BACKGROUND: Food-based dietary guidelines (FBDGs) offer broad recommendations based on scientific evidence, focusing on food groups rather than nutrients that should be included in the diet. Emerging adulthood (18-30 years) is a critical period for poor dietary quality and mental health. Eating habits (EHs) are formed early in life and are influenced by various factors, such as emotional state, which can lead to either binge or restricted eating, ultimately increasing the risk of eating disorders (EDs). This cross-sectional study aimed to investigate the extent of adherence to the Saudi Healthy Plate Dietary Guidelines (SHPDGs) and its potential association with Eating Concerns (ECs) among Saudi females (aged 18-30 years) from all provinces in the Kingdom of Saudi Arabia.
METHODS: A validated online questionnaire was used to assess eating behaviors (EBs) using the Starting The Conversation (STC) instrument and EC symptoms using the Eating Disorders Screen for Primary Care (ESP) screening tool.
RESULTS: The total sample size was 1092 participants with a mean age of 23.02 ± 3.47. Only 0.7% of the participants adhered to the SHPDGs and were free of EC symptoms. Conversely, 50.4% of participants who exhibited EC symptoms had poor adherence to the SHPDGs. Across Saudi Arabian provinces, high adherence to the SHPDGs was more prominent in both the Eastern and Western provinces (37.5%) than in the Central and Southern provinces (0%). The most striking result was that the Central province exhibited a high percentage of poor adherence to the SHPDGs (25.6%). Moreover, high adherence to SHPDGs was not associated with the probability of ECs.
CONCLUSIONS: The present study revealed a trend of poor adherence to SHPDGs among Saudi females, with a large proportion also experiencing EC symptoms. Accordingly, the authors recommend increasing awareness within the Saudi community about SHPDGs using educational campaigns on social media platforms to enhance the importance of adopting a healthy diet, especially among females, and demonstrate that the impact on their health and well-being is that they are experiencing multiple phases that involve pregnancy and giving birth involves specific nutritional requirements.

Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.

The Dietary Guidelines for Americans (DGA) provides science-based advice on dietary intake to promote health, reduce risk of chronic disease, and meet nutrient needs. It is jointly published by the United States Departments of Health and Human Services and Agriculture (USDA) every 5 y. As chronic diseases continue to rise to pervasive levels, helping the United States population follow the DGA is especially important for improving the health of our nation. The DGA is developed using a rigorous and transparent scientific process, and with the advice of an independent, external committee of leading scientists. Career federal nutrition scientists who manage the process ensure that the methods used to develop the DGA remain state of the art. Unfortunately, misinformation about the scientific basis, transparency, and relevance of the DGA for the United States population threatens its credibility. The main objective of this article is to correct this misinformation with factual information about the process used to develop the DGA. The DGA provides guidelines for the general public, and its primary audience includes policymakers and nutrition and health professionals who help individuals and families consume a healthy dietary pattern. Providing accurate information may bolster trust in the recommendations among these audiences while improving implementation across sectors to promote better adherence to the DGA, thereby improving diet quality among the United States population.

BACKGROUND: In the context of global shifts in food systems, this paper explores the unique dietary practices of the Santal tribe, an indigenous group in eastern India, to understand the health, nutrition, and sustainability aspects of their traditional food systems. This study evaluates the nutritional content of the Santal diet in comparison to the EAT-Lancet Commission\'s 2019 dietary guidelines for healthy and sustainable diets.
METHODS: The University of East Anglia, in collaboration with the NNEdPro Global Institute for Food, Nutrition and Health in Cambridge, PRADAN; colleagues in India and local Santal youth, conducted nutritional analyses of traditional Santal recipes. Two menu templates, Kanhu Thali and Jhano Thali, were selected for comparative analysis based on their representation of diverse dietary practices within the Santal community. Nutritional data, including energy as well as the distribution of macronutrients and micronutrients, were compiled and compared with the EAT-Lancet guidelines.
RESULTS: The Santal menu templates (nutritionally complete meals) demonstrated alignment with EAT-Lancet recommendations in aspects such as whole grains, starchy vegetables, vegetables, plant-based protein sources, unsaturated fats, and limited added sugars. However, notable deviations included the absence of animal-based protein sources and dairy. The Santal diet showed high protein intake, largely from plant-based sources, and emphasised the importance of whole grains. Seasonal variations in nutritional content were observed between the two templates.
CONCLUSIONS: While the Santal diet aligns with some aspects of global dietary guidelines, there are notable deviations that underscore the complexity of aligning traditional diets with universal recommendations. The findings emphasise the need for culturally sensitive dietary recommendations that respect traditional diets while promoting sustainability. Research needs to support tailored global guidelines enshrining core principles of nutritional adequacy which are inter-culturally operable in order to accommodate cultural diversity, local practices, and seasonal variations, crucial for fostering sustainable and healthy eating habits in diverse sociodemographic contexts.

