Healthy diet

• A healthy diet helps to avoid malnutrition in all its forms and to prevent non-communicable diseases (NCDs), including diabetes, heart disease, brain disorders and cancer.
• Unhealthy diets and lack of physical activity are major risk factors for health worldwide.
• Practising healthy eating habits starts early in life – breastfeeding promotes healthy growth, improves cognitive development and can provide long-term health benefits – for example, reducing the risk of becoming overweight and obese and developing NCDs later in life.
• Energy intake (in calories) must be balanced with energy expenditure. Evidence suggests that total fat intake should not provide more than 30% of total energy intake to avoid unhealthy weight gain (1, 2, 3) and should be accompanied by a shift from saturated to unsaturated fats (3) and the elimination of industrial trans fats from the diet (4).
• One manifestation of a healthy diet is limiting the intake of free sugars to less than 10% of total energy intake (2, 5). For additional health benefits, it is recommended to reduce this further to less than 5% of total energy intake (6).
• Limiting salt intake to less than 5 g per day helps prevent hypertension and reduces the risk of heart disease and stroke in adults (7).
• WHO Member States have agreed to reduce salt intake by 30% to end the rise in diabetes and obesity among adults, adolescents and children by 2025.

A healthy diet throughout life helps to avoid malnutrition in all its forms and to prevent a range of non-communicable diseases (NCDs) and conditions. However, the rise of processed foods, rapid urbanisation and lifestyle changes have led to shifts in dietary patterns. Populations are consuming more foods high in energy, saturated fat, trans fats, free sugars or salt/sodium, and many are not eating enough fruit, vegetables and dietary fibre such as whole grains.

The exact composition of a varied, balanced and healthy diet will depend on individual needs (e.g. age, gender, lifestyle, degree of physical activity), cultural context, available local foods and customs. But the basic principles of building a healthy diet remain the same.

A healthy diet includes:

• Fruits, vegetables, legumes (e.g., lentils, beans), nuts, and whole grains (e.g., unprocessed corn, millet, oats, wheat, unpolished rice).
• At least 400 g (5 servings) of fruit and vegetables per day.(2) Potatoes, yams, kasava and other starchy root vegetables are neither fruits nor vegetables.
• Less than 10% of total energy from free sugars (2.5), which is equivalent to 50 g (or about 12 teaspoons without topping) for a person of healthy body weight consuming about 2000 calories per day, but ideally less than 5% of total energy for additional health benefits.(6) Most free sugars are added to foods by the manufacturer, cook or consumer and may also be found as natural sugar in honey, syrups, fruit juices and fruit concentrates.
• Less than 30% of total energy due to fat. (1, 2, 3) Unsaturated fats (e.g. found in fish, avocados, nuts, sunflower oil, canola oil, olive oil) are preferred over saturated fats (e.g. found in fatty meats, butter, palm and coconut oil, cream, cheese, ghee and pork lard). (3) Industrial trans fats (found in processed foods, convenience foods, snack foods, fried foods, frozen pizzas, pies, biscuits, margarines and sandwich mixes) are not part of a healthy diet.
• Less than 5 g of salt (equivalent to about one teaspoon) per day (7) and the use of iodised salt.

In the first two years of a child’s life, optimal nutrition promotes healthy growth and improves cognitive development. It also reduces the risk of becoming overweight and obese and developing NCDs later in life.

Recommendations for a healthy diet for infants and young children are similar to those for adults, but these elements are also important.

• Infants should be exclusively breastfed for the first 6 months of life.
• Infants should be breastfed continuously until age 2 years and older.
• From 6 months of age, breast milk should be supplemented with a variety of suitable safe and nutrient-rich complementary foods. Salt and sugar should not be added to complementary foods.

Fruits and vegetables

Eating at least 5 servings or 400 grams of fruit and vegetables a day reduces the risk of NCDs (2) and helps ensure adequate fibre intake.

To improve your fruit and vegetable intake you can:

• always include vegetables in your meals;
• eat fruit and raw vegetables as a snack;
• eat fresh vegetables in season;
• diversify fruits and vegetables.

Fats

Reducing total fat intake to less than 30% of total energy helps prevent unhealthy weight gain among adults.(1, 2, 3)

In addition, the risk of NCDs is reduced by reducing saturated fats to less than 10% of total energy (2,3) and trans fats to less than 1% of total energy and replacing them with unsaturated fats found in vegetable oil.(2,3)

Fat intake can be reduced

• by changing the way food is cooked – remove the fatty part of meat; use vegetable oil (of non-animal origin), and use boiling, steaming or baking instead of frying;
• avoid processed foods containing trans fats;
• limit consumption of foods high in saturated fat (e.g. cheese, ice cream, fatty meats).

