Smitasiri Suttilak, Uauy Ricardo
Division of Communication and Behavioral Science, Institute of Nutrition, Mahidol University (INMU), Phuthamonthon 4 Road, Salaya, Nakorn Phathom 73170, Thailand.
Food Nutr Bull. 2007 Mar;28(1 Suppl International):S141-51. doi: 10.1177/15648265070281S112.
To reduce the increased burden of diet-related disease and promote human potential through food and nutrition globally, harmonization of efforts is urgently needed. This article examines the concept of food-based dietary guidelines (FBDGs) and discusses the possibilities and challenges of harmonizing the process of developing and implementing dietary guidelines. The authors argue that while the development of FBDGs has contributed to the understanding of the role of nutrients and foods in achieving optimal health, the impact of these guidelines on human health has been limited. Science or evidence must be used in FBDG development; nevertheless, there are limitations in current nutrition science. FBDGs should address the health consequences of dietary insufficiency, excess, or imbalance with a broader perspective, considering the totality of the effects of a given dietary pattern, rather than focusing on single nutrients alone. Moreover, the food selection guideline should be seen as complementary to a strategic, comprehensive, and culturally appropriate dietary and health promoting intervention, and not only as a tool for providing nutrition policy and information. Technically, a single unified global set of FBDGs may be desirable and even achievable. This concept, however, presents novel challenges on how to address cultural diversity and the complex social, economic, and political interactions between humans and the food supply, not to mention the complexity of its communication and implementation. Therefore, global harmonized efforts in support of strategic dietary interventions, together with strong global scientific support and facilitation for the development and communication of FBDGs at national or regional levels, are proposed to implement FBDGs for healthier populations.
为了在全球范围内减轻与饮食相关疾病日益增加的负担，并通过食物和营养促进人类潜能，迫切需要协调各方努力。本文探讨了基于食物的膳食指南（FBDGs）的概念，并讨论了协调膳食指南制定和实施过程的可能性与挑战。作者认为，虽然FBDGs的制定有助于理解营养素和食物在实现最佳健康方面的作用，但这些指南对人类健康的影响有限。在FBDG制定过程中必须运用科学或证据；然而，当前营养科学存在局限性。FBDGs应以更广阔的视角来应对饮食不足、过量或不均衡带来的健康后果，考虑特定饮食模式的总体影响，而不是仅关注单一营养素。此外，食物选择指南应被视为对一项具有战略性、全面性且符合文化背景的饮食与健康促进干预措施的补充，而不仅仅是提供营养政策和信息的工具。从技术层面讲，一套统一的全球FBDGs或许是理想的，甚至是可行的。然而，这一概念在如何应对文化多样性以及人类与食物供应之间复杂的社会、经济和政治互动方面提出了新的挑战，更不用说其传播和实施的复杂性了。因此，建议开展全球协调努力以支持战略性饮食干预，并为国家或地区层面FBDGs的制定和传播提供强有力的全球科学支持与便利，从而为更健康的人群实施FBDGs。
