What are Dietary Guidelines?
Dietary Guidelines are produced by over 100 countries to assist entire populations in making nutrition decisions. The hope is that in doing so, overall health is improved and healthcare costs go down. Because people have so many different needs at different stages of life, it’s certainly a difficult task. The US Department of Health updates its guidelines every 5 years and now is the time for them to start thinking about version 2025. In thinking about how the guidelines can be improved, I took a quick look at what doesn’t seem to be working.
Advice on What to Eat and How to Eat May be Lacking
In general, health departments create a Food Guide in order to simplify the more lengthy guidelines for the public. Overwhelmingly, Food Guides are creatively designed in easy to remember pictures of shapes making extensive nutrition guidelines more memorable. Remember the old U.S. Food Pyramid? Currently the U.S. uses My Plate, which is a circle shape, but resembles a plate. My Plate tells us to build a plate that is part fruit, vegetable, grain, and protein groups. Unfortunately, no matter how we try to distill diet education down to an easy-to-recall formation, it is clearly not working. The adult obesity rate in the US as of 2018 was 42.4% and childhood rates are increasing with recent data showing almost 20%. So what is going wrong? Well, for the most part Americans don’t actually sit down and build a plate or think of food in groups. We rush from place to place and we grab our food and go based on preferences and availability rather than food groups. But recent data suggests that processing, rather than nutrients, and ‘how’ we eat, rather than what we eat, may be more important when it comes to health outcomes.
An Introduction to the Brazilian Dietary Guidelines
In 2015 the Brazil Ministry of Health adopted new dietary guidelines and I have found this to be the healthiest, most common-sense, diet pattern in the world, literally! The main goal of the update was to address the most prominent diet-related issues currently facing the country. Brazil has public policies in place to eradicate nutrient deficiencies and undernutrition, therefore the sole purpose of their new Dietary Guideline is to promote a healthy diet for all and focus on the reduction of obesity and diet related disease. Basically the Brazil Dietary Guidelines has a narrower focus. With that in mind, the guidelines offer a roadmap for success by detailing what food to choose and how to eat it.
According to the Guidelines, food is recommended based on the degree of processing, how it’s prepared, and how it will be consumed. Put simply, this means that we should eat food that is nutrient dense, healthfully prepared, and provides a pleasurable experience. Levels of processing are described so the public is informed on what to choose, how to incorporate them into the diet and how best to transform them into meals. What I love most about the Guidelines is it’s emphasis on using planning, shopping and meal time to enhance enjoyment of meals in a pleasurable environment. The entire process leads to improved personal health, better relationships, and attention to environment and social impact for the community. That is why I think the US could take some advice from Brazil, as they have managed to capture a philosophy on food rather than rules about specific nutrients and food groups.
Brazil Dietary Guidelines Framework
- Degree of Processing affects Nutrient Density
- Preparation affects Healthfulness
- Environment affects Pleasure
All foods Fit Into 4 categories
- Group 1 Natural or Minimally Processed Foods
- Group 2 Minimally Processed Culinary Ingredients
- Group 3 Processed Food
- Group 4 Ultra-Processed Food
Group 1 Natural or Minimally Processed Foods: The basis for the diet
Food is most nutrient dense in its natural state or having gone through minimal processing. So as not to confuse the issue about what minimal processing means I’ll just define that here. Minimally processed food has had something removed or altered for it to be consumed…and THIS is vastly different than the addition of substances. Minimal processing includes processes such as cleaning, cutting, freezing, grinding and pasteurization. Note: Group 1 foods should be the basis of your diet and offers the highest degree of nutrient density. We have a biological need for these foods.
- Plants offer more fiber with lower energy
- Meats offer higher protein and no fiber
- Use meat sparingly and plenty of plant foods for social and sustainable purposes
Group 2 Minimally Processed Culinary Ingredients: Use in moderation
The purpose of Group 2 foods are to make tasty and varied meals out of Group 1 foods. They are culinary ingredients that have been extracted from natural foods such as fats, oils, salt and sugar. The key here is moderation, not avoidance. What is interesting to note here is that other dietary patterns have heralded the use of olive oil, and with good reason for its high quantity of antioxidants and cardiovascular benefits, but without noting appropriate amounts. The Brazilian Dietary Pattern includes fats used in moderation.
