Official name

Dietary guidelines for the Belgian adult population (French: Recommandations alimentaires pour la population Belge adulte; Dutch: Voedingsaanbevelingen voor de Belgische volwassen bevolking; German: Ernährungsleitlinien für die Belgische erwachsenenbevölkerung)

Publication year

Belgium published its first set of dietary guidelines in 2019.

Stakeholder involvement                                                                              

The Superior Health Council (SHC) of Belgium took the initiative of developing the guidelines based on available scientific knowledge. Experts in the fields of nutrition and health were part of a SHC Working Group which was responsible for the process. The setting up of this working group was prepared by a strategic committee of the SHC in collaboration with organisations operated by the Communities and Regions. This has led to an extensive and successful call for collaboration which brought together 29 experts from a broad range of backgrounds, both affiliated and not affiliated to the SHC. The experts were selected from various institutions only based on their expertise; they did not represent any institutions or stakeholders and were free of conflicts of interest.

The FBDGs were endorsed by the SHC College at the federal level. The guidelines were published on the SHC website in September 2019.

Products, Resources and Target audiences

Development process

The Belgian dietary guidelines target a healthy adult population and are not addressed to patients or individuals who, for one reason or another, have had to adopt a specific diet. The guidelines are a tool to convey messages on a healthy and balanced diet, and their purpose is to contribute to health promotion by relying on the scientific knowledge currently available on the impact of food on human health. The guidelines are expressed in terms of foods, but also consider the knowledge that pertains to nutrients. It should be noted that the health impact of some foods remains uncertain or insufficiently clear for any claims to be made about them.

The SHC Working Group developed the dietary guidelines using the methodology recommended by the European Food Safety Authority (EFSA, 2010) between 2016 and 2019. The EFSA methodology informed the following stepwise approach:

1. identify the main diet-related health issues in Belgium and the foods and nutrients associated with them,
2. identify and categorise foods that largely contribute to the main health problems in Belgium,
3. determine the amounts consumed daily and/ or intake frequency. Assign a nutritional value to the data, and
4. broaden the choice in foods and translate the findings into concrete and practical guidelines.

The decision was made to build on the 2016 Nutritional Recommendations for Belgium for the data pertaining to nutrients and on the results of the Food Consumption Survey conducted in 2014 (Bel, 2016; De Ridder, 2016) for the data pertaining to the current eating habits of the Belgian population. The guidelines were also based on a review of the peer-reviewed scientific literature published in both scientific journals and reports from national and international organisations competent in this field, as well as the opinion of the experts in the working group.

The EFSA model was supplemented with sustainability considerations, social aspects of the link between eating habits, health and well-being and elements pertaining to communication with the target audience.

Implementation

The implementation of the SHC's FBDGs is managed by the communities of the country. The SHC is aware that the dietary guidelines are a tool to convey messages on a healthy and balanced diet. The way they are spread and the channels to use are issues that go beyond the scope of these guidelines. Various communication tools can be used to convey a message in a visual format or other. The SHC expects that this crucial communication process will be undertaken by the appropriate institutions in the different communities of the country that have the necessary expertise to carry out this task.

Evaluation

There is no official monitoring and evaluation plan for the guidelines.

Food guide

The Épi Alimentaire/Voedingstak is the visual representation of the SHC’s FBDGs.

In Belgium, other visuals have been developed by the Communities (Pyramide Alimentaire (FR) / Voedingsdriehoek (VL).

The Épi Alimentaire/Voedingstak (illustrating a spike of grain cereals) represents, in descending order, the top five guidelines that are associated with the greatest health benefit:

• Whole grain products - At least 125 g per day
• Fruits & vegetables - 250g of fruit and at least 300g of vegetables per day
• Legumes - At least once a week
• Nuts & seeds - 15 to 25 g per day
• Salt - Limit salt in cooking and do not use salt at the table

Messages

For general adult population, in order of importance:

1. To enjoy the benefits of whole grains, they should replace refined grains, e.g., eat wholegrain or wholemeal bread rather than white bread, give preference to wholemeal pasta over white pasta, etc. Eat at least 125 g of whole-grain products that meet your energy needs every day.
2. Eat 250 g of fruit daily, or an average of two pieces of fruit per day. To avoid an excess of added sugars and/or fats, choose fresh fruit without adding sugar or fats. Vary your choices according to seasonal availability. Always wash and, if necessary, peel the fruit before eating it. Eat at least 300 g of vegetables (raw or prepared) every day and vary your choices according to seasonal availability: they will provide you with a wide range of useful vitamins and minerals.
3. Eat legumes every week: this allows you to combine certain proteins and essential amino acids from a variety of sources. Replace meat with legumes at least once a week. Another advantage is that the cultivation and production of legumes has a low impact on climate because the production of vegetable proteins results in lower greenhouse gas emissions compared to the production of animal proteins.
4. Eat 15 to 25 g of plain nuts or seeds (unsalted and/or without a sweet coating) every day; a handful is about 30 g. Nuts contain useful fats, proteins and fibres. Walnuts, for example, are high in omega-3 fatty acids.
5. Choose products that are low in salt and avoid adding salt when cooking or during meals: this will contribute to a healthy blood pressure!

Sustainability

The guidelines address sustainability considerations and social issues regarding the link between eating habits, health and well-being.

In the context of the dietary guidelines, the SHC cites the FAO’s definition for a sustainable diet:

“… those diets with low environmental impacts that contribute to food and nutritional security and to healthy lives for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair, and affordable, are nutritionally adequate, safe, and healthy, and optimize natural and human resources.” (FAO, 2012).

The SHC wishes to endorse this approach explicitly and calls for these sustainability considerations to remain an integral part of future updates of the FBDGs developed at the national level and for specific regions. In the advisory report, several adaptations have been made to make FBDGs more sustainable, such as:

• Vary your choices according to seasonal availability for fruits & vegetables.
• For fish, eat fish once or twice a week, focusing on sustainable products high in omega3 fatty acids.

Other recommendations are inherently sustainable, such as the recommendation to replace meat with legumes at least once a week.