Key facts

• A healthy diet helps protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including obesity, diabetes, heart disease, stroke and cancer.
• Unhealthy diet and lack of physical activity are leading global risks to health.
• Healthy dietary practices start early in life – breastfeeding may have longer-term benefits, like reducing the risk of overweight and obesity in childhood and adolescence.
• Energy intake (calories) should balance energy expenditure. Evidence indicates that total fat should not exceed 30% of total energy intake to avoid unhealthy weight gain [2] , [3], [4], with a shift in fat consumption away from saturated fats to unsaturated fats [4], and towards the elimination of industrial trans fats [5].
• Limiting intake of free sugars to less than 10% of total energy [3], [6] is part of a healthy diet. A further reduction to less than 5% of total energy [7] is suggested for additional health benefits.
• Keeping salt intake to less than 5 g per day helps prevent hypertension and reduces the risk of heart disease and stroke in adult population. [8]
• WHO Member States have agreed to reduce the global population’s intake of salt by 30% and halt the rise in diabetes and obesity by 2025.

Overview

Consuming a healthy diet throughout the life-course helps prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. But increasing production of processed food, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are consuming more foods high in energy, saturated fats, trans fats, free sugars or salt/sodium, and many do not eat enough fruit, vegetables and dietary fibre such as whole grains.

The exact make-up of a healthy, balanced diet will vary depending on the individual needs (e.g. age, gender, lifestyle, degree of physical activity).

For adults

A healthy diet contains:

• fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice);
• at least 400 g (5 portions) of fruit and vegetables a day [3]. Potatoes, sweet potatoes, cassava and other starchy roots are not classified as fruits or vegetables;
• less than 10% of total energy from free sugars [3], [6] equivalent to 50g (or around 12 level teaspoons), but possibly less than 5% of total energy for additional health benefits. [7] Most free sugars are added to foods by the manufacturer, cook or consumer, and can also be found in sugars naturally present in honey, syrups, fruit juices and fruit concentrates;
• less than 30% of total energy from fat. [2], [3], [4] Unsaturated fats (e.g. found in fish, avocado, nuts, sunflower, canola and olive oils) are preferable to saturated fats (e.g. found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard). [4] Industrial trans fats (found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads) are not part of a healthy diet;
• less than 5 g of salt (equivalent to approximately one teaspoon) per day [8] and use iodized salt.

Infants and young children

The first 2 years of a child’s life are vital as optimal nutrition during this period reduces the risk of dying and of developing NCDs. It also fosters better development and healthy growth and development overall.

Advice on a healthy diet for infants and children is similar to that for adults but these elements are also important.

• Infants should be breastfed exclusively for the first 6 months of life.
• Infants should be continuously breastfed until 2 years and beyond.
• From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient dense complementary foods. Salt and sugars should not be added to complementary foods.

Practical advice on how to have a healthy diet

Fruit and vegetables

Eating at least 5 portions, or 400 g, of fruit and vegetables per day reduces the risk of NCDs [3], and helps ensure an adequate daily intake of dietary fibre.

In order to improve fruit and vegetable consumption you can:

• always include vegetables in your meals;
• eat fruit and raw vegetables as snacks;
• eat fresh vegetables in season;
• vary choices of fruits and vegetables.

Fats

Reducing the amount of total fat intake to less than 30% of total energy helps prevent unhealthy weight gain in adult population. [2], [3], [4]

Also, the risk of developing NCDs is lowered by reducing saturated fats to less than 10% of total energy, [3], [4] and trans fats to less than 1% of total energy, and replacing them with unsaturated fats contained in vegetable oils. [3], [4]

Fats intake can be reduced by:

• changing how you cook – remove the fatty part of meat; instead of butter, use vegetable oil (not animal); and boil, steam or bake rather than fry;
• avoid processed foods containing trans fats;
• limit the consumption of foods containing high amounts of saturated fats (e.g. cheese, ice creams, fatty meat).

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to an average of 9–12 g of salt per day) and not enough potassium. High salt consumption and insufficient potassium intake (less than 3.5 g) contribute to high blood pressure, which in turn increases the risk of heart disease and stroke. [9]

Millions of deaths could be prevented each year if people’s salt consumption were reduced to the recommended level of less than 5 g per day.

People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals, processed meats like bacon, ham and salami, cheese and salty snacks) or from food consumed frequently in large amounts (e.g. bread). Salt is also added to food during cooking (e.g. bouillon, stock cubes) or at the table (e.g. table salt, soy sauce and fish sauce).

You can reduce salt consumption by:

• not adding salt, soy sauce or fish sauce during the preparation of food;
• not having salt on the table;
• limiting the consumption of salty snacks;
• choosing products with lower sodium content.

Some food manufacturers are reformulating recipes to reduce the salt content of their products, and it is good to check food labels to see how much sodium is in a product.

Potassium, which can mitigate the negative effects of elevated sodium consumption on blood pressure, can be increased with consumption of fruits and vegetables.

Sugars

Evidence indicates that intake of free sugars by adults and children should not exceed 10% of total energy [3], [6], and that a reduction of under 5% of total energy provides additional health benefits. [7] Free sugars are all sugars added to food or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and concentrates. [3]

Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity.

Sugars intake can be reduced by:

• limiting the consumption of foods and drinks containing high amounts of sugars (i.e. sugar-sweetened beverages, sugary snacks and candies); eating fruit and raw vegetables as snacks instead of sugary snacks.

How to promote healthy diets

Diet can depend on an individual’s food choices, but also the availability and affordability of healthy foods, and sociocultural factors. Therefore, promoting a healthy food environment requires involvement across multiple sectors and stakeholders, including government, public and the private sector.

Governments have a central role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices.

Effective actions by policy-makers include:

• Coordinate trade, food and agricultural policies with the protection and promotion of public health:
  • increase incentives for producers and retailers to grow, use and sell fruits and vegetables;
  • reduce incentives for the food industry to use saturated fats and free sugars;
  • set and enforce targets to reformulate food products to cut the contents of salt, fats (i.e. saturated fats and trans fats) and free sugars;
  • implement the WHO recommendations on the marketing of foods and non-alcoholic beverages to children;
  • establish standards to promote healthy, safe and affordable food in public institutions;
  • encourage private companies to provide healthy food in their workplaces;
  • set incentives and rules so consumers have healthy, safe and affordable food choices;
  • encourage transnational, national and local food services and catering outlets to improve the nutritional quality of their food, create real choices, and review portion size and price;
  • consider taxes and subsidies to encourage food manufacturers to produce healthier food and make healthy products available and affordable.
• Encourage consumers demand for healthy foods and meals:
  • promote consumer awareness;
  • develop school policies and programmes that encourage children to adopt a healthy diet;
  • educate children, adolescents and adults about nutrition and healthy dietary practices;
  • encourage culinary skills, including in schools;
  • allow informed choices through proper food labelling that ensures accurate, standardized and comprehensible information on food content in line with the Codex Alimentarius Commission guidelines;
  • provide dietary counselling in primary health care.
• Promote healthy nutrition in infants and young children:
  • implement the International Code of Marketing of Breast-milk Substitutes
  • promote and support breastfeeding in health services and the community, including through the Baby-Friendly Hospital Initiative.