Author: Blaise Ntacyabukura, MD, MMedSc
Consuming a healthy diet throughout the life course helps to prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. However, increased production of processed foods, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars, and salt/sodium, and many people do not eat enough fruit, vegetables, and other dietary fiber such as whole grains.
The exact make-up of a diversified, balanced, and healthy diet will vary depending on individual characteristics (e.g. age, gender, lifestyle, and degree of physical activity), cultural context, locally available foods, and dietary customs. However, the basic principles of what constitutes a healthy diet remain the same.
Fruit and vegetables
Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs and helps to ensure an adequate daily intake of dietary fiber.
Fruit and vegetable intake can be improved by:
always including vegetables in meals;
eating fresh fruit and raw vegetables as snacks;
eating fresh fruit and vegetables that are in season; and
eating a variety of fruit and vegetables.
Fats
Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population. Also, the risk of developing NCDs is lowered by:
reducing saturated fats to less than 10% of total energy intake;
reducing trans-fats to less than 1% of total energy intake; and
replacing both saturated fats and trans-fats with unsaturated fats – in particular, with polyunsaturated fats.
Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:
steaming or boiling instead of frying when cooking;
replacing butter, lard, and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower, and sunflower oils;
eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat; and
limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits, and wafers) that contain industrially-produced trans-fats.
Salt, sodium, and potassium
Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke.
Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year.
People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats such as bacon, ham, and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce, and fish sauce) or at the point of consumption (e.g. table salt).
Salt intake can be reduced by:
limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce, and bouillon) when cooking and preparing foods;
not having salt or high-sodium sauces on the table;
limiting the consumption of salty snacks; and
choosing products with lower sodium content.
Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.
Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.
Sugars
In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake. A reduction to less than 5% of total energy intake would provide additional health benefits.
Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases.
Sugars intake can be reduced by:
limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies, and sugar-sweetened beverages (i.e. all types of beverages containing free sugars – these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavored water, energy, and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee, and flavored milk drinks); and
eating fresh fruit and raw vegetables as snacks instead of sugary snacks.
What a healthy diet looks like:
Fruit, vegetables, legumes
Fruit, vegetables, legumes (e.g. lentils and beans), nuts, and whole grains (e.g. unprocessed maize, millet, oats, wheat, and brown rice).
At least 400 g (i.e. five portions) of fruit and vegetables per day, excluding potatoes, sweet potatoes, cassava, and other starchy roots.
Free Sugars
Less than 10% of total energy intake from free sugars, which is equivalent to 50 g (or about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories per day, but ideally is less than 5% of total energy intake for additional health benefits. Free sugars are all sugars added to foods or drinks by the manufacturer, cook, or consumer, as well as sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates.
Fats
Less than 30% of total energy intake is from fats. Unsaturated fats (found in fish, avocado, and nuts, and in sunflower, soybean, canola, and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee, and lard) and trans-fats of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats, and camels). It is suggested that the intake of saturated fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake (5). In particular, industrially-produced trans-fats are not part of a healthy diet and should be avoided.
Salt
Less than 5 g of salt (equivalent to about one teaspoon) per day. Salt consumed should be iodized.
Source: WHO
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