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Food-based dietary guidelines - Portugal

Official name

Food Wheel Guide (in English)

A Roda dos Alimentos (in Portuguese) 

Publication year

The first Food wheel guide was issued in 1977. A revised version was published in 2003. In 2016, Portugal revised the Food Wheel Guide and created a version adapted to the Mediterranean Diet (the Mediterranean Diet Food Wheel).

Stakeholder involvement

The development of the Dietary Guidelines was mandated to several entities, including the Portuguese Ministry of Health, the Directorate-General of Health (DGS), the Ministry of Economy, and the Directorate-General for the Consumer. This collaborative effort was led by the Faculty of Food Sciences and Nutrition at the University of Porto (FCNAUP), with support from the Directorate-General for the Consumer and the Ministry of Health, who served as the principal editors. Additionally, the National Council for Food and Nutrition (CNAN), a division of the Health Ministry responsible for Portuguese Food Policy, provided advisory support in the initial stages of the development process. The Food Wheel Guide received its official endorsement from the Portuguese Ministry of Health.

Products, Resources and Target Audiences

Products

Intended target audience

Policy briefs

Academic community

Consumer education materials

General population

Posters

General population

Communications materials

General population

Manuals

General population

Technical documents

Educators, Health workers, Trainers, and Teachers

Development process

The development of the Portuguese Dietary Guidelines (DGs) was an extensive process aimed at promoting healthy eating habits in a simple, understandable manner. These guidelines were specifically tailored to meet the needs of the general healthy population in Portugal. The main objective was to translate scientific knowledge in food and nutrition into basic concepts accessible to a wide audience, providing advice on dietary intakes and nutrient needs to promote health and prevent disease.

Although the exact timeline of the development process is not available, the approach was methodically planned. It involved a nine-step procedure: 1) Gathering opinions from food and nutrition experts, particularly members of the National Council for Food and Nutrition (CNAN); 2) Establishing nutritional objectives; 3) Defining food groups and their subgroups; 4) Determining standard food portions for each group; 5) Establishing equivalent portions within each group; 6) Recommending daily food portions for each group; 7) Assessing the supply of certain components; 8) Transforming the results into an engaging and easy-to-understand guide; 9) Creating dissemination materials.

The committee responsible for leading the guide’s development, included experts in various fields such as human nutrition, dietetics, public health nutrition, food policy, and CNAN members. To collect the evidence, they relied on the most recent data from the 1990-1997 food balance sheets and the 1990-1995 household budget surveys, despite their limitations. These statistical data, as the only national representative data on food consumption at the time, along with recommended dietary intakes for the Portuguese population and expert opinions, formed the basis for the guidelines.

The technical recommendations for the food guide were developed by addressing the needs of individuals with a sedentary lifestyle, the most common among Portuguese. It calculated energy requirements across 13 age groups and both genders (infants under one year of age excluded), aligning with both the US Recommended Dietary Allowances (1989) and Gonçalves Ferreira's recommendations (1982). The macronutrient energy distribution was set in line with the Eurodiet Core Report 2000 and the FAO/WHO 1990 recommendations.

The guide included 7 food groups and 21 subgroups, determined by their nutritional composition, common usage in Portuguese diets, and the structure of the previous food guide. To determine the average nutritional composition of each group and subgroup, the Portuguese and the British food composition tables were used for raw and cooked items, respectively. Standard portion sizes were based on average household measures and usual consumption units, with careful consideration of the main nutrient suppliers for each group.

Implementation

Portugal has a well-structured official strategy for implementing the Dietary Guidelines, with the Directorate-General of Health (DGS) being the primary responsible body. This implementation strategy is rooted within the health sector, particularly under the supervision of the Directorate-General of Health.

The main objectives and priority actions of this implementation plan are encapsulated in the National Programme for the Promotion of Healthy Eating (PNPAS). It is a significant initiative of the Directorate-General of Health that aims to promote the creation of healthy food environments, enhance health literacy, and empower the population to make healthier food choices.

The PNPAS has five general objectives:

  1. Increase Knowledge: Increase awareness about the dietary habits of the Portuguese population, including their determinants and consequences.
  2. Modify Food Availability: Change the types of foods available, especially in settings like schools, workplaces, and public areas.
  3. Inform and empower Individuals: Provide information and resources to help people, especially those in disadvantaged groups, make informed choices about purchasing, preparing, and storing healthy foods.
  4. Promote Coordinated Actions: Identify and support actions that foster the consumption of nutritionally rich foods, working in a coordinated manner with other sectors such as agriculture, sports, environment, education, social security, and municipalities.
  5. Improve Professional Skills: Enhance the qualifications and methodologies of various professionals who can influence food-related knowledge, attitudes, and behaviors.

Evaluation

Portugal's Dietary Guidelines (DGs) include an official monitoring and evaluation plan to ensure their effective implementation and adherence. This plan is anchored on specific goals and measurable indicators, with a set timeline for achievement by 2030. The primary objectives and their corresponding indicators are as follows:

  • Goal 1: Increase knowledge about the principles of the Mediterranean Diet by at least 20% by 2027.
    • Indicator 1: Percentage of the population that knows the principles of the Mediterranean Diet.

