Food-based dietary guidelines

Food-based dietary guidelines - Italy

Official name

Dietary Guidelines for Healthy Eating– Revision 2018 (Linee Guida per una sana alimentazione - Revisione 2018)

Publication year

Italy published its first set of dietary guidelines in 1986, and they have been regularly updated since then. A second edition was published in 1997 and the third in 2003. The most recent revision was published in 2019. There is no short term plan for a fifth revision.

Stakeholder involvement

The development, periodic revision and implementation of the Italian Dietary Guidelines is an institutional task (defined by Law n.258 / 63; Law n.70 / 75; Legislative Decree 454/99) of CREA Food and Nutrition Research Centre (formerly National Institute of Nutrition). 

It is a consensus document accepted and endorsed by a large scientific and political community. A National Task Force was established including experts from academia, other research institutes, scientific societies and consumers associations. In addition, the document has been accepted across governmental departments, with the inclusion of representatives from Ministry of Agriculture, Health, Environment and Education.

Development process

The FBDGs aim to improve the nutritional quality, safety and the sustainability of the diet of Italians. 

The development process of the present edition started in 2013 with the appointment of the national task force. In 2015 the first draft of the scientific dossier was produced. In 2017 a first version of the FBDGs was released by the coordination board and revised by the national task force. The amended final versions of the documents (Scientific dossier and FBDGs) were officially launched in 2019.

The main aspects of the development process included the evaluation of the health and nutrition situation of the country, the evaluation of implications of the health and nutrition situation and determine strategies for alleviating them and the prioritization of problems and setting of national objectives to be addressed through the FBDGs.

The National Task Force was responsible for structuring the scientific dossier representing the basis for the development of the guidelines, that as policy document, is articulated and addressed to large audience. The statement of the policy document was then translated into a synthetic leaflet, graphically appealing, for wider dissemination.

Implementation

The FBDGs implementation plan will be shaped according to the availability of resources. The FBDGs will be the basis for creating training and information materials for different non-specialist audiences, including short videos and infographics. A training package for university students has also been planned. 

Evaluation

Monitoring and impact evaluation will depend on availability of resources. Evaluation of diet quality indices will be considered especially in term of longitudinal adherence to the FBDGs (as they are based on Mediterranean Diet principles). Potential plans may include the adaptation of international questionnaires to the Italian context, creation of indexes of adherence to recommendations, evaluation of nutrition literacy in the general population and in selected groups. 

Sustainability

Two compelling themes for the revision of the Italian guidelines were the environmental impact of food consumption and the economic cost of a healthy diet for consumersThese issues were addressed in a dedicated chapter on sustainability, which considered key published evidence and aimed at defining healthy food choices considering environmental sustainability, social protection and inequitable distribution. Focus was placed on the selection of foods depending on their estimated impact on health, cost and the environment. Main resulting recommendations included: selecting poultry or legumes over red meat, small fish from the Mediterranean sea over exploited species, seasonal products over imported products or those that require large use of inputs. At household level, recommendations were developed for planning, preparing and storing food that can help consumers waste less food, save money, and eat healthier food. Food losses and waste were largely addressed in the sustainability chapter of the guidelines, also in consideration of the fact that Italy endorsed the international commitment on this aspect with regulatory efforts and allocation of duly dedicated funds at governmental level.

Food guide

The graphical representation of the guidelines has not been developed at present.

Recommendations

Recommendations cover all age groups from infants to the elderly, including physiological conditions such as pregnancy and lactation. There is also a focus on special requirements for people who practice sports, as well as on providing recommendations for people at increased risk of obesity and most common non-communicable chronic diseases.

The 13 recommendations have been divided into four blocks. The first is related to balance (1). The second is dedicated to foods for which consumption needs to be increased, such as fruits and vegetables (2-4). The third concerns critical foods in the current diet and for which consumption should be reduced, such as fat, salt, sugar and alcohol (5-8). And the last block is dedicated to "How to" ensure a varied, safe, healthy and sustainable diet (9-13).

  1. Keep your weight under control and always be active
  2. Eat more fruits and vegetables
  3. Eat whole grain and legumes
  4. Drink abundant water every day
  5. Fats: select which ones and limit the quantity
  6. Sugar, sweets and sugar sweetened beverages: less is better
  7. Salt: less is better (but iodised)
  8. Alcoholic beverages: the least possible
  9. Enjoy a variety of food choices
  10. Follow special recommendations for target groups
  11. Be careful of dieting and misuse of dietary supplements
  12. Food safety depends also on you
  13. Select a sustainable diet