A Global Review of Food-Based Dietary Guidelines Herforth, Anna; Arimond, Mary; Álvarez-Sánchez, Cristina ...
Advances in nutrition (Bethesda, Md.),
07/2019, Letnik:
10, Številka:
4
Journal Article
Recenzirano
Odprti dostop
ABSTRACT
The objective of this review is to provide a concise, descriptive global review of current food-based dietary guidelines (FBDG), and to assess similarities and differences in key elements of ...a healthy diet articulated across countries. Information was sourced from the FBDG repository of the FAO, which catalogs FBDG for all countries where they are available, including a description of the food guide (the graphic representation of the dietary guidelines), a set of key messages, and downloadable documents provided by the countries. FBDG are currently available for 90 countries globally: 7 in Africa, 17 in Asia and the Pacific, 33 in Europe, 27 in Latin America and the Caribbean, 4 in the Near East, and 2 in North America. The year of publication of current versions ranges from 1986 to 2017 (mean 2009). This review provides summaries of the key messages and food guides that are used to communicate national dietary guidance, organized by food group, and evaluates the extent to which each set of FBDG includes existing recommendations articulated by the WHO. Some guidance appears nearly universally across countries: to consume a variety of foods; to consume some foods in higher proportion than others; to consume fruits and vegetables, legumes, and animal-source foods; and to limit sugar, fat, and salt. Guidelines on dairy, red meat, fats and oils, and nuts are more variable. Although WHO global guidance encourages consumption of nuts, whole grains, and healthy fats, these messages are not universally echoed across countries. Future frontiers in FBDG development include the incorporation of environmental sustainability and increased attention to sociocultural factors including rapidly changing dietary trends. Steps toward regional and global dietary recommendations could be helpful for refinement of country-level FBDG, and for clear communication and measurement of diet quality both nationally and globally.
Introduction and purpose Diabetes is a set of metabolic disorders whose common, characteristic feature is the occurrence of hyperglycemia. Elevated glycemia levels result from impaired insulin ...secretion and/or defects in its action. In type 2 diabetes, we have modified risk factors such as improper diet, reduced physical activity, and obesity. In the context of these reversible factors, intervention in patients' lifestyle, with particular emphasis on physical activity, seems advisable. To investigate the implementation of recommendations for the treatment of type 2 diabetes, relating to physical activity as a component of behavioral treatment of diabetes. Materials and methods. Author's survey covering patients' knowledge about their disease, needs and expectations regarding education. The questionnaire examines the physical activity of patients newly diagnosed and already treated for type 2 diabetes. Results. The most frequently undertaken exercise was of medium intensity in the form of walking or "Nordic walking". This was also more likely to be intensified. Patients choosing this type of activity practiced it much more often and more regularly than other types of activity. Running and cycling were other activities undertaken by the patients, although in the younger group of patients. Patients who enjoyed physical exercise were more likely and willing to do it and it was more regular. Conclusions. Patients were reluctant to undertake physical exercise and usually did not treat it as an integral part of treatment. Usually, it was not a very intense effort. They also rarely intensified it when the diagnosis was made. Most of the respondents did not understand the role of exercise in the treatment process and its impact on sugar levels.
The aim of EU project MyNewGut is to contribute to future public health-related recommendations supported by new insight in gut microbiome and nutrition-host relationship. In this Opinion Paper, we ...first revisit the concept of dietary fiber, taking into account their interaction with the gut microbiota. This paper also summarizes the main effects of dietary fibers with prebiotic properties in intervention studies in humans, with a particular emphasis on the effects of arabinoxylans and arabinoxylo-oligosaccharides on metabolic alterations associated with obesity. Based on the existing state of the art and future development, we elaborate the steps required to propose dietary guidelines related to dietary fibers, taking into account their interaction with the gut microbiota.
Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40–50 years. From the knowledge gained, countries have developed guidelines ...for their populations on the optimal amount of fibre to be consumed each day. Food composition tables from many countries now contain values for the dietary fibre content of foods, and, from these, combined with dietary surveys, population intakes have been determined. The present review assessed the uniformity of the analytical methods used, health claims permitted, recommendations and intakes, particularly from national surveys across Europe and around the world. It also assessed current knowledge on health effects of dietary fibre and related the impact of different fibre types on health. The overall intent was to be able to provide more detailed guidance on the types of fibre which should be consumed for good health, rather than simply a total intake figure, the current situation. Analysis of data indicated a fair degree of uniformity in the definition of dietary fibre, the method used for analysis, the recommended amount to be consumed and a growing literature on effects on digestive health and disease risk. However, national dietary survey data showed that intakes do not reach recommendations and very few countries provide guidance on the types of fibre that are preferable to achieve recommended intakes. Research gaps were identified and ideas suggested to provide information for more detailed advice to the public about specific food sources that should be consumed to achieve health benefits.
The aim of this article was to prepare a basis for further quantitative research concerning the nutritional knowledge of medical professionals (doctors) and dieticians in view of the accuracy of ...dietary recommendations given to patients. For this purpose, a review of literature data in this area was performed and logical fallacies were proposed as the ‘tool’ that doctors rely on in cases when they lack the proper knowledge required to be able give an informed and beneficial recommendation. In the course of the study, it was found that nutritional education is neglected in medical curricula, while dieticians are underused as professionals in clinical settings. Furthermore, numerous characteristics of the medical profession and the doctor–patient relationship are conducive to committing several types of logical fallacies, prompted mainly by the need for providing advice without delay and the infallibility traditionally expected from doctors. Hence, the gaps in nutritional knowledge and the fallacious character of recommendations, in addition to the re-valuation of the role of the nutritionist, need to be further investigated in order to improve the quality of patient advice in the area of dietary requirements as well as to propose the necessary changes in curricula.
Choline, an essential dietary nutrient for humans, is required for the synthesis of the neurotransmitter, acetylcholine, the methyl group donor, betaine, and phospholipids; and therefore, choline is ...involved in a broad range of critical physiological functions across all stages of the life cycle. The current dietary recommendations for choline have been established as Adequate Intakes (AIs) for total choline; however, dietary choline is present in multiple different forms that are both water-soluble (e.g., free choline, phosphocholine, and glycerophosphocholine) and lipid-soluble (e.g., phosphatidylcholine and sphingomyelin). Interestingly, the different dietary choline forms consumed during infancy differ from those in adulthood. This can be explained by the primary food source, where the majority of choline present in human milk is in the water-soluble form, versus lipid-soluble forms for foods consumed later on. This review summarizes the current knowledge on dietary recommendations and assessment methods, and dietary choline intake from food sources across the life cycle.
The concept of a 'recommended dietary allowance' (RDA) and similar terms describing the daily intake of essential nutrients recommended for healthy individuals is widely used by various health ...authorities around the world. For vitamin C, however, there remain significant discrepancies in the criteria used to establish dietary recommendations and consequently, global recommendations for daily vitamin C intake vary by more than five fold. While it appears that the scientific data underlying the recommendations are more or less the same, the interpretation differs considerably. Moreover, although a number of the assumptions used in e.g. the body pool estimates of the 1960s and 1970s have later been proven wrong and give rise to significant underestimations, these data are still used as the main support of several recommendations. Aspects that modify vitamin C requirements, such as gender, age, pregnancy, lactation, and smoking, have been taken into consideration by many but not all regulatory authorities, and are thus subject of debate. In contrast, body weight, a significant predictor of vitamin C status and requirement, has not been taken into consideration with respect to vitamin C recommendations, even in the face of the looming global obesity pandemic. The present review examines the discrepancies in vitamin C dietary recommendations of international authorities and critically discusses representative examples of criteria and the underlying health perspectives used to derive current recommended intakes of vitamin C. New biological signatures of vitamin C nutriture are also explored with regard to their potential use for future updates of dietary recommendations.
Nutrition can play a key role in cardiovascular disease risk reduction, and its risk factors modification. This paper aims to present, compare, and summarize the main dietary concepts for preventing ...the main cardiovascular disease risk factors – obesity, hypertension, and dyslipidemia. The dietary models and macronutrient intakes were compared between main cardiovascular risk factors prevention recommendations.