Salt, sodium, and potassium

Most people consume too much sodium in the form of salt (corresponding to an average of 9-12 g of salt per day) and not enough potassium. High salt intake and insufficient potassium intake (less than 3.5 g) contribute to high blood pressure, which in turn increases the risk of heart disease and stroke.(8)

1.7 million deaths could be prevented each year if salt intake was reduced to the recommended level of less than 5 g per day.(9)

People often do not realise how much salt they consume per day. In many countries, most salt comes from processed foods (e.g. ready meals, processed meat products such as bacon, ham and salami, cheese and salty snack foods) or from foods consumed in large quantities (e.g. bread). Salt is also added to food when it is prepared (e.g., in broth, bouillon cubes) or at the table (e.g., as table salt, soy sauce, and fish sauce).

Salt intake can be reduced by:

• by not adding salt, soy sauce or fish sauce during cooking;
• by not putting salt on the table;
• limiting the consumption of salty snack foods;
• choosing foods with lower sodium content.

Some food manufacturers make recipe changes to reduce the salt content of their products, and it is advisable to read food labels to check how much sodium they contain.

Potassium intake, which can mitigate the negative effects of increased sodium intake on blood pressure, may increase as a result of eating fruit and vegetables.

Sugars

Evidence indicates that intakes of free sugars in adults and children should not exceed 10% of total energy (2, 5) and that a reduction to less than 5% of total energy provides additional health benefits.(6) Free sugars are all sugars added to food or beverages by the manufacturer, cook, or consumer, as well as all sugars naturally found in honey, syrup, fruit juices, and concentrated fruit juices.(2)

Consumption of free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks rich in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity.

Sugar intake can be reduced

• by limiting the consumption of foods and drinks high in sugar (i.e. sweetened beverages, sugary snack foods and candy); By eating fruits and raw vegetables for snacks instead of sugary snack foods.

Dietary patterns change over time due to multiple factors and complex interactions. Income, food prices (which affect the availability and affordability of healthy foods), individual preferences and religious beliefs, cultural traditions, and geographic, environmental, social and economic factors all interact in complex ways to shape individual dietary patterns. Therefore, creating an enabling environment for healthy diets, including food systems that promote diverse, balanced and healthy diets, requires the involvement of multiple sectors and stakeholders, including governments, the public and the private sector.

Governments have a central role to play in creating an enabling environment for healthy diets that enables populations to adopt and comply with healthy eating approaches.

Effective policy interventions to create an environment favourable to healthy diets include:

Ensuring that national policies and investment plans, including trade, food and agriculture policies, are aligned to promote healthy diets and protect public health:

• Strengthen incentives for producers and retailers to grow, utilise and sell fruit and vegetables;
• reduce the impact of factors that encourage the food industry to continue or expand the production of processed foods containing saturated fats and free sugars;
• promote food reformulation to reduce salt, fats (i.e. saturated fats and trans fats) and free sugars;
• fulfil WHO recommendations on the marketing of food and non-alcoholic beverages to children;
• set standards that promote healthy eating practices by ensuring access to healthy, safe and affordable foods in preschools, schools, other public institutions and workplaces;
• use regulatory and voluntary instruments such as marketing, food labelling policies, economic incentives or disincentives (e.g. taxation, subsidies) to promote healthy eating;
• encourage transnational, national or local caterers to improve the nutritional quality of their food products, ensure the availability and affordability of healthy foods, and review portion sizes and prices.

Stimulate consumer demand for healthy food products and meals:

• raise consumer awareness of healthy food choices;
• develop policies and programmes for schools that encourage children to make and maintain healthy food choices;
• educate children, adolescents and adults about nutrition and healthy eating practices;
• encourage the development of cookery skills, including in schools;
• support point-of-sale information, including through labelling that provides accurate,
• standardised and understandable information on the nutrient content of foods, in line with the Codex Alimentarius Commission guidelines; and provide nutrition and dietary counselling in primary health care.

Promote good nutrition practices for infants and young children:

• implement the International Code of Marketing of Breastmilk Substitutes and subsequent relevant World Health Assembly resolutions;
• implement policies and practices to protect working mothers;
• strengthen, protect and support breastfeeding in health facilities and communities, including through the Hospital Breastfeeding Enabling Environment Initiative.

Source: WHO