Healthy diets throughout life contribute to the prevention of malnutrition in all its forms, as well as a range of noncommunicable diseases (NCDs) and health disorders. At the same time, the growth in the production of processed foods, rapid urbanization and changing lifestyles have led to a shift in food patterns. Nowadays, people consume more high-calorie foods, fats, free sugars, and salt/sodium, and many people don’t consume enough fruits, vegetables, and other types of fiber, such as whole grains.The exact composition of a varied, balanced and healthy diet depends on individual characteristics (such as age, gender, lifestyle and degree of physical activity), cultural context, available local foods and dietary customs. However, the basic principles of healthy eating remain the same.

For adults

A healthy diet includes the following components:

• Fruits, vegetables, legumes (e.g., lentils, beans), nuts, and whole grains (e.g., unprocessed corn, millet, oats, wheat, and unpeeled rice).
• At least 400 grams (i.e., five servings) of fruits and vegetables per day (2), except potatoes, sweet potatoes, cassava, and other starchy root vegetables.
• Free sugars should be less than 10% of total energy intake (2, 7), which is equivalent to 50 grams (or 12 teaspoons without a top) per normal-weight person consuming about 2000,5 calories per day, but ideally, in order to provide additional health benefits, they should be less than 7% of total energy intake (<>). Free sugars are all sugars added to foods or beverages by a manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and their concentrates.
• Fats should make up less than 30% of total energy intake (1, 2, 3). Preference should be given to unsaturated fats (found in fish, avocados and nuts, as well as sunflower, soybean, rapeseed and olive oil) as opposed to saturated fats (contained in fatty meat, butter, palm and coconut oil, cream, cheese, gi and pork fat) and trans fats of all kinds, including as trans fats of industrial production (contained in baked and fried foods, pre-packaged eateries and other products such as frozen pizzas, pies, cookies, waffles, cooking fats and sandwich mixes) and naturally occurring trans fats (found in meat and dairy products derived from ruminants such as cows, sheep, goats and camels). It’s a good idea to reduce your intake of saturated fat to less than 10% and trans fats to less than 1% of your total energy intake (5). Especially avoid consuming industrially produced trans fats, which aren’t part of a healthy diet (4, 6).
• Consume less than 5 grams of salt (equivalent to about one teaspoon) per day (8). Salt should be iodized.

For infants and young children

Optimal nutrition throughout the first two years of life contributes to the healthy growth of the child and improves his cognitive development. It also reduces the risk of overweight and obesity gain and the development of NCDs later in life.

Recommendations for a healthy diet for infants and children of other age groups are similar to recommendations for adults, but the following components are also important:

• During the first 6 months of life, babies should be exclusively breastfed.
• Breastfeeding of children should be continued during the first two years of life and later.
• From the age of six months, breast milk needs to be supplemented with a variety of appropriate, safe and nutritious foods. Salt and sugar should not be added to complementary foods.

Practical recommendations for maintaining a healthy diet

Fruits and vegetables

Daily consumption of at least 400 grams, or five servings, of fruits and vegetables reduces the risk of developing NCDs (2) and helps ensure daily fiber intake.

Consumption of fruits and vegetables can be improved. To do this, you need to:

• always include vegetables in the diet;
• eat fresh fruits and vegetables as snacks;
• consume seasonal fruits and vegetables; and
• consume a variety of fruits and vegetables.

Fats

Reducing total fat intake to less than 30% of total energy intake helps prevent unhealthy weight gain in adults (1, 2, 3). In addition, the risk of developing NCDs can be reduced by:

• reducing saturated fat intake to less than 10% of total energy intake;
• reducing trans fat intake to less than 1% of total energy intake; and
• replacing saturated fats and trans fats with unsaturated fats (2, 3), particularly polyunsaturated fats.

Consumption of fats, especially saturated fats and industrially produced trans fats, can be reduced in the following ways:

• steam or boil rather than fry or bake;
• replace butter, lard and gi with vegetable oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oil;
• eat dairy products with a reduced fat content and lean meat or cut visible fat from meat; and
• limit the consumption of baked and fried foods, as well as pre-prepared snack bars and other products (for example, donuts, muffins, pies, cookies and waffles) containing trans fats of industrial production.

Salt, sodium and potassium

Many people consume too much sodium, which comes with salt (corresponding to an average intake of 9-12 grams of salt per day), and not enough potassium (less than 3.5 grams). High sodium intake and insufficient potassium intake contribute to higher blood pressure, which in turn increases your risk of heart disease and stroke (8, 11).

Reducing salt intake to the recommended level of less than 5 grams per day could help prevent 1.7 million deaths per year (12).

People often don’t know how much salt they consume. In many countries, the bulk of salt enters the human body from processed foods (ready meals; meat products such as bacon, ham and salami; cheese; and salty snacks) or from foods often consumed in large quantities (for example, bread). Salt is also added to food during its preparation (for example, by adding broth, bouillon cubes, soy sauce and fish sauce) or during meals (by adding table salt).

Salt intake can be reduced in the following ways:

• limit the amount of salt and seasonings with a high sodium content (for example, soy sauce, fish sauce and broth) added during cooking;
• do not put salt and sauces with a high sodium content on the table;
• limit the consumption of salty snacks; and
• choose foods that are low in sodium.

Some food manufacturers change the composition of their products to reduce the sodium content, and before purchasing or consuming products, you should check the labeling for sodium content in them.

Potassium can mitigate the negative effects of excess sodium intake on blood pressure. Potassium intake can be increased by consuming fresh fruits and vegetables.

