Elsevier

Advances in Nutrition

Volume 9, Issue 5, September 2018, Pages 544-560
Advances in Nutrition

Perspective: Food-Based Dietary Guidelines in Europe—Scientific Concepts, Current Status, and Perspectives

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Abstract

Food-based dietary guidelines (FBDGs) are important tools for nutrition policies and public health. FBDGs provide guidelines on healthy food consumption and are based on scientific evidence. In the past, disease prevention and nutrient recommendations dominated the process of establishing FBDGs. However, scientific advances and social developments such as changing lifestyles, interest in personalized health, and concerns about sustainability require a reorientation of the creation of FBDGs to include a wider range of aspects of dietary behavior. The present review evaluates current European FBDGs with regard to the concepts and aspects used in their derivation, and summarizes the major aspects currently discussed to be considered in future establishment or updates of FBDGs. We identified English information on official European FBDGs through an Internet search (FAO, PubMed, Google) and analyzed the aspects used for their derivation. Furthermore, we searched literature databases (PubMed, Google Scholar) for conceptional considerations dealing with FBDGs. A total of 34 out of 53 European countries were identified as having official FBDGs, and for 15 of these, documents with information on the scientific basis could be identified and described. Subsequently, aspects underlying the derivation of current FBDGs and aspects considered in the literature as important for future FBDGs were discussed. Eight aspects were identified: diet-health relations, nutrient supply, energy supply, dietary habits, sustainability, food-borne contaminants, target group segmentation, and individualization. The first 4 have already been widely applied in existing FBDGs; the others have almost never been taken into account. It remains a future challenge to (re)conceptionalize the development of FBDGs, to operationalize the aspects to be incorporated in their derivation, and to convert concepts into systematic approaches. The current review may assist national expert groups and clarifies the options for future development of local FBDGs.

Keywords

diet-health relations
dietary habits
energy
food-based dietary guidelines
food-borne contaminants
individualization
nutrients
nutrition policy
sustainability
target group segmentation

Abbreviations used

CVD
cardiovascular disease
CINDI
Country-wide Integrated Noncommunicable Diseases Intervention
DRV
Dietary Reference Value
EFSA
European Food Safety Authority
FBDG
food-based dietary guideline
GRADE
Grading of Recommendations Assessment, Development and Evaluation
NCD
noncommunicable chronic disease
NNR
Nordic Nutrition Recommendations
PNNS
Guides nutritions du Programme National Nutrition Santé
TDS
total diet study
T2D
type 2 diabetes

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Perspectives articles allow authors to take a position on a topic of current major importance or controversy in the field of nutrition. As such, these articles could include statements based on author opinions or points of view. Opinions expressed in Perspectives articles are those of the author and are not attributable to the funder(s) or the sponsor(s) or the publisher, Editor, or Editorial Board of Advances in Nutrition. Individuals with different positions on the topic of a Perspective are invited to submit their comments in the form of a Perspectives article or in a Letter to the Editor.

AB was supported by the competence cluster Diet-Body-Brain funded by the German Federal Ministry of Education and Research (BMBF; grant 01EA1410A) and by the Foundation for the Promotion of German Nutrition Society (DGE).

Author disclosures: AB, HB, IT, LS, and UN, no conflicts of interest.