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| HEALTHY DIET |
Healthy diet
Key
facts
●
A healthy diet
helps to protect against malnutrition in all its forms, as well as noncommunicable
diseases (NCDs), including such as diabetes, heart disease, stroke, and cancer.
●
Unhealthy diet
and lack of physical activity is leading global risks to health.
●
Healthy dietary
practices start early in life – breastfeeding fosters healthy growth and
improves cognitive development, and may have long term health benefits such
as reducing the risk of becoming overweight or obese and developing NCDs later
in life.
●
Energy intake
(calories) should be in balance with energy expenditure. To avoid unhealthily
weight gain, total fat should not exceed 30% of total energy intake.
Intake of saturated fats should be less than 10% of total energy intake, and
intake of trans-fats less than 1% of total energy intake, with a shift in fat
consumption away from saturated fats and trans-fats to unsaturated fats,
and towards the goal of eliminating industrially-produced trans-fats.
●
Limiting intake
of free sugars to less than 10% of total energy intake is part of a
healthy diet. A further reduction to less than 5% of total energy intake is
suggested for additional health benefits.
●
Keeping salt
intake to less than 5 g per day (equivalent to sodium intake of less than 2 g
per day) helps to prevent hypertension and reduces the risk of heart disease
and stroke in the adult population.
●
WHO Member
States have agreed to reduce the global population’s intake of salt by 30% by
2025; they have also agreed to halt the rise in diabetes and obesity in adults
and adolescents as well as in childhood overweight by 2025.
Overview
Consuming a healthy diet throughout the
life-course helps to prevent malnutrition in all its forms as well as a range
of noncommunicable diseases (NCDs) and conditions. However, increased
production of processed foods, rapid urbanization, and changing lifestyles have
led to a shift in dietary patterns. People are now consuming more foods high in
energy, fats, free sugars, and salt/sodium, and many people do not eat enough
fruit, vegetables, and other dietary fiber such as whole grains.
The exact make-up of a diversified, balanced
and a healthy diet will vary depending on individual characteristics (e.g. age,
gender, lifestyle and degree of physical activity), cultural context, locally
available foods and dietary customs. However, the basic principles of what
constitutes a healthy diet remain the same.
A healthy diet includes the following:
●
Fruit, vegetables, legumes (e.g. lentils and
beans), nuts, and whole grains (e.g. unprocessed maize, millet, oats, wheat and
brown rice).
●
At least 400 g (i.e. five portions) of fruit
and vegetables per day, excluding
potatoes, sweet potatoes, cassava, and other starchy roots.
●
Less than 10% of total energy intake from free
sugars, which is equivalent to
50 g (or about 12 level teaspoons) for a person of healthy body weight
consuming about 2000 calories per day, but ideally is less than 5% of total
energy intake for additional health benefits. Free sugars are all sugars added to foods or drinks by the
manufacturer, cook, or consumer, as well as sugars naturally present in honey,
syrups, fruit juices and fruit juice concentrates.
●
Less than 30% of total energy intake from fats. Unsaturated fats (found in
fish, avocado and nuts, and in sunflower, soybean, canola, and olive oils) are
preferable to saturated fats (found in fatty meat, butter, palm, and coconut
oil, cream, cheese, ghee, and lard) and trans-fats
of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks
and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking
oils and spreads) and ruminant trans-fats
(found in meat and dairy foods from ruminant animals, such as cows, sheep,
goats, and camels). It is suggested that the intake of saturated fats be reduced
to less than 10% of total energy intake and trans-fats
to less than 1% of total energy intake.
In particular, industrially-produced trans-fats
are not part of a healthy diet and should be avoided.
●
Less than 5
g of salt (equivalent to about one teaspoon) per day (8). Salt should be iodized.
In the first 2 years of a child’s life, optimal
nutrition fosters healthy growth and improves cognitive development. It also
reduces the risk of becoming overweight or obese and developing NCDs later in
life.
Advice on a healthy diet for infants and
children are similar to adults, but the following elements are also
important:
●
Infants should be breastfed exclusively during
the first 6 months of life.
●
Infants should be breastfed continuously until
2 years of age and beyond.
●
From 6 months of age, breast milk should be
complemented with a variety of adequate, safe, and nutrient-dense foods. Salt
and sugars should not be added to complementary foods.
Fruit
and vegetables
Eating at least 400 g, or five portions, of
fruit and vegetables per day reduce the risk of NCDs (2) and help to ensure an adequate daily intake of dietary fiber.
