Global Push for Healthy Diets: A New Framework to Combat Malnutrition and NCDs

The "Guidance for Monitoring Healthy Diets Globally" report by WHO, FAO, and UNICEF outlines strategies for nations to monitor and improve public health through better dietary assessment. It highlights the importance of healthy diets in preventing malnutrition and noncommunicable diseases (NCDs), providing a comprehensive framework for dietary data collection and monitoring.

In an ambitious bid to curb the rising tide of malnutrition and diet-related noncommunicable diseases (NCDs), the World Health Organization (WHO), Food and Agriculture Organization (FAO), and United Nations Children's Fund (UNICEF) have jointly released a comprehensive guide titled "Guidance for Monitoring Healthy Diets Globally." This document lays out a robust framework for nations to monitor their populations' dietary habits, aiming to foster healthier societies worldwide.

The Urgent Need for Dietary Monitoring

The global burden of poor diets is staggering. In 2017 alone, one in five deaths was associated with unhealthy eating habits. By 2030, the annual death toll from NCDs is projected to skyrocket to 55 million if current trends continue unchecked. The report underscores the critical role of healthy diets in preventing various forms of malnutrition and NCDs, including heart disease, diabetes, and diet-related cancers. Despite the clear benefits, few countries regularly assess the healthiness of their populations' diets. Recognizing this gap, the Healthy Diets Monitoring Initiative (HDMI) was launched to provide standardized guidance on measuring and monitoring dietary habits at the national and global levels. The initiative aims to inform public health actions and policies to improve both human and planetary health.

Core Properties of a Healthy Diet

A healthy diet, according to the guidance, comprises four essential properties: nutrient adequacy, macronutrient balance, diversity, and moderation. Nutrient adequacy ensures sufficient intake of essential nutrients, including micronutrients, macronutrients, and energy, without excess. Macronutrient balance involves maintaining a balanced intake of carbohydrates, proteins, and fats. Diversity entails consuming a variety of foods from distinct healthy food groups to meet nutrient requirements. Moderation emphasizes limiting the intake of foods and nutrients associated with health risks when consumed excessively, such as processed meats, sugar-sweetened beverages, salt, and trans fats. These properties provide a foundation for developing healthy diet metrics and monitoring frameworks that can guide public health interventions and policies.

Effective Dietary Assessment Methods

The report details various dietary assessment methods that can be employed to measure the healthiness of diets. The 24-hour dietary recall is a retrospective method where individuals recall all foods and beverages consumed in the past 24 hours. Food Frequency Questionnaires (FFQ) assess the frequency of consumption of specific foods over a set period. Food records involve real-time recording of all foods and drinks consumed over a period. Brief dietary assessment instruments are quick methods for assessing specific dietary components, while nutritional biomarkers are biological specimens reflecting dietary intake and nutritional status. Each method has its strengths and weaknesses, and the choice of method depends on the specific purposes and available resources.

Key Metrics for Monitoring Healthy Diets

The guidance identifies four primary metrics for global dietary monitoring: the Global Diet Quality Score (GDQS), Global Dietary Recommendations (GDR) Score, Minimum Dietary Diversity for Women (MDD-W), and Nova Ultra-processed Food (UPF) Score. These metrics capture different aspects of diet healthiness and are designed for use at the population level. They provide a standardized way to assess and compare dietary habits across different contexts, aiding in the formulation of targeted interventions and policies.

While the guidance offers a comprehensive framework for monitoring healthy diets, it also highlights the need for further research to validate and ensure the cross-context equivalence of these metrics. There is a particular emphasis on understanding the validity of these metrics for children and adolescents, an area that requires more evidence. The HDMI aims to foster a collaborative community of countries committed to developing and implementing this technical guidance. Through iterative and consultative processes involving various stakeholders, the initiative seeks to refine and expand the guidelines based on ongoing evidence reviews and validation research.

The "Guidance for Monitoring Healthy Diets Globally" represents a significant step forward in the global effort to promote healthier diets and combat malnutrition and NCDs. By providing a clear framework for dietary monitoring, WHO, FAO, and UNICEF are equipping nations with the tools needed to make informed decisions and take effective actions to improve public health. Countries are urged to prioritize the collection of dietary intake data, leveraging the guidance provided to enhance their public health strategies and ultimately improve the well-being of their populations.