Dietary recommendations related to selected cardiovascular risk factors share the points, that can be suggested as crucial for overall cardiovascular risk factors reduction. Recommendations suggest limiting saturated fatty acids intake to <10% of total caloric intake in obesity, and <7 % in hypercholesterolemia, along with an increased intake of mono- and polyunsaturated fatty acids. In addition, daily dietary fiber intake should reach a level of 25-40 g. The vegetables and fruits should be consumed at a daily minimum level of 200g (or 4-5 portions) each. Salt intake should not exceed 5g/day. Alcohol should be generally avoided, and moderate intake levels (sex-specific) should not be exceeded. It is also worth noting, that proteins are essential for tissue formation and regeneration. Carbohydrates are the main source of energy, but it is necessary to choose products with a low glycemic index. Dietary antioxidants help combat free radicals and prevent cell damage.
The immediate need to build resilient food systems with lower greenhouse gas (GHG) emissions and protection of water resources is a global challenge. To address this, the EAT-Lancet Commission ...described the global reference diet with principles of nutritional quality and environmental sustainability. With this in mind, the carbon and water footprints of the current Spanish dietary pattern have been compared with the EAT-Lancet global dietary recommendations, taking into account deviations in food intake. To provide additional context, differences between the average Spanish dietary pattern and dietary guidelines applied in other countries in Europe (Italy, the Netherlands and the Mediterranean region) and America have also been analyzed and discussed from a sustainability approach.
We found that the EAT-Lancet diet requires less water resources (3056 L·person−1·day−1) and lower level of GHG emissions (2.13 kgCO2eq·person−1·day−1) in comparison with the Spanish dietary pattern (3732 L·person−1·day−1 and 3.62 kgCO2eq·person−1·day−1, respectively). Starch-based products and oils and fats were identified as largest contributors to both environmental indicators in the EAT-Lancet diet. On the other hand, meat and dairy were the environmental hotspots in the Spanish dietary pattern. Comparison with other food-based dietary patterns also raises environmental concerns about the high meat consumption in Spain.
Overall, this analysis suggests that reducing the consumption of beef meat and dairy to a level in line with the global environmental targets set by the EAT-Lancet Commission would ensure a shift in Spanish dietary habits towards more environmentally sustainable food consumption patterns.
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•The Spanish dietary pattern has been compared with the EAT-Lancet diet from carbon and water perspectives.•Starch-based products and oils and fats are the main contributors to carbon and water footprints in the EAT-Lancet diet.•Meat and dairy are responsible for the greatest carbon and water footprints in the Spanish dietary pattern.•Major reductions in meat and dairy are needed to transitioning to low carbon and water footprint eating habits in Spain.
The future of precision nutrition requires treating amino acids as essential nutrients. Currently, recognition of essential amino acid requirements is embedded within a generalized measure of protein ...quality known as the PDCAAS (Protein Digestibility-Corrected Amino Acid Score). Calculating the PDCAAS includes the FAO/WHO/UNU amino acid score, which is based on the limiting amino acid in a food, that is, the single amino acid with the lowest concentration compared to the reference standard. That “limiting” amino acid score is then multiplied by a bioavailability factor to obtain the PDCAAS, which ranks proteins from 0.0 (poor quality) to 1.0 (high quality). However, the PDCAAS has multiple limitations: it only allows for direct protein quality comparison between 2 proteins, and it is not scalable, transparent, or additive. We therefore propose that shifting the protein quality evaluation paradigm from the current generalized perspective to a precision nutrition focus treating amino acids as unique, metabolically active nutrients will be valuable for multiple areas of science and public health. We report the development and validation of the Essential Amino Acid 9 (EAA-9) score, an innovative, nutrient-based protein quality scoring framework. EAA-9 scores can be used to ensure that dietary recommendations for each essential amino acid are met. The EAA-9 scoring framework also offers the advantages of being additive and, perhaps most importantly, allows for personalization of essential amino acid needs based on age or metabolic conditions. Comparisons of the EAA-9 score with PDCAAS demonstrated the validity of the EAA-9 framework, and practical applications demonstrated that the EAA-9 framework is a powerful tool for precision nutrition applications.
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