What healthy diets are in this 21 st century

Transcription

1 Building healthy global food systems. A new imperative for public health Oxford, September 8-9th, 2014 What healthy diets are in this 21 st century Implications for food systems Carlos A Monteiro Center for Epidemiological Studies in Health and Nutrition School of Public Health, University of São Paulo

2 What healthy diets are in this 21 st century Narrow and broad views on health and on diet What is gained by the broad view Main features of healthy diets in this 21st century Implications for food systems

3 Narrow and broad views of health Health as the mere absence of disease vs. Health as a state of complete physical, mental and social well-being* *Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June - 22 July 1946

4 Narrow view of diet Diet reduced to the sum of isolated nutrients existing in the foods eaten during the day (foods as mere carriers of nutrients) Sodium, Sucrose, Fatty acids Proteins Vitamins, Minerals Carbohydrates

5 Narrow and broad views of diet Diet reduced to the sum of isolated nutrients existing in the foods eaten during the day (foods as mere carriers of nutrients) Diet as including foods, meals and ways of eating Sodium, Sucrose, Fatty acids Proteins Vitamins Minerals Carbohydrates

6 What is gained with the broad view 1. Effect of the food matrix on human biological systems 2 Effect of meals on human biological systems 3 Effect of ways of eating on energy balance 4 Effect of foods, meals, and ways of eating on mental and social well-being 5 Effect of food system sustainability on physical, mental and social well-being

7 1. Effect of the food matrix on human biological systems Although a few foods are a single molecule, most foods are organisms or derived from organisms in all the complexity that life requires See: Fardet A 2014 The parts and the whole. World Nutrition 5, 9, Jacobs Jr, DR & Tapsell LC Food synergy: the key to a healthy diet. Proceeding of the Nutrition Society 72, 2,

8 1. Effect of the food matrix on human biological systems Foods as complex, nonrandom mixtures of natural compounds, developed under biological evolutionary control See: Fardet A 2014 The parts and the whole. World Nutrition 5, 9, Jacobs Jr, DR & Tapsell LC Food synergy: the key to a healthy diet. Proceeding of the Nutrition Society 72, 2,

9 h benefits due to he slow and nuous release of through the gut Health benefits due to the slow and continuous release of phenolic compounds bound to dietary fiber through the gut Vitaglione P et al 2008 Trends in Food Science & Technology 19:

10 Nonrandom mixtures of natural compounds developed under biological evolutionary control Technological formulations of substances extracted or derived from constituents of foods or synthetized from other organic sources, designed as ready-toconsume, long-duration, hyper-palatable products

11 Antiviral Factors Antiviral Factors Antiviral Factors Antiviral Factors Antiviral Factors Antiviral Factors Hormones Hormones Hormones Growth Factors Growth Factors Growth Factors Enzymes Enzymes INGREDIENTS FOUND IN BREAST MILK INGREDIENTS FOUND IN FORMULA

12 2. Effect of meals on human biological systems Meals as complex, nonrandom mixture of foods, developed under biocultural evolutionary control Rice, beans, stir-fried kale, roasted manioc grits, orange, and vinaigrette salsa of tomato and onions

13 Chicken, pasta, herbs, lettuce, tomato Meals as complex, nonrandom mixture of foods, developed under biocultural evolutionary control Technological formulations of substances extracted or derived from constituents of foods or synthetized from other organic sources, designed as ready-to-consume, long-duration, hyper-palatable products

14 3. Effect of ways of eating on energy balance See: Cohen DA, Farley TA. Eating as an automatic behavior. Preventing Chronic Disease 5: 1-7, 2008 Wansink B. Mindless Eating: Why We Eat More Than We Think. New York: Bantam, 2006

15 4. Effect of foods, meals and ways of eating on mental, social well-being See: Pollan M. Cooked. A Natural History of Transformation. New York: Penguin, Fischler C. Commensality, society and culture. Social Science Information 50: , 2011.