Fruit and vegetable intake can be improved by:
●
always including vegetables in meals;
●
eating fresh fruit and raw vegetables as
snacks;
●
eating fresh fruit and vegetables that are in
season; and
●
eating a variety of fruit and vegetables.
Reducing the amount of total fat intake to less
than 30% of total energy intake helps to prevent unhealthy weight gain in the
adult population. Also, the
risk of developing NCDs is lowered by:
●
reducing saturated fats to less than 10% of
total energy intake;
●
reducing trans-fats
to less than 1% of total energy intake; and
●
replacing both saturated fats and trans-fats with unsaturated fats – in particular, with
polyunsaturated fats.
Fat intake, especially saturated fat and
industrially-produced trans-fat
intake can be reduced by:
●
steaming or boiling instead of frying when
cooking;
●
replacing butter, lard, and ghee with oils rich
in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower
and sunflower oils;
●
eating reduced-fat dairy foods and lean meats,
or trimming visible fat from meat; and
●
limiting the consumption of baked and fried
foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies,
biscuits and wafers) that contain industrially-produced trans-fats.
Most people consume too much sodium through
salt (corresponding to consuming an average of 9–12 g of salt per day) and not
enough potassium (less than 3.5 g). High sodium intake and insufficient
potassium intake contributes to high blood pressure, which in turn increases the
risk of heart disease and stroke.
Reducing salt intake to the recommended level
of less than 5 g per day could prevent 1.7 million deaths each year.
People are often unaware of the amount of salt
they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats such as
bacon, ham, and salami; cheese; and salty snacks) or from foods consumed
frequently in large amounts (e.g. bread). Salt is also added to foods during
cooking (e.g. bouillon, stock cubes, soy sauce, and fish sauce) or at the point
of consumption (e.g. table salt).
Salt intake can be reduced by:
●
limiting the amount of salt and high-sodium
condiments (e.g. soy sauce, fish sauce, and bouillon) when cooking and preparing
foods;
●
not having salt or high-sodium sauces on the
table;
●
limiting the consumption of salty snacks; and
●
choosing products with lower sodium content.
Some food manufacturers are reformulating
recipes to reduce the sodium content of their products, and people should be
encouraged to check nutrition labels to see how much sodium is in a product
before purchasing or consuming it.
Potassium can mitigate the negative effects of
elevated sodium consumption on blood pressure. Intake of potassium can be
increased by consuming fresh fruit and vegetables.
In both adults and children, the intake of free
sugars should be reduced to less than 10% of total energy intake.
A reduction to less than 5% of total energy intake would provide
additional health benefits.
Consuming free sugars increases the risk of
dental caries (tooth decay). Excess calories from foods and drinks high in free
sugars also contribute to unhealthy weight gain, which can lead to overweight
and obesity. Recent evidence also shows that free sugars influence blood
pressure and serum lipids, and suggests that a reduction in free sugars intake
reduces risk factors for cardiovascular diseases .
Sugars intake can be reduced by:
●
limiting the consumption of foods and drinks
containing high amounts of sugars, such as sugary snacks, candies and
sugar-sweetened beverages (i.e. all types of beverages containing free sugars –
these include carbonated or non‐carbonated soft drinks, fruit or vegetable
juices and drinks, liquid and powder concentrates, flavored water, energy and
sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee, and flavored milk
drinks); and
●
Eating fresh fruit and raw vegetables as snacks
instead of sugary snacks.
Diet evolves over time, being influenced by
many social and economic factors that interact in a complex manner to shape
individual dietary patterns. These factors include income, food prices (which
will affect the availability and affordability of healthy foods), individual
preferences and beliefs, cultural traditions, and geographical and
environmental aspects (including climate change). Therefore, promoting a
healthy food environment – including food systems that promote a diversified,
balanced and healthy diet – requires the involvement of multiple sectors and
stakeholders, including government, and the public and private sectors.
