main conclusions. First, women, but not men, tend to eat fresh fruits and vegetables more frequently in more developed countries. Second, there is substantial heterogeneity in health differences between men and women, depending on individual eating behaviors and national development context. We conclude by discussing the academic and policy implications for health and development of our findings regarding the effect of structural factors on eating behaviors and health outcomes.