- Oils and fats are many more times energy dense than plant foods
- Sugar is way more energy dense than fruit
- Salt is an essential nutrient but in excess can increase the risk of heart diseases
Group 3 Processed Food: Limited use
Group 3 processed foods distinguish themselves as natural foods that have been preserved using methods that, for the most part, add Group 2 foods to Group 1. The purpose is to directly preserve a recognizable version of the food. Drying, salting, pickling, curing and smoking are methods of preservation established by necessity at a time before industrialization and refrigeration. Fermenting, another traditional method of preservation, has seen recent popularity. Cheeses and breads processed with enzymes and yeast belong to Group 3. Group 3 foods aren’t intended to be the main basis of the meal but added to a dish to make it more enjoyable or used as a side dish. Check labels and compare for lowest salt and sugar options too.
- Purpose is preservation and enjoyment
- Adds flavor to dishes
- Can be a side dish
- Compare labels for sugar and salt levels
Group 4 Ultra-Processed Food: Avoid
Group 4, is ultra-processed foods which are adequately defined as industrial formulations with a very small proportion of the food having been derived from Group 1. Group 4 foods can be recognized as having flavor enhancers and other food additives with the purpose of making food more palatable and shelf stable. Unfortunately, Group 4 foods are associated with chronic disease, full stop. The reason may be as simple as the fact that these foods are higher in saturated fat, sodium and sugar, and replace more nutrient dense food. Another reason could be that the greater energy density per volume may not be appropriately stimulating our internal satiety mechanisms. Astonishingly ultra-processed foods tend to wear labels such as “light” and “low in sugar” but those are just a wolf in sheep’s clothing. But if that is not enough to deter the you from consumption of ultra-processed foods then perhaps the fact that industrialization has a negative effect on the planet contributing to environmental damage through packaging, bottles, wrapping, garbage, and transportation energy use.
Disease associated with Group 4 ultra-processed food:
- Metabolic Syndrome
- Obesity
- Cardiovascular Disease
- Coronary Heart Disease
- Cerebrovascular Disease
- Hypertension
- All cause mortality
- Irritable Bowel Syndrome
- Asthma and Wheezing in Adolescents
- Depression
- Breast Cancer
Consider How Food is Consumed
This area has gotten a lot of buzz lately so I find it fascinating that the Brazil Ministry of Health had this written into their guidelines back in 2015. Context, or mode of eating, includes time and attention, environment, and who you share meals with. By incorporating these principles one can improve digestion, control portions, and elevate the social experience and pleasure of eating.
Eating Regularly and Carefully
- Strive for having meals at similar times each day
- Avoid snacking between meals, when meals are appropriately timed
- Eat Mindfully; chewing slowly allows time for mechanisms that regulate appetite to function properly
- Pleasure; varied textures of natural and minimally processed dishes provide a more pleasurable experience than a quick easy to chew ultra-processed food
- Shop mindfully; this extends to selecting food with less environmental impact: local farmer markets, trying your own garden, avoiding fast food, buy only what you need on a shopping list, in season produce.
Environment of Eating
- Clean, quiet, comfortable places encourage mindful eating
- Avoiding distractions to control portions (studies show that distraction by phones and screens lead to more intake)
- Avoid buffets or all you can eat experiences
- Avoid fast food which promotes ultra-processed food and super sizes
Eating is a Social Experience
This idea gets its roots in the value of sharing ideas about food and recipes as well as shopping and preparing. Involving children is a learning experience for them and I know moms stress about how to get kids to eat a more varied healthy diet…THIS is how! Fun fact: eating in the company of others prevents eating too quickly and that cycles right back to mindful eating.
- Prioritize eating with friends, family or colleagues
- Incorporate eating, shopping, preparing and cooking into home life
Learn More
A Brazilian diet pattern is an accumulation of the latest research and by incorporating these lessons you can improve your health and reach your goals. By learning to incorporate all of the principles of a Brazilian Dietary Pattern you will learn how to build a nutrient dense diet, pay attention to hunger cues, eat mindfully, enhance the social experience of eating, and reduce your environmental impact. One of the most efficient and realistic ways to accomplish this long term is through weekly meal planning, grocery shopping lists and easy to make at home recipes. Or, if you would like to learn more about how to make small changes in your current diet toward this evidence-based dietary pattern contact me.