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Sugar intake in both adults and children needs to be reduced to less than 10% of total energy intake (2, 7). Reducing consumption to less than 5% of total energy intake will provide additional health benefits (7).

Consumption of free sugars increases the risk of developing dental caries. Excess calories from foods and drinks containing free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recently, there is evidence that free sugars have an effect on blood pressure and serum lipids. This suggests that reducing your intake of free sugars helps reduce your risk of heart disease (13).

Sugar intake can be reduced in the following ways:

• limit the consumption of foods and beverages high in sugars, such as sugary snacks, sweets and sweetened beverages (i.e. all types of beverages containing free sugars, which include carbonated and non-carbonated soft drinks, fruit and vegetable juices and drinks, liquid and powder concentrates, flavored waters, energy and sports drinks, ready-made tea, ready-made coffee and dairy drinks with flavors); and
• replace sweet snacks with fresh fruits and vegetables.

How to promote healthy eating?

Diets change over time under the influence of many social and economic factors and because of their complex interaction, contributing to the formation of individual eating patterns. These factors include income, food prices (which have an impact on food availability and affordability), individual preferences and beliefs, cultural traditions, and geographical and environmental aspects (including climate change). Therefore, multiple sectors and stakeholders, including governments and the public and private sectors, need to be involved in building healthy food environments – including food systems that promote diverse, balanced and healthy diets.

Governments play a central role in creating healthy food environments that enable people to adopt and maintain healthy eating practices. Effective actions by policy-makers to create a healthy food environment include the following:

• • Ensure coherence in national policies and investment plans, including in the areas of trade, food and agriculture, to promote healthy diets and protect public health through:
    • strengthening incentives to encourage producers and retailers to grow, use and sell fresh fruits and vegetables;
    • stimulating changes in the composition of food products to reduce the content of saturated fats, trans fats, free sugars and salt / sodium in order to exclude trans fats of industrial production from the composition of food products;
    • implementation of WHO recommendations on marketing of food and non-alcoholic beverages to children;
    • establishing standards that promote healthy eating practices by ensuring the availability of healthy, nutritious, safe and affordable food in preschools, schools, other public institutions and workplaces;
    • Exploring regulatory and voluntary instruments (e.g. marketing rules and policies on food labelling) and economic incentives or constraints (e.g. taxation and subsidies) to promote healthy diets; and
    • Promoting transnational, national and local food services and businesses to improve the nutritional quality of their products — ensuring that healthy food options are available and affordable — and to revise portion sizes and prices.

 

• Stimulating consumer demand for healthy foods and meals through the following measures:
  • raising consumer awareness of healthy eating;
  • the development of school policies and programmes aimed at adopting and maintaining healthy eating practices among children;
  • educating children, adolescents and adults on healthy eating practices;
  • assistance in the development of culinary skills, including in children in the framework of schooling;
  • Support for the provision of point-of-sale information, including through labelling containing accurate, standardized and comprehensive information on the nutrient content of food (in accordance with Codex Alimentarius Commission guidelines) and additional labelling on the front of the package to make this information easier for consumers to understand; and
  • nutrition counselling at the primary health care level.

   

• Promote good infant and young child feeding practices through the following measures:
  • implementation of the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions;
  • implementing policies and practices to strengthen the protection of working mothers; and
  • Promoting, protecting and supporting breastfeeding in health services and communities, including through the Hospital-Friendly Breastfeeding Initiative.

WHO activities

In 2004, the Health Assembly adopted the WHO Global Strategy on Diet, Physical Activity and Health (14). The strategy called on governments, WHO, international partners, the private sector and civil society to take action at the global, regional and local levels to promote healthy diets and physical activity.

In 2010, the Health Assembly approved a set of recommendations for the marketing of food and non-alcoholic beverages to children (15). With these recommendations, countries are developing new and improving existing strategies to reduce the impact of junk food marketing on children. WHO has also developed regional tools (such as regional nutrient model lists) that countries can use to implement marketing recommendations.

In 2012, the Health Assembly adopted a “Comprehensive Implementation Plan for Maternal and Infant and Young Child Nutrition” and six global nutrition targets to be achieved by 2025, including reducing the number of children suffering from stunting, wasting and overweight, improving breastfeeding and reducing the number of children with anaemia and low birth weight (9).

In 2013, the Health Assembly agreed on nine global voluntary targets to prevent and control NCDs. These goals include halting the increase in diabetes and obesity cases and a relative 30% reduction in salt intake by 2025. “Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020” (10) provide guidance and policy options to assist Member States, WHO and other United Nations agencies in achieving these objectives.

In May 2014, in view of the rapid increase in the number of infants and other age groups with obesity in many countries, WHO established the Commission to End Childhood Obesity. In 2016, the Commission proposed a set of recommendations to successfully tackle obesity among children and adolescents around the world (16).

In November 2014, WHO, together with the Food and Agriculture Organization of the United Nations (FAO), organized the Second International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration on Nutrition (17) and the Framework for Action (18), which provide recommendations on a range of policy options and strategies to promote diverse, safe and healthy diets at all stages of life. WHO assists countries in implementing the commitments made at ICN2.

In May 2018, the Health Assembly adopted the thirteenth General Programme of Work (GPW13), which will guide WHO’s work in 2019–2023 (19). Reducing salt/sodium intake and eliminating industrial trans fats from food are identified in OPP13 as priority actions for WHO to achieve the goals of healthy lifestyles and well-being for all at all ages. To assist Member States in taking the necessary measures to eliminate industrial trans fats from food, WHO has developed a roadmap for countries (REPLACE package of measures) to accelerate action (6)