Implementing food-based dietary guidelines for - United Nations ...

Beyond recommendations: Implementing food-based dietary
guidelines for healthier populations
Suttilak Smitasiri and Ricardo Uauy
Abstract
To reduce the increased burden of diet-related disease
and promote human potential through food and nutrition
globally, harmonization of efforts is urgently needed.
This article examines the concept of food-based dietary
guidelines (FBDGs) and discusses the possibilities and
challenges of harmonizing the process of developing and
implementing dietary guidelines. The authors argue
that while the development of FBDGs has contributed to
the understanding of the role of nutrients and foods in
achieving optimal health, the impact of these guidelines
on human health has been limited.
Science or evidence must be used in FBDG development;
nevertheless, there are limitations in current
nutrition science. FBDGs should address the health consequences
of dietary insufficiency, excess, or imbalance
with a broader perspective, considering the totality of the
effects of a given dietary pattern, rather than focusing
on single nutrients alone. Moreover, the food selection
guideline should be seen as complementary to a strategic,
comprehensive, and culturally appropriate dietary and
health promoting intervention, and not only as a tool for
providing nutrition policy and information.
Technically, a single unified global set of FBDGs may
be desirable and even achievable. This concept, however,
presents novel challenges on how to address cultural
diversity and the complex social, economic, and political
interactions between humans and the food supply, not
to mention the complexity of its communication and
Suttilak Smitasiri is affiliated with the Institute of Nutrition,
Mahidol University (INMU), Nakorn Phathom, Thailand;
Ricardo Uauy is affiliated with the Instituto de Nutrición
y Technología de los Alimentos (INTA), University of Chile,
Santiago, Chile, and the Nutrition and Public Health Intervention
Research Unit, London School of Hygiene and Tropical
Medicine, London.
Please direct queries to the corresponding author: Suttilak
Smitasiri, Division of Communication and Behavioral
Science, Institute of Nutrition, Mahidol University (INMU),
Phuthamonthon 4 Road, Salaya, Nakorn Phathom 73170,
Thailand; e-mail: nussm@mahidol.ac.th.
implementation. Therefore, global harmonized efforts in
support of strategic dietary interventions, together with
strong global scientific support and facilitation for the
development and communication of FBDGs at national
or regional levels, are proposed to implement FBDGs for
healthier populations.
Key words: Food-based dietary guidelines, nutrientbased
dietary guidelines, food selection guides, unified
food guidelines
Introduction
The establishment of food- or nutrient-based dietary
guidelines (FBDGs or NBDGs) is a complex issue; this
complexity will most likely continue to increase in the
future as knowledge of the science base and the need to
consider context in the application of FBDGs/NBDGs
increase. International agencies and national authorities
around the world are faced with the need to inform
and educate all constituencies involved in this process.
Food and nutrition policy makers, planners, and
common citizens need to be able to manage and make
food choices at the national, community and individual
levels. Several countries, beginning with those in the
industrialized world, have developed FBDGs as one
of many tools for this purpose. FBDGs are generally
developed with the expectation that they will help to
improve the effectiveness of nutrition education efforts,
directed both to the general public and at the national
level [1].
The US Government has developed and tendered
official dietary advice for the public since 1894. The
first US food guides were promoted in 1916 as conceptual
frameworks for selecting the kinds and amounts
of a variety of foods, which together provided a nutritionally
satisfactory diet [2, 3]. Over the years, the US
food guides have changed as nutrition knowledge has
advanced and new discoveries relating diet and health
have been made. The guides primarily focused on the
Food and Nutrition Bulletin, vol. 28, no. 1 (supplement) © 2007, The United Nations University. S141