The objective of this review is to provide a concise, descriptive global review of current food-based dietary guidelines (FBDG), and to assess similarities and differences in key elements of a healthy diet articulated across countries. Information was sourced from the FBDG repository of the FAO, which catalogs FBDG for all countries where they are available, including a description of the food guide (the graphic representation of the dietary guidelines), a set of key messages, and downloadable documents provided by the countries. FBDG are currently available for 90 countries globally: 7 in Africa, 17 in Asia and the Pacific, 33 in Europe, 27 in Latin America and the Caribbean, 4 in the Near East, and 2 in North America. The year of publication of current versions ranges from 1986 to 2017 (mean 2009). This review provides summaries of the key messages and food guides that are used to communicate national dietary guidance, organized by food group, and evaluates the extent to which each set of FBDG includes existing recommendations articulated by the WHO. Some guidance appears nearly universally across countries: to consume a variety of foods; to consume some foods in higher proportion than others; to consume fruits and vegetables, legumes, and animal-source foods; and to limit sugar, fat, and salt. Guidelines on dairy, red meat, fats and oils, and nuts are more variable. Although WHO global guidance encourages consumption of nuts, whole grains, and healthy fats, these messages are not universally echoed across countries. Future frontiers in FBDG development include the incorporation of environmental sustainability and increased attention to sociocultural factors including rapidly changing dietary trends. Steps toward regional and global dietary recommendations could be helpful for refinement of country-level FBDG, and for clear communication and measurement of diet quality both nationally and globally.
Background:For the optimal nutrition of children under 2 years of age, it is considered important that they be exclusively breastfed for the first 6 months before being given complementary food.Aims and Objectives:A cross-sectional nutritional baseline survey was undertaken in 2011 in the Kasungu and Mzimba Districts of Malawi to assess the nutritional status of children under 2 years of age and its determinants in order to prepare a nutrition education intervention programme. The intention of this study was to assess the nutritional status of infants aged 0–<6 months with regard to food intake.Methods:Interviews were conducted on randomly selected families with children under 2 years; anthropometric measurements were obtained from mothers and their children. Only infants between 0 and <6 months were selected for analysis (n = 196). An ANCOVA test was performed on age of the infant with mothers’ height and weight as covariates.Results:Prevalence of stunting (infants’ length-for-age Z-score (LAZ) <−2SD) was 39%, wasting (WLZ <−2SD) 2%, and underweight (WAZ <−2SD) 13%. Of the infants under 6 months, 43% were exclusively breastfed. Predominant breastfeeding and mixed breastfeeding were less common (21% and 36%, respectively). The ANCOVA confirmed the association between exclusive breastfeeding and LAZ and WAZ: exclusively breastfed infants had a higher mean (SE) LAZ (−1·13, 0·12) and WAZ (−0·41, 0·13) than infants not being exclusively breastfed (−1·59, 0·11, and −0·97, 0·11, respectively). There was no overall significant association between breastfeeding practice and WLZ.Conclusion:Exclusive breastfeeding of infants under 6 months is associated with higher mean LAZ and WAZ. Promotion of exclusive breastfeeding in low-income countries is important in preventing growth retardation.
Background:Adequate young child feeding practices are influenced by a multitude of factors which affect growth and development. A combination of indicators is needed to explain the role of complementary feeding practices in growth retardation.Methods:A cross-sectional nutrition baseline survey was conducted in rural Cambodia in September 2012. Villages in pre-selected communes were randomly selected using stunting as a primary indicator. Data were collected from 803 randomly selected households with children aged 6–23 months, based on a standardised questionnaire and on length/height and weight measurements of mother and child. WHO Infant and Young Child Feeding (IYCF) indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD)] and a child feeding index (CFI) were created. The latter consisted of five components: breastfeeding, use of bottle, dietary diversity, food frequency and meal frequency which were adjusted for three age groups: 6–8, 9–11 and 12–23 months. The highest possible score was 10. Associations between length-for-age Z-scores (LAZ) and WHO indicators or CFI were explored.Results:Mean (SD) LAZ was −1.25 (1.14) (n = 801). Mean (range) CFI was 6.7 (1–10) (n = 797). Mean CFI was highest in the 9–11-months age group (7.93) and lowest for those aged 12–23 months (5.96). None of the WHO IYCF indicators was associated with LAZ, whereas CFI showed significant association with LAZ (P < 0.01). The association between higher CFI scores and LAZ became weaker as age increased.Conclusion:The results highlight the need to include a wide range of information in the analysis in order to understand the association between appropriate infant feeding practices and child growth.
Objective: To assess the school food environment in terms of breakfast consumption, school meals, learners' lunch box, school vending and classroom activities related to nutrition. Design: Cross-sectional survey. Setting: Ninety purposively selected poorly resourced schools in South Africa. Subjects: Questionnaires were completed by school principals (n 85), school feeding coordinators (n 77), food handlers (n 84), educators (n 687), randomly selected grade 5 to 7 learners (n 2547) and a convenience sample of parents (n 731). The school menu (n 75), meal served on the survey day, and foods at tuck shops and food vendors (n 74) were recorded. Results: Twenty-two per cent of learners had not eaten breakfast; 24 % brought a lunch box, mostly with bread. Vegetables (61 %) were more often on the school menu than fruit (28 %) and were served in 41 % of schools on the survey day compared with 4 % serving fruit. Fifty-seven per cent of learners brought money to school. Parents advised learners to buy fruit (37 %) and healthy foods (23 %). Tuck shops and vendors sold mostly unhealthy foods. Lack of money/poverty (74 %) and high food prices (68 %) were major challenges for healthy eating. Most (83 %) educators showed interest in nutrition, but only 15 % had received training in nutrition. Eighty-one per cent of educators taught nutrition as part of school subjects. Conclusions: The school food environment has large scope for improvement towards promoting healthy eating. This includes increasing access to vegetables and fruit, encouraging learners to carry a healthy lunch box, and regulating foods sold through tuck shops and food vendors. Keywords School food vendorsSchool tuck shop Lunch box School feeding South AfricaSouth Africa experiences the double burden of undernutrition and overweight. A national survey showed that 20?7 % of 1-to 9-year-old children were stunted, 8?1 % were underweight, 5?8 % were wasted, and 14?0 % were either overweight or obese (1) . Overweight/obesity increases progressively as children become older (2) , and the second national youth risk behaviour survey showed that 20 % of secondary-school learners were overweight and 5 % were obese (3) . Overweight/obesity is even more prevalent during adulthood and, in 2003, 54?9 % of adult women and 29?8 % of adult men were either overweight or obese (4) .
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