An article, written by Emeritus Professor of Nutrition at UC Davis University, Barbara O. Schneeman, traces how national dietary guidelines in Europe, the US and at the World Health Organisation (WHO) have evolved over time and concludes that the focus on individual nutrients is an insufficient approach to managing risk of NCDs.
Dietary policies have tended to focus on the food component or ingredient to limit, such as added sugars, trans fatty acids, saturated fatty acids, rather than entire food categories, such as sugary drinks, sweets, bakery products or salty snacks, she notes.
“In terms of public health, the progress since the 1990s has illustrated that while understanding the role of specific components of foods for NCD risk is necessary, it may not be sufficient to fully understand the importance of diets in reducing risk," the report states.
“The orientation toward single nutrients or food components (e.g., sugars, saturated fatty acids, trans fatty acids) tends to emphasize one component of the diet in managing risk for NCDs rather than recognizing the importance of interactions among dietary factors and disease risk reduction, especially for macronutrients."
Schneeman argues the next phase of recommendation and policy development will require a greater understanding of and focus on dietary patterns related to modulating risk.
“Dietary patterns or eating plans can be constructed to encourage food choices reflecting limiting intake of saturated fats, trans fatty acids, cholesterol, sugars and refined carbohydrates while selecting foods providing fibre and foods meeting the needs for required nutrients.
“Such an approach emphasises dietary patterns that will result in the desired changes to the intake of specific food components," she writes. "In other words, recommendations are increasingly focusing on food choices rather than specific nutrients, thus emphasising a complete dietary strategy rather than a reductionist strategy focused on specific nutrients.
Two diets are of particular interest thanks to evidence that shows they modify risk factors for NCDs: the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension), promoted by the US Department of Health.
Both are made up of whole grains, fruits and vegetables, seeds and nuts, dairy products and eating fish and seafood in place of some meats and poultry.
Policy guidance is needed
“[…It] suggests that some policy guidance is needed for claims about the contribution that ingredients in packaged foods, such as fruits, vegetables, whole grains, and oils, make to achieve recommended dietary patterns.”
For instance, a product may have a ‘healthy whole grain’ logo on pack but this does not give the consumer an idea of the meaningful amount of whole grain need to form part of a recommended dietary pattern.
This is the same for all food groups that are recommended as part of a healthy diet, she says.
Schneeman notes that many FOP approaches are nutrient-focused rather than focused on encouraging intake of food groups as part of a recommended dietary pattern relevant to a population.
“As countries develop systems, such as FOP labelling and labelling claims to highlight ingredients that contribute positively to recommended dietary patterns, data will be needed to determine if these approaches provide sufficient dietary guidance to improve food selection among consumers so that effective policies can be established.”