Monday, March 03, 2014

Guest Post: Are Brazil's New National Dietary Guidelines the World's Best?

Photo by Luciana Christante of Mercado Ver-o-Peso in Brazil
A few weeks ago Brazil announced the launch of their new national dietary guidelines. Unlike those from North America, Brazil's focuses on the real issue at hand - we've stopped cooking. At least half of our average food dollar is now being spent on foods purchased outside the home and of the foods we bring in, the amount of processed foods have doubled since just the 1980s. So how did Brazil do it? How did Brazil, rather than join North American in issuing a misguided, nutrient focused, and food industry friendly dietary guideline, put out an actually useful and thoughtful food guide? Here to explain is Dr. Jean-Claude Moubarac who himself was involved in Brazil's guidelines' creation.

Tips from the tropics
Brazil’s new dietary guidelines focus on food and the enjoyment of meals

Suddenly, it may be that Canada can gain inspiration from Latin America. On February 10th the federal Ministry of Health of Brazil issued the final draft of a new guide not only to food and nutrition, but also to the enjoyment of healthy meals. The guide has been approved at this stage by the Minister of Health. It is now out for public consultation. The guide at this stage in Portuguese, and can be seen here.

Announcing the guide on her blog, Food Politics author and New York University professor Marion Nestle says: ‘Now if only our Dietary Guidelines Advisory Committee would take note and do the same. Would you like us to have sensible, unambiguous food-based guidelines like these?’

After obtaining a PhD from the School of Public Health at Université de Montréal, I spent the last two years in São Paulo, Brazil’s biggest city, during the time the new guide was being prepared. I was a member of the University of São Paulo team responsible to the Ministry of Health for developing the guide, also with support and guidance of the Pan American Health Organization. I had the privilege of participating in the work of preparing the guide, supervised by my post-doctoral mentor and world-renowned authority on diet and health Professor Carlos Monteiro.

The guide preparation has also been supported by workshops held in 2011 and 2013, involving researchers, other health professionals and educators, and civil society organisations, from all regions of Brazil.

The guide is designed to prevent and protect against all forms of malnutrition. These include undernutrition, already in sharp decline in Brazil. Its main focus is the same as any guide issued in North America, to prevent and control overweight and obesity, and chronic diseases such as diabetes, all now sharply increasing in Latin America.

This Brazilian guide goes further. It is not just concerned with avoiding obesity and disease. It is also designed to encourage positive good health and well-being among all Brazilians.

The guide takes into account the latest scientific evidence. It is written in a style attractive to everybody interested in their own health and that of their family and community. It is also designed for use by policy-makers, educators, and all those responsible for food supplies. And as another innovation, it takes as a starting point, what the Brazilian people from all social classes actually eat every day.

All the advice in the guide has been summed up in three ‘golden rules’. These are universal. Everybody in the world will benefit from following them:
  • Make fresh and minimally processed foods the basis of your diet
  • Use oils, fats, sugar and salt in moderation when preparing dishes and meals
  • Limit consumption of ready-to eat food and drink products.
Most countries are now faced with rapidly rising rates of obesity and related chronic diseases. The Brazilian guide is a whole new look at food and nutrition. It takes a broad and comprehensive view of health, including the social, cultural, economic amd environmental dimensions of food systems and supplies and so of dietary patterns. In particular it examines the central role of different types of processing on the quality of diets.

The ten main recommendations in the guide are:
  1. Prepare meals from staple and fresh foods.
  2. Use oils, fats, sugar and salt in moderation.
  3. Limit consumption of ready-to-consume food and drink products
  4. Eat regular meals, paying attention, and in appropriate environments.
  5. Eat in company whenever possible.
  6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for consumption.
  7. Develop, practice, share and enjoy your skills in food preparation and cooking.
  8. Plan your time to give meals and eating proper time and space.
  9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food chains.
  10. Be critical of the commercial advertisement of food products.
Patricia Jaime, Ministry of Health coordinator of Food and Nutrition, the pivotal point of contact in Brazil for the guide, makes a statement that resonates in other countries and all over the world. She says:
"We need to protect and preserve the Brazilian tradition of enjoyment of meals as a central part of family, social and workplace life. The planning of meals, exchange of recipes with friends, and involvement of the whole family in preparing food to enjoy together, are all part of a healthy life. Of course it is true that making meals at home takes time. But this is time we can share with our loved ones, including children. Freshly prepared meals are still cheaper than ready-to-consume snack and drink products. Also, protecting personal and family good health and well-being will save time and money spent on health care"
Public health and nutrition professionals in Canada agree that new ways of thinking are needed to face and deal with the obesity and diabetes crises. Our food system is saturated with ready-to-consume ultra-processed food products that are intrinsically unhealthy. We often hear that today people have little or no time to cook “real” food and to share meals. Maybe this is true. Or maybe it’s a question of what we most value in life and to what we choose to give the highest priorities.

So here is a whole new idea. Maybe our inspiration to appreciate the value of freshly prepared meals will come from Brazil, and the global South.

Jean-Claude Moubarac has a background in anthropology and a PhD in public health. He undertook his post-doctoral studies in public health and nutrition at the School of Public Health at the University of São Paulo in Brazil. He is committed to an integrated approach to health which involves taking into account its social, cultural, economic, political and environmental dimensions. His mission includes devising, developing and helping to enact rational public policies and effective actions to improve the quality of dietary patterns and of food systems, so as to reverse current trends in obesity and related chronic diseases and to protect and enhance good health and well-being. He now coordinates an international research program studying the role of cooking and of food processing in shaping dietary practices, with implications for diet quality and obesity, in low, middle and high income countries. He recently participated in the development of Brazil's new official national dietary guidelines. He is a member of an expert committee convened by the UN Food and Agriculture Organization in order to devise guidelines for the incorporation of food processing into dietary surveys.