16 5. Effect of food system sustainability on physical, mental, social well-being

17 See: Lang T, Barling D, Caraher M. Food Policy: Integrating Health, Environment and Society. Oxford: Oxford University Press, 2009 FAO. Sustainable diets and biodiversity: directions and solutions for policy, research and action, Rome, Effect of food system sustainability on physical, mental, social well-being Scale, use, protection of soil, land Use of water and of non-renewable energy Use of conventional or transgenic seeds Biological or chemical control of plagues Intensive or extensive rearing of animals Husbandry of forests, landscape and wildlife Maintenance of secure and settled local communities Nature and intensity of food processing Distance and intermediaries between farms and consumers Generation of jobs and income distribution Fairness of dealing and trading with purchasers Security of tenure and employment of farmers, workers

18 Dietary Guidelines for the Brazilian Population Issued by the Brazilian Federal Ministry of Health, Brasília DF Draft. Now subject to final revisions

19 Brazil Food Guide 2014 Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Principles Choosing foods From foods to meals Mindful eating and commensality Overcoming obstacles Ten steps to healthy diet Further reading

20 Chapter 1. Principles Diet is more than the consumption of nutrients Diet fulfills physical, mental and social human needs Healthy diets derive from sustainable food systems Food guides must be tuned to their time Food guides are based on a full range of evidence Food guides enlighten consumers and empowers citizens

21 1 Make the basis of your diet a variety of fresh or minimally processed plant foods provided by socially, culturally and environmentally sustainable food systems 2 Use processed culinary ingredients (oils, fats, sugar and salt) in moderation to cook foods and prepare meals 3 Limit processed foods (simple breads and cheeses) to small amounts and as part of freshly-prepared meals 4 Avoid ultra-processed food and drink products Ten steps to healthy diets For everybody, everywhere 5 Eat freshly cooked meals regularly, mindfully, in pleasant places, and in company 6 Buy food in places that offer a variety of fresh, locally produced foods 7 Learn, value, practice and share the art of cooking 8 Give the pleasure of eating a central place in your life 9 Choose places to eat out that serve freshly cooked meals 10 Beware of information and orientation from sources with conflicted interests

22 Implications for food systems 1. Give top national priority to farming that produces all sorts of plant foods for human use 2. Promote family farming as part of a general policy to sustain rural livelihoods 3. Uphold food systems that respect climate and natural resources as central to civilisation 4. Tax, restrict and warn against ultra-processed food and drink products 5. Ensure that all housing and offices have adequate facilities for cooking and eating 6. Protect independent restaurants and vendors that make fresh dishes and meals 7. Base all official and informed education and guidance on foods and meals 8. Make food, nutrition and cooking part of the core curriculum in schools 9. Celebrate gastronomy as central to national and local culture and identity 10. Prohibit all advertising and promotion of any product to children under the age of 16

23 Can We Say What Diet Is Best for Health? D.L. Katz and S. Meller. Annu. Rev. Public Health : The aggregation of evidence in support of diets comprising preferentially minimally processed plant foods and food (meals) made up of such ingredients is noteworthy for its breadth, depth, diversity of methods, and consistency of findings. The case that we should, indeed, eat true food, mostly plants, is all but incontrovertible. this (also) offers considerable advantages to other species, the environment around us, and even the ecology within us. An important aspect of this message is that the same basic dietary pattern exerts favorable influences across a wide spectrum of health conditions

24 THE FOOD SYSTEM The big issue for nutrition Carlos Monteiro, Geoffrey Cannon Renata Bertazzi Levy, Rafael Claro, Jean-Claude Moubarac Ana Paula Martins, Daniela Cannela, Diana Parra, Maluh Barciotte, Maria Laura Louzada, Larissa Baraldi, Euridice Martinez, Carla Martins, Josefa Garzillo Centre for Epidemiological Studies in Health and Nutrition (NUPENS) School of Public Health, University of Säo Paulo. Brazil

25 (SOME OF) THE USP TEAM