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2023-11-22 10:27:04
29 April 2020
Key facts
- A healthy diet helps to protect against malnutrition in all its forms, as
well as noncommunicable diseases (NCDs), including diabetes, heart disease,
stroke and cancer.
- Unhealthy diet and lack of physical activity are leading global risks to
health.
- Healthy dietary practices start early in life breastfeeding fosters healthy
growth and improves cognitive development, and may have longer 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 unhealthy weight gain, total fat should not exceed 30% of total energy
intake (1, 2, 3). 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 (3), and towards the goal of eliminating industrially-produced
trans-fats (4, 5, 6).
- Limiting intake of free sugars to less than 10% of total energy intake (2, 7)
is part of a healthy diet. A further reduction to less than 5% of total energy
intake is suggested for additional health benefits (7).
- 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 (8).
- 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
(9, 10).
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
fibre such as whole grains.
The exact make-up of a diversified, balanced and 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.
For adults
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 (2),
excluding potatoes, sweet potatoes, cassava and other starchy roots.
- Less than 10% of total energy intake from free sugars (2, 7), 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 (7). 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 (1, 2, 3). 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 (5). In particular, industrially-produced trans-fats are not part of a
healthy diet and should be avoided (4, 6).
- Less than 5 g of salt (equivalent to about one teaspoon) per day (8). Salt
should be iodized.
For infants and young children
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 is similar to that for
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.
Practical advice on maintaining a healthy diet
Fruit and vegetables
Eating at least 400 g, or five portions, of fruit and vegetables per day
reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of
dietary fibre.
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.
Fats
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 (1, 2, 3). 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 (2, 3)
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.
Salt, sodium and potassium
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 contribute to high blood
pressure, which in turn increases the risk of heart disease and stroke (8, 11).
Reducing salt intake to the recommended level of less than 5 g per day could
prevent 1.7 million deaths each year (12).
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.
Sugars
In both adults and children, the intake of free sugars should be reduced to
less than 10% of total energy intake (2, 7). A reduction to less than 5% of
total energy intake would provide additional health benefits (7).
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 (13).
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, flavoured water, energy and sports drinks, ready‐to‐drink
tea, ready‐to‐drink coffee and flavoured milk drinks); and
- eating fresh fruit and raw vegetables as snacks instead of sugary snacks.
How to promote healthy diets
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:
fruit and vegetables;
of processed foods containing high levels of saturated fats, trans-fats, free
sugars and salt/sodium;
saturated fats, trans-fats, free sugars and salt/sodium, with the goal of
eliminating industrially-produced trans-fats;
non-alcoholic beverages to children;
the availability of healthy, nutritious, safe and affordable foods in
pre-schools, schools, other public institutions and the workplace;
and nutrition labelling policies), and economic incentives or disincentives
(e.g. taxation and subsidies) to promote a healthy diet; and
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:
and maintain a healthy diet;
dietary practices;
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 labelling to facilitate consumer
understanding; and
facilities.
- Promoting appropriate infant and young child feeding practices through:
and subsequent relevant World Health Assembly resolutions;
and
community, including through the Baby-friendly Hospital Initiative.
WHO response
The WHO Global Strategy on Diet, Physical Activity and Health (14) 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 (15). 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 the 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
anaemia and low birthweight (9).
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 (10) provides guidance and policy options for 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 (16).
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 (17), and
the Framework for Action (18) 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 (19). 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
(the REPLACE action package) to help accelerate actions (6).
References
(1) Hooper L, Abdelhamid A, Bunn D, Brown T, Summerbell CD, Skeaff CM. Effects
of total fat intake on body weight. Cochrane Database Syst Rev. 2015;
(8):CD011834.
(2) Diet, nutrition and the prevention of chronic diseases: report of a Joint
WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva:
World Health Organization; 2003.
(3) Fats and fatty acids in human nutrition: report of an expert consultation.
FAO Food and Nutrition Paper 91. Rome: Food and Agriculture Organization of the
United Nations; 2010.
(4) Nishida C, Uauy R. WHO scientific update on health consequences of trans
fatty acids: introduction. Eur J Clin Nutr. 2009; 63 Suppl 2:S1 4.
(5) Guidelines: Saturated fatty acid and trans-fatty acid intake for adults and
children. Geneva: World Health Organization; 2018 (Draft issued for public
consultation in May 2018).
(6) REPLACE: An action package to eliminate industrially-produced trans-fatty
acids. WHO/NMH/NHD/18.4. Geneva: World Health Organization; 2018.
(7) Guideline: Sugars intake for adults and children. Geneva: World Health
Organization; 2015.
(8) Guideline: Sodium intake for adults and children. Geneva: World Health
Organization; 2012.
(9) Comprehensive implementation plan on maternal, infant and young child
nutrition. Geneva: World Health Organization; 2014.
(10) Global action plan for the prevention and control of NCDs 2013 2020.
Geneva: World Health Organization; 2013.
(11) Guideline: Potassium intake for adults and children. Geneva: World Health
Organization; 2012.
(12) Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE et
al. Global sodium consumption and death from cardiovascular causes. N Engl J
Med. 2014; 371(7):624 34.
(13) Te Morenga LA, Howatson A, Jones RM, Mann J. Dietary sugars and
cardiometabolic risk: systematic review and meta-analyses of randomized
controlled trials of the effects on blood pressure and lipids. AJCN. 2014; 100
(1): 65 79.
(14) Global strategy on diet, physical activity and health. Geneva: World
Health Organization; 2004.
(15) Set of recommendations on the marketing of foods and non-alcoholic
beverages to children. Geneva: World Health Organization; 2010.
(16) Report of the Commission on Ending Childhood Obesity. Geneva: World Health
Organization; 2016.
(17) Rome Declaration on Nutrition. Second International Conference on
Nutrition. Rome: Food and Agriculture Organization of the United Nations/World
Health Organization; 2014.
(18) Framework for Action. Second International Conference on Nutrition. Rome:
Food and Agriculture Organization of the United Nations/World Health
Organization; 2014.
(19) Thirteenth general programme of work, 2019 2023. Geneva: World Health
Organization; 2018.
https://www.who.int/news-room/fact-sheets/detail/healthy-diet