Food-Based Dietary Guidelines For Healthier Populations: International Considerations1

Food-Based Dietary Guidelines For Healthier Populations: International Considerations1

Ricardo Uauy

Sophie Hawkesworth

Alan D. Dangour

The modern approach toward defining the nutritional adequacy of diets has progressed over the past two centuries in parallel with scientific understanding of the biochemical and physiologic basis of human nutritional requirements in health and disease. The definition of essential nutrients and nutrient requirements has provided the scientific underpinnings for nutrient-based dietary recommendations, which now exist for virtually every essential nutrient known (1, 2, 3, 4, 5, 6). However, obvious limitations exist to the reductionist nutrient-based approach because people consume foods and not nutrients. Moreover, the effect of specific foods and of dietary patterns on health goes well beyond the combination of essential nutrients the food may contain.

Given our present understanding of food-health relationships, it seems likely that a large variety of foods can be combined in varying amounts to provide a healthy diet. Thus, it is difficult to determine a precise indispensable intake of individual foods that can, when combined with other foods, provide a nutritionally adequate diet under all conditions. The prevailing view is that a large set of food combinations are compatible with nutritional adequacy, but that no given set of foods can be extrapolated as absolutely required or sufficient across different ecologic settings. Trends in the globalization of food supply provide clear evidence that dietary patterns and even traditionally local foods can move across geographic niches.

Recommended nutrient intakes (RNIs) are customarily defined as the intake of energy and specific nutrients necessary to satisfy the requirements of a group of healthy individuals. These are discussed further in the chapter on dietary reference intakes (DRIs). This nutrient-based approach has served well to advance science but has not always fostered the establishment of nutritional and dietary priorities consistent with broad public health interests at national and international levels. For example, the emphasis on protein quality of single food sources placed a premium on the development of animal foods and failed to include amino acid complementarities, which increase the quality of mixed vegetable protein sources. We now know that human protein needs can also be met with predominantly plant-based protein sources. In contrast to this nutrient-based approach, food-based dietary guidelines (FBDGs) address health concerns related to dietary insufficiency, excess, or imbalance with a broader perspective, considering the totality of the effects of a given dietary pattern (7). They are more closely linked to the diet-health relationships of relevance to the particular country or region of interest (8). In addition, they take into account the customary dietary pattern, the foods available, and the factors that determine the consumption of foods. They consider the ecologic setting, the socioeconomic and cultural factors, and the biologic and physical environment that affects the health and nutrition of a given population or community. Finally, they are easy to understand and accessible for all members of a population.

In this chapter we examine the steps required to develop FBDGs, strategies which can be employed to
improve nutritional intake and end with a discussion of the future direction of FBDGs.

Jul 27, 2016 | Posted by in PUBLIC HEALTH AND EPIDEMIOLOGY | Comments Off on Food-Based Dietary Guidelines For Healthier Populations: International Considerations1
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