Governments have a central role in creating a
healthy food environment that enables people to adopt and maintain healthy
dietary practices. Effective actions by policy-makers to create a healthy food
environment include the following:
●
Creating coherence in national policies and
investment plans – including trade, food, and agricultural policies – to promote
a healthy diet and protect public health through:
○
increasing incentives for producers and
retailers to grow, use, and sell fresh fruit and vegetables;
○
reducing incentives for the food industry to
continue or increase production of processed foods containing high levels of
saturated fats, trans-fats, free
sugars and salt/sodium;
○
encouraging reformulation of food products to
reduce the contents of saturated fats, trans-fats,
free sugars and salt/sodium, with the goal of eliminating industrially-produced
trans-fats;
○
implementing the WHO recommendations on the
marketing of foods and non-alcoholic beverages to children;
○
establishing standards to foster healthy
dietary practices through ensuring the availability of healthy, nutritious,
safe and affordable foods in pre-schools, schools, other public institutions
and the workplace;
○
exploring regulatory and voluntary instruments
(e.g. marketing regulations and nutrition labeling policies), and economic
incentives or disincentives (e.g. taxation and subsidies) to promote a healthy
diet; and
○
Encouraging transnational, national, and local
food services and catering outlets to improve the nutritional quality of their
foods – ensuring the availability and affordability of healthy choices – and
review portion sizes and pricing.
●
Encouraging consumer demand for healthy foods
and meals through:
○
promoting consumer awareness of a healthy diet;
○
developing school policies and programs that
encourage children to adopt and maintain a healthy diet;
○
educating children, adolescents and adults
about nutrition and healthy dietary practices;
○
encouraging culinary skills, including in
children through schools;
○
supporting point-of-sale information, including
through nutrition labeling that ensures accurate, standardized and
comprehensible information on nutrient contents in foods (in line with the
Codex Alimentarius Commission guidelines), with the addition of front-of-pack labeling
to facilitate consumer understanding; and
○
providing nutrition and dietary counseling at
primary health-care facilities.
●
Promoting appropriate infant and young child
feeding practices through:
○
implementing the International Code of
Marketing of Breast-milk Substitutes and subsequent relevant World Health
Assembly resolutions;
○
implementing policies and practices to promote
protection of working mothers; and
○
Promoting, protecting, and supporting
breastfeeding in health services and the community, including through the
Baby-friendly Hospital Initiative.
WHO
response
The “WHO Global Strategy on Diet, Physical
Activity and Health” was adopted
in 2004 by the Health Assembly. The strategy called on governments, WHO,
international partners, the private sector, and civil society to take action at
global, regional, and local levels to support healthy diets and physical
activity.
In 2010, the Health Assembly endorsed a set of
recommendations on the marketing of foods and non-alcoholic beverages to
children. These recommendations
guide countries in designing new policies and improving existing ones to reduce
the impact on children of the marketing of foods and non-alcoholic beverages to
children. WHO has also developed region-specific tools (such as regional
nutrient profile models) that countries can use to implement marketing
recommendations.
In 2012, the Health Assembly adopted a
“Comprehensive Implementation Plan on Maternal, Infant and Young Child
Nutrition” and six global nutrition targets to be achieved by 2025, including
the reduction of stunting, wasting, and overweight in children, the improvement
of breastfeeding, and the reduction of anemia and low birth weight.
In 2013, the Health Assembly agreed to nine
global voluntary targets for the prevention and control of NCDs. These targets
include a halt to the rise in diabetes and obesity and a 30% relative
reduction in the intake of salt by 2025. The “Global Action Plan for the
Prevention and Control of Noncommunicable Diseases 2013–2020” provides guidance and policy
options for the Member States, WHO, and other United Nations agencies to achieve the
targets.
With many countries now seeing a rapid rise in
obesity among infants and children, in May 2014 WHO set up the Commission on
Ending Childhood Obesity. In 2016, the Commission proposed a set of
recommendations to successfully tackle childhood and adolescent obesity in
different contexts around the world.
In November 2014, WHO organized, jointly with
the Food and Agriculture Organization of the United Nations (FAO), the Second
International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration
on Nutrition, and the Framework
for Action which recommends a
set of policy options and strategies to promote diversified, safe and healthy
diets at all stages of life. WHO is helping countries to implement the
commitments made at ICN2.
In May 2018, the Health Assembly approved the
13th General Programme of Work (GPW13), which will guide the work of WHO in
2019–2023. Reduction of
salt/sodium intake and elimination of industrially-produced trans-fats from the food supply are
identified in GPW13 as part of WHO’s priority actions to achieve the aims of
ensuring healthy lives and promote well-being for all at all ages. To support
Member States in taking necessary actions to eliminate industrially-produced trans-fats, WHO has developed a roadmap
for countries to help accelerate actions.