  • Goal 2: Increase the consumption of at least 400g of fruits and vegetables daily in adults, children, and adolescents by 2030.
    • Indicator 2: Percentage of the adult population consuming at least 400 g of fruits and vegetables daily.
    • Indicator 3: Percentage of children consuming at least 400 g of fruits and vegetables daily.
    • Indicator 4: Percentage of adolescents consuming at least 400 g of fruits and vegetables daily.

  • Goal 3: Reduce the consumption of processed meat by 2030.
    • Indicator 5: Percentage of the population consuming more than 50 g of processed meat per week.

  • Goal 4: Decrease the consumption of unhealthy foods (ultraprocessed foods and foods not included in the Food Wheel Guide) by 2030.
    • Indicator 6: Percentage of the population consuming ultraprocessed foods.
    • Indicator 7: Percentage contribution of foods not included in the Food Wheel Guide to the total energy intake.

  • Goal 5: Reduce the consumption of sodas and other sugar-sweetened beverages in children and adolescents by 2030.
    • Indicator 8: Percentage of children consuming sodas and other sugar-sweetened beverages daily.
    • Indicator 9: Percentage of adolescents consuming sodas and other sugar-sweetened beverages daily.

  • Goal 6: Reduce sodium intake by 30% by 2030.
    • Indicator 10: Average sodium intake in the Portuguese population.

  • Goal 7: Decrease the proportion of children and adolescents consuming free sugars above the WHO recommendation by 2030.
    • Indicator 11: Percentage of children with a free sugar intake exceeding the WHO recommendation.
    • Indicator 12: Percentage of adolescents with a free sugar intake exceeding the WHO recommendation.

  • Goal 8: Halt and reverse the trend in adult obesity prevalence by 2030.
    • Indicator 13: Percentage of obesity in the adult population.
    • Indicator 14: Percentage of pre-obesity in the adult population.

  • Goal 9: Reduce the prevalence of overweight and obesity in children and adolescents by at least 5% by 2030.
    • Indicator 15: Percentage of obesity in school-aged children (7 years).
    • Indicator 16: Percentage of pre-obesity in school-aged children (7 years).

Food guide

Portugal's food guide is designed as a wheel, a graphic choice that effectively illustrates the variety and balance of foods recommended for a healthy diet. The food guide wheel includes seven major food groups, each representing essential components of a balanced diet. These groups are:

  1. Fats and Oils: Recommended daily intake of 1 to 3 portions.
  2. Milk and Dairy Products: Advised to consume 2 to 3 portions daily.
  3. Meat, Fish, Seafood, and Eggs: Suggested intake ranges from 1.5 to 4.5 portions per day.
  4. Pulses: It is recommended to have 1 to 2 portions daily.
  5. Potato, Cereal, and Cereal Products: A significant part of the diet, with 4 to 11 portions recommended each day.
  6. Vegetables: Essential for a balanced diet, with a recommendation of 3 to 5 portions daily.
  7. Fruits: advised at 3 to 5 portions per day.

Messages

  • Eat Well, Live Better!
  • Eat Foods from Each Food Group Every Day to Have a Complete Diet.
  • Eat More from the Bigger Segments and Less from the Smaller Ones to Maintain a Correct Balance.
  • Eat a Variety of Foods Within Each Food Group; Vary Them Daily, Weekly, and Seasonally.
  • Prefer Water to Beverages Containing Added Sugar, Alcohol, and Caffeine.
  • Limit Consumption of Products with High Sugar Content to Special Occasions. Read Food Labels to Identify Products with the Lowest Amounts!
  • Limit Consumption of Salt to Less than 5g a Day. Moderate Consumption of Foods and Food Products High in Salt Such as Cold Meats, Canned Foods, Chips, and Salty Snacks.
  • Do Moderate Physical Activity Regularly.

Sustainability

Sustainability was formally addressed, focusing on socio-cultural and environmental aspects. These aspects were integrated after the initial development process of the guidelines.

To integrate sustainability, significant adaptations were made in 2016 when the Food Wheel Guide was revised. A version adapted to the Mediterranean Diet was created, known as the Mediterranean Diet Food Wheel. This adaptation aimed to highlight the characteristics of the Mediterranean dietary pattern (MAP), emphasizing not just the food components but also lifestyle elements related to sustainability.

Key features of this adaptation included:

  1. Respect for Seasonality: Emphasis on consuming locally sourced food in accordance with the seasons.
  2. Use of Aromatic Herbs: Encouraging the use of herbs to enhance flavor, thereby reducing the need for added salt.
  3. Traditional Cooking Techniques: Promoting healthy cooking methods like soups and stews, which are integral to Mediterranean cuisine.
  4. Cultural Importance of Meals: Encouraging dedicating time to cooking and enjoying meals with family and friends, reinforcing the social aspect of eating.
  5. Lifestyle Considerations: A focus on combating sedentary lifestyles by encouraging leisure activities.

The development of this adapted version was led by a team from the Faculty of Nutrition and Food Sciences at the University of Porto, who had previously worked on the Food Wheel Guide. This process included consulting with other partners like the Directorate-General for the Consumer and gathering opinions from experts across various fields and institutions.