FAO DietSolve: A Diet Optimization Tool for Low- and Middle-Income Countries Developing Dietary Guidelines.

The history of recommending certain food composition to the diet of the general public in Finland goes back to the 1950s. Since that time, the food circle with modifications has been the only official, and most widely used, tool for diet composition visualization for nutrition education. Official national dietary recommendations and guidelines have been launched in 1981, 1987 and the newest ones in 1998. Nordic Nutrition Recommendations have been used in Finland as a reference when national dietary guidelines have not been available or up to date. Specific quantitative food-based dietary guidelines have not been given, because dietary guidelines may be reached with a wide range of foods. Data from the 1992 Dietary Survey of Finnish Adults was used to identify differences in dietary intake and food consumption patterns between subgroups of the study population that represented the highest and lowest quartiles of fat, saturated fatty acid (SFA), fibre, and fruit and vegetable intake. The population groups having the lowest fat or SFA intakes or the highest fibre or fruit and vegetable intakes reached the nutrient recommendations of macronutrients and fibre reasonably well. Similarities in food consumption pattern associated with a nutrient profile close to the recommendations were high consumption of fruit, berries, vegetables, roots, legumes and rye. Differences, e.g. in fats used, were also found between diets that were close to the nutrient recommendations. More research is needed to determine the differences in food consumption patterns of different population groups before developing food-based dietary guidelines for these groups.

Dietary pattern studies are traditionally the domain of epidemiological research. From a clinical perspective, there is a need to explore the effects of changing food and dietary patterns of individuals. The aim was to identify patterns of food choice in the context of a clinical weight loss trial. Cluster analysis based on reported serves of food groups revealed dietary patterns informative for the clinical setting. Cluster analysis was conducted using diet history data from two clinical trials at baseline, and outcomes at 3 months were reviewed based on these clusters (n=231). The cluster solution was analysed using defined food groups in serves and with respect to clinical parameters and requirements for selected nutrients. Two distinct dietary patterns were identified from the reported baseline dietary intakes. Subjects in Cluster 1 reported food patterns characterised by higher intakes of low-fat dairy and unsaturated oils and margarine and were generally more closely aligned to food choices encouraged in national dietary guidelines. Subjects in Cluster 2 reported a dietary pattern characterised by non-core foods and drinks, higher- and medium-fat dairy foods, fatty meats and alcohol. At 3 months, Cluster 2 subjects reported greater reductions in energy intake (-5317 kJ; P<0.001) and greater weight loss (-5.6 kg; P<0.05) compared with Cluster 1. Overweight subjects with reported dietary patterns similar to dietary guidelines at baseline may have more difficulty in reducing energy intake than those with poor dietary patterns. Correcting exposure to non-core foods and drinks was key to successful weight loss.

Overcoming barriers to sustainable, healthy diets

Food inflammation index reveals the key inflammatory components in foods and heterogeneity within food groups: How do we choose food?

Background The food sector contributes to a third of global Greenhouse gas emissions. Food-based dietary guidelines (FBDG) are policy tools that provide food advice compatible with health. There is a growing effort to include environmental sustainability in dietary guidelines, but less is known about the extent to which different countries include dietary recommendations with climate change mitigation potential. Methods Based on a systematic review and quantitative content analysis of food-based dietary guidelines (FBDG), a Dietary Climate Mitigation (DCM) score was developed to assess and rank the climate change mitigation potential of dietary guidelines at three levels: food life cycle, dietary patterns, and food groups. To avoid an overestimation of recommendations with relatively lower climate mitigation potential, the overall DMC score assigns higher weights to the dietary patterns and food groups sub-scores, compared to the food life cycle sub-score. Results Of the selected 92 countries, 38 mention environmental sustainability in their dietary guidelines. The Dietary Climate Mitigation (DCM) score ranged 4-84 (median 31.14 IQR 19.71-39.14, score range 0-100). Scores were significantly higher in high-income countries, dietary guidelines published after 2010, and those that explicitly address environmental sustainability. The highest scores are those from Belgium-Flemish, Australia, Zambia, Israel, Spain, Netherlands, Seychelles, Denmark, Sweden, and United Kingdom. Food advice with high climate mitigation potential are less frequent than advice with relatively lower mitigation potential. Conclusions Future dietary guidelines can be more aligned to health and climate goals if they factor in the differential environmental footprints of food choices. Explicit inclusion of environmental considerations in dietary advice has grown, yet most guidelines can still evolve from pro-environmental (intent-based), to environmentally significant (impact-based) food advice. Key messages • While there is a growth in dietary guidelines that mention environmental sustainability, most countries have still a low coverage of food recommendations with high climate mitigation potential. • To be compatible with planetary health, dietary guidelines can benefit from an impact-weighted approach to dietary advice.

