Overview
Eating a healthy diet throughout life helps prevent malnutrition in all its forms, as well as different non-communicable diseases and disorders. However, increased production of processed foods, rapid urbanization and changing lifestyles have led to a change in eating habits. Currently, people consume more high-calorie foods, fats, free sugars and salt/sodium; On the other hand, many people do not eat enough fruits, vegetables and dietary fiber, such as whole grains.
The exact composition of a varied, balanced and healthy diet will be determined by the characteristics of each person (age, sex, lifestyle habits and degree of physical activity), the cultural context, the food available in the place and the eating habits. However, the basic principles of healthy eating remain the same.
For adults
A healthy diet includes the following:
- Unprocessed fruits, vegetables, legumes (such as lentils and beans), nuts, and whole grains (e.g., unprocessed corn, millet, oats, wheat, or brown rice).
- At least 400 g (i.e. five portions) of fruit and vegetables per day (2), except potatoes, sweet potatoes, cassava and other starchy tubers.
- Less than 10% of the total caloric intake of free sugars (2, 7), which is equivalent to 50 grams (or about 12 level teaspoons) for a person with a healthy body weight who consumes approximately 2000 calories per day, although for additional health benefits an ideal consumption of less than 5% of total caloric intake (7). Free sugars are all those that manufacturers, cooks or consumers add to foods or beverages, as well as sugars naturally present in honey, syrups and fruit juices and concentrates.
- Less than 30% of daily caloric intake from fat (1, 2, 3). Unsaturated fats (found in fish, avocados, nuts and sunflower, soy, canola and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, clarified butter and lard), and trans fats of all types, in particular those produced industrially (present in frozen pizzas, cakes, biscuits, cakes, wafers, cooking oils and spreads), and trans fats from ruminants (present in the meat and dairy products of ruminants such as cows, sheep, goats and camels). It was suggested to reduce saturated fat intake to less than 10% of total calorie intake, and trans fat intake to less than 1% (5). In particular, industrially produced trans fats are not part of a healthy diet and should be avoided (4,6).
- Less than 5 grams (about one teaspoon) a day (8). Salt should be iodized.
For infants and young children
In the first two years of a child’s life, optimal nutrition promotes healthy growth and improves cognitive development. In addition, it reduces the risk of overweight and obesity and non-communicable diseases in the future.
The tips for healthy eating during breastfeeding and childhood are the same as for adults, but the following are also important:
- Infants should be fed exclusively with human milk for the first six months of life.
- Breastfeeding should continue until at least two years.
- From six months of age, breastfeeding should be supplemented with a variety of safe and nutritious foods. Salt and sugars should not be added to complementary foods.
Practical tips for maintaining a healthy diet
Fruits and vegetables
Eating at least 400 g, or five servings of fruits and vegetables a day, reduces the risk of developing noncommunicable diseases (2) and helps ensure a sufficient daily intake of dietary fiber.
To improve the consumption of fruits and vegetables it is recommended:
- include vegetables at all meals;
- as snacks, eat fresh fruits and raw vegetables;
- eating fresh seasonal fruits and vegetables; and
- Eat a varied selection of fruits and vegetables.
Fats
Reducing total fat intake to less than 30% of daily caloric intake helps prevent unhealthy weight gain among the adult population (1, 2, 3).
In addition, to reduce the risk of developing noncommunicable diseases, it is necessary to:
- limit saturated fat intake to less than 10% of daily caloric intake;
- limit trans fat intake to less than 1%; and
- replace saturated fats and trans fats with unsaturated fats (2, 3), particularly polyunsaturated fats.
To reduce fat intake, especially saturated fats and industrially produced trans fats you can:
- steaming or boiling, instead of frying;
- replace butter, lard and clarified butter with oils rich in polyunsaturated fats, for example, soybean, canola, corn, safflower and sunflower;
- eating low-fat dairy products and lean meats, or removing visible fat from meat; and
- Limit the consumption of baked or fried foods, as well as snacks and packaged foods (e.g., doughnuts, cakes, pies, cookies, biscuits, and wafers) containing industrially produced trans fats.
Salt, sodium and potassium
Most people consume too much sodium through salt (an average of 9 g to 12 g of salt daily) and do not consume enough potassium (less than 3.5 g). High salt intake and insufficient potassium contribute to high blood pressure, which in turn increases the risk of coronary heart disease and stroke (8, 11).
