Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
University of Washington School of Medicine, Seattle, WA, USA.
Food Nutr Bull. 2020 Dec;41(2_suppl):7S-30S. doi: 10.1177/0379572120973111.
Healthy diets promote optimal growth and development and prevent malnutrition in all its forms, including undernutrition, obesity, and diet-related noncommunicable diseases (NCDs).
This background paper for the International Expert Consultation on Sustainable Healthy Diets characterizes healthy diets and their implications for food system sustainability.
Three complementary approaches to defining healthy diets are compared: World Health Organization (WHO) guidelines or recommendations developed between 1996 and 2019; 2017 Global Burden of Disease (GBD) risk factor study estimates of diet-related risk-outcome associations; and analyses associating indices of whole dietary patterns with health outcomes in population studies and clinical trials.
World Health Organization dietary recommendations are global reference points for preventing undernutrition and reducing NCD risks; they emphasize increasing intakes of fruits, vegetables (excepting starchy root vegetables), legumes, nuts, and whole grains; limiting energy intake from free sugars and total fats; consuming unsaturated rather than saturated or fats; and limiting salt intake. Global Burden of Disease findings align well with WHO recommendations but include some additional risk factors such as high consumption of processed meat; this approach quantifies contributions of diet-related risks to the NCD burden. Evidence on whole dietary patterns supports WHO and GBD findings and raises concerns about potential adverse health effects of foods with high levels of industrial processing.
Implied shifts toward plant foods and away from animal foods (excepting fish and seafood), and for changes in food production systems have direct relevance to the sustainability agenda.
健康饮食可促进最佳生长发育，预防各种形式的营养不良，包括营养不足、肥胖和与饮食相关的非传染性疾病（NCD）。
这份国际可持续健康饮食专家协商会背景文件阐述了健康饮食及其对食物系统可持续性的影响。
本文比较了三种定义健康饮食的互补方法：世界卫生组织（WHO）在 1996 年至 2019 年期间制定的准则或建议；2017 年全球疾病负担（GBD）风险因素研究对饮食相关风险-结果关联的估计；以及将整个饮食模式指数与人群研究和临床试验中的健康结果相关联的分析。
WHO 的饮食建议是预防营养不足和降低 NCD 风险的全球参考点；它们强调增加水果、蔬菜（除淀粉类根茎蔬菜外）、豆类、坚果和全谷物的摄入量；限制来自游离糖和总脂肪的能量摄入；食用不饱和脂肪而不是饱和脂肪或反式脂肪；并限制盐的摄入量。全球疾病负担研究结果与 WHO 建议一致，但包括一些额外的风险因素，如加工肉类的大量摄入；这种方法量化了与饮食相关的风险对 NCD 负担的贡献。关于整体饮食模式的证据支持了 WHO 和 GBD 的发现，并引发了对高工业化处理食品可能对健康产生不利影响的关注。
向植物性食物转变，减少动物性食物（除了鱼和海鲜）的摄入，以及改变食物生产系统，这与可持续性议程直接相关。