The balanced diet - why so difficult to achieve?

Background/Objectives: The water footprint (WF) provides information on the impact of individual foods on water consumption, but to better direct food production toward water saving, we need to understand how to reduce the WF of our diets while keeping it healthy. In this study, we compared the WF of healthy diets based on national food-based dietary guidelines with the aim of highlighting changes in dietary patterns that could reduce water requirements without compromising nutritional adequacy. Methods: Three 2000 kcal/day dietary patterns were elaborated following the Italian, Spanish, and American dietary guidelines, and their total, green, blue, and grey WFs were calculated. Results: The Italian dietary pattern showed the lowest total WF (2806 L per capita/day), with the American and Spanish patterns being 8% and 10.5% higher, respectively. The food groups contributed differently to the total WF. In the USA, animal foods were the main contributor (56% versus 41% in Spain and 38% in Italy). The contribution of plant foods was higher in Italy (61%) than in Spain (54%) and the USA (38%). The distribution of the total WF between WFgreen, WFblue, and WFgrey was similar across the dietary patterns. Within each food group, and mainly in the animal-origin food group, the type of product significantly modulated the WF. Conclusions: Different diets can be equally nutritionally sustainable but have different impacts on environmental sustainability. The comparison of their WFs can be the starting point to promote dialogue between nutritionists, operators in the environmental sector, and the agri-food industry to ensure a healthy and balanced approach.

Dietary patterns: from nutritional epidemiologic analysis to national guidelines

The term ‘sustainable diets’ (SDs) was first introduced in the scientific literature in 1986 and later defined in detail by the Food and Agriculture Organization (FAO) as pertaining to those diets that can promote environmental health ad effectively ensure food and nutrition security as well as a healthy lifestyle in humans, combining the notion of sustainability with dietary patterns and their beneficial impacts. Since then, various international events have been held promoting sustainability as a significant component of food production, nutrition, and human health. These events have enhanced the knowledge transition and awareness between the scientific community and policymakers concerning the importance of SDs. In this aspect, this is the first study that aims to identify trends and turning points over time concerning the research on SDs. We performed a comprehensive bibliometric analysis of 1407 scientific documents published in Scopus during the period 1986–2022. The documents were screened following the PRISMA guidelines, and bibliometric analysis was conducted using the Bibliometrix R-package and VOSviewer and the detection of Sustainable Development Goals with the text2sdg R-package. Overall, there was an exponential growth in the literature on SDs that followed international events from 2009 onward. Among the most impactful journals were Sustainability, Nutrients, and Frontiers in Nutrition. The leading countries in research were pointed out, as well as the high rate of collaborations and partnerships between them. The research interest was mainly focused on (a) climate change, greenhouse gas emissions, and environmental impact; (b) food systems, security, and consumption; and (c) health, Mediterranean Diet (MD), and dietary guidelines. The significance of these keywords changed over time, following the evolution of SDs concepts from the planetary environmental impact of food production to the healthier dietary habits of individuals. Among several dietary patterns, MD was identified as the most popular among the local SDs, with synergies among scientists in the Mediterranean region. Overall, the novelty of this study is the mapping of the expansion of knowledge over the last 36 years regarding the term SDs while taking into consideration international events and their impact on scientific research.