Reducing salt intake to the recommended level, i.e. less than 5 grams per day, would prevent 1.7 million deaths each year (12).
People are usually not aware of how much salt they consume. In many countries, most salt intake is through processed foods (e.g. ready meals, processed meats such as bacon, ham, salami; cheese or salty snacks) or foods that are frequently consumed in large quantities (e.g. bread). Salt is also added to foods when they are cooked (e.g., broths, various types of broth concentrates, soy sauce, and fish sauce) or where they are consumed (e.g., table salt).
To reduce salt consumption it is advisable to:
- limit the amount of salt and sodium-rich seasonings (e.g., soy sauce, fish sauce, and broth) when cooking and preparing food;
- do not put salt or sodium-rich sauces on the table;
- limit the consumption of salty snacks; and
- Choose products with lower sodium content.
Some food manufacturers are reformulating their recipes to reduce the sodium content of their products; In addition, consumers should be encouraged to read food labels to check the amount of sodium a product contains before buying or consuming it.
Potassium intake can mitigate the negative effects of high sodium intake on blood pressure. Potassium intake can be increased by eating fresh fruits and vegetables.
Sugars
Adults and children should reduce their intake of free sugars to less than 10% of total caloric intake (2, 7). A reduction to less than 5% of total caloric intake would bring additional health benefits (7).
The consumption of free sugars increases the risk of tooth decay. Excess calories from foods and beverages high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent scientific evidence reveals that free sugars influence blood pressure and serum lipids, and suggests that a decrease in their intake reduces risk factors for cardiovascular disease (13).
Sugar intake can be reduced as follows:
- limiting the consumption of foods and beverages high in sugars, e.g. snacks and sugary drinks and sweets (i.e. all types of beverages containing free sugars, including carbonated or still soft drinks; fruit or vegetable juices and drinks; liquid and powder concentrates; flavoured water; energy and isotonic drinks; ready-to-drink tea and coffee; and flavoured milk drinks); and
- Eat, as snacks, raw fruits and vegetables instead of sugary products.
How to promote healthy eating
Diet evolves over time, and is influenced by many socioeconomic factors that interact in complex ways and determine personal 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 factors (including climate change). Therefore, the promotion of a healthy food environment and, in particular, food systems that promote a diversified, balanced and healthy diet, requires the involvement of different sectors and stakeholders, including governments, the public sector and the private sector.
Governments play a critical role in creating a healthy food environment that enables people to adopt and maintain healthy eating practices.
Actions that policymakers can take to create healthy food environments include:
- Harmonization of national policies and investment plans, in particular trade, food and agricultural policies, to promote healthy diets and protect public health through measures aimed at:
- increase incentives for producers and retailers to grow, use and sell fresh fruits and vegetables;
- reduce incentives to the food industry that allow it to maintain or increase the production of processed foods with high levels of saturated fats, trans fats, free sugars and salt/sodium;
- encourage the reformulation of food products to reduce the contents of saturated fats, trans fats, free sugars and salt/sodium, with a view to eliminating industrially produced trans fats;
- implement WHO recommendations on the marketing of food and non-alcoholic beverages to children;
- establish standards to promote healthy eating practices through the assured availability of healthy, nutritious, safe and affordable food in preschools, schools and other public institutions, as well as in the workplace;
- examine policy and voluntary instruments (e.g. marketing regulations and nutrition labelling standards) and economic incentives or disincentives (e.g. taxation and subsidies) to promote a healthy diet; and
- Encourage transnational, national and local food services and their outlets to improve the nutritional quality of their products, ensure the availability and affordability of healthy options and review portion sizes and prices.
- Encourage consumers to demand healthy food and meals through measures aimed at:
- promote consumer awareness of a healthy diet;
- develop school policies and programs that encourage children to adopt and maintain a healthy diet;
- impart knowledge about nutrition and healthy eating practices to children, adolescents and adults;
- promoting culinary skills, including in children, through schools;
- support point-of-sale information, in particular through nutrition labelling that ensures accurate, standardised and comprehensible information on nutrient content in foods (in line with Codex Alimentarius Commission guidelines), by adding front-end labelling to facilitate consumer understanding; and
- Provide nutritional and dietary counselling in primary health care centres.
- Promote appropriate infant and young child feeding practices through measures to:
- implement the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions;
- implement policies and practices that promote the protection of working mothers; and
- Promote, protect and support breastfeeding in health services and the community, including through the Baby-Friendly Hospital initiative.