New Findings from the Feeding Infants and Toddlers Study: Data to Inform Action

Calls to boost agricultural production in order to meet the demands of a growing global population are now commonplace. Yet, depending on where productivity changes and population growth occur, international trade could be increasingly necessary in the transfer of food from farms to consumers. Fader et al (2013) offer a nuanced view of this spatial disconnect and its food security implications by considering a valuable thought experiment: what countries could foreseeably meet their food requirements from internal production alone circa 2000 and for contrasting scenarios in 2050? They investigate the extent to which available renewable water and land resources constrain domestic per capita crop production, assuming current as well as broadly improved yields. The findings convey an intuitive, though often overlooked, point that population growth is likely to increase the reliance of certain regions on food imports unless substantial productivity improvements are realized.

Can children follow a fat-modified diet and have adequate nutrient intakes essential for optimal growth and development?

Defining dietary consumption: is the sum greater than its parts?

Diet modelling is one of the important steps in developing food-based dietary guidelines (FBDGs). However, this component remains uncommon in the FBDGs of many low-and middle-income countries. A diet modelling package (DietSolve) provided by the Food and Agriculture Organization (FAO) was used to formulate a healthy diet based on estimating the daily proportions of food groups that best meet the dietary goals established for the FBDGs for Ghana. Input data for the modelling included a list of commonly eaten foods across the agreed food groups, nutrient and energy content of the foods, current energy and nutrient consumption, and energy and nutrient constraints linked to the dietary goals, as determined by the FBDG multi-Sectoral Technical Task Team (MTTT). The modelling was based on assumptions and constraints including a total daily dietary energy target of 2000 kcal/day; the percentage contribution (energy targets) of the macronutrients as follows: carbohydrates (55-70%), protein (10-20 %), and fat (20-30%) to the total energy target; and calcium (1100 mg/day), iron (20 mg/day), and zinc (11 mg/day) constraints. The situation analysis and evidence review carried out as a prior step guided the diet modelling constraints. Energy contributions were also set for a serving of each food group. The final recommendations were based on food groups with each food group consisting of a variety of commonly consumed foods. The total weight of the optimized diet was estimated at 1514 g/day, including 144g/day of animal-source foods, 41.5g/day of discretionary choices, 226g/day of fruit, 227g/day of vegetables, 6g/day of healthy fats and oil, 198g/day of legumes, nuts, and seeds, and 672g/day of staples. This food group composition will provide an estimated 2639 kcal/day, a deviation of about 32% above the energy target set, made up of ~59% from carbohydrates, ~15% from protein and ~25% from fat, and meeting/exceeding the micronutrient targets set. The Optimised diet is healthier compared to the present dietary patterns of the population; its lower ASF component is known to impact less on the environment. Key words: Food-based dietary guidelines, linear programming, diet modelling, healthy diet, infood-graphic, Ghana

To achieve global and country-level climate goals, changes in food production and population diets are essential. There is a growing attention to environmental sustainability aspects in national Food-based dietary guidelines (FBDG), but less is known about the extent to which different countries communicate food advice with climate change mitigation potential.A systematic review and quantitative content analysis of food-based dietary guidelines for the adult population were conducted. A score was developed to assess and rank the climate change mitigation potential of FBDG at three levels: food life cycle, dietary patterns, and food groups.Selection criteria were met by 93 FBDG from 92 countries. Overall, most countries include little low-emissions food advice in their dietary guidelines (Dietary Climate Mitigation score median 31.14, IQR 19.71–39.14, score range 0–100). Scores were significantly higher for high-income countries, guidelines published after 2010, and the 38 countries that explicitly mention environmental sustainability. Recommendations with high climate mitigation potential, such as limiting red meat consumption, are less frequent than those with relatively lower mitigation potential, such as reducing the transport impact of food. Positioning meat within a broader food group, so not as default, and recommending legume intake is already prevalent in most guidelines. Explicit meat replacements, legumes within the protein-rich food group, and maximum intake limits for dairy, meat, and red meat, are included in a growing minority. Future food-based dietary guidelines can be better aligned with human and planetary health by clearly communicating what dietary shifts have limited or substantial climate change mitigation potential.