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients\' health by implementing dietary interventions that foster the development of healthy eating habits.

Diabetes is a disease in which lifestyle-based interventions, including recommendations for a healthy diet, play a critical role, and many countries have established their own nutritional guidelines [...].

The Chinese Dietary Guidelines propose a balanced diet for healthy living, but the affordability of this diet needs to be considered, especially for low-income households. To investigate the affordability of a healthy diet, this study analyzes the daily retail prices of 46 food items in 36 Chinese cities from 2016 to 2021. This study compares expenditure, diet composition, and nutritional status in two scenarios aligned with the guidelines. The results show that the mean minimum cost of a balanced diet exceeds the current per capita food expenditure for at least 182.85 million urban households. This suggests that low-income people would need to increase their expenditure by at least 20-121% to achieve the recommended diets. This study also identifies affordable and nutrient-dense foods such as standard flour, eggs, black beans, and cabbage, which policymakers should focus on when monitoring food prices. The findings recommend a combination of social and food system policies to reduce prices and make healthy diets accessible. This study identifies the gaps in the Chinese Dietary Guidelines for ensuring accessibility for vulnerable groups and provides a template for policymakers and researchers to track diet affordability using available food price data in China, contributing to China\'s 2030 Health Plan and the UN\'s Sustainable Development Goals.

The purpose of this review is to share the process for reviewing, updating, and developing the most recent version of the Healthy Eating Index-2020 (HEI-2020) for ages 2 and older, following the release of the Dietary Guidelines for Americans (DGA), 2020-2025. The overall review process included: 1) gathering information from the updated DGA, experts, and federal stakeholders; 2) considering substantive changes and needs for new development, keeping in mind the HEI\'s key features and guiding principles, the US Department of Agriculture\'s Dietary Patterns that serve as the foundation for the HEI, and scoring considerations; and 3) completing evaluation analyses, including the examination of content validity. The review process led to the development of the HEI-2020; a separate HEI-Toddlers-2020 was developed for ages 12 through 23 months. The 13 components and scoring standards of the HEI-2020 fully align with the HEI-2015, although the index was renamed to clarify that it aligned with the most recent 2020-2025 DGA. As the evidence informing the DGA continues to evolve, various aspects of the HEI may need to evolve in the future as well. Further methodological research is encouraged to add to the scientific evidence base on dietary patterns, to examine needs specific to each life stage, and to model optimal trajectories of healthy dietary patterns over the lifespan.

The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary patterns (Healthy US-Style [H-US], Mediterranean [Med], and vegetarian [Veg]) has been drawn largely from observational studies among White populations.
The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns.
The AAs (ages 18-65 y, BMI 25-49.9 kg/m2, and BMI was measured in kg/m2) with ≥3 type 2 diabetes mellitus risk factors were recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index [HEI]) were collected at baseline and 12 wk. In addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed models with maximum likelihood estimation, and robust computation of standard errors were tested.
Of the 227 participants screened, 63 were eligible (83% female; age 48.0 ± 10.6 y, BMI 35.9 ± 0.8 kg/m2) and randomly assigned to the Healthy US-Style Eating Pattern (H-US) (n = 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n = 22, 86% completion), or healthy vegetarian eating pattern (Veg) (n = 20, 70% completion) groups. Within-group, but not between groups, weight loss was significant (-2.4 ± 0.7 kg H-US, -2.6 ± 0.7 kg Med, -2.4 ± 0.8 kg Veg; P = 0.97 between group). There was also no significant difference between groups for changes in HbA1c (0.03 ± 0.05% H-US, -0.10 ± 0.05% Med, 0.07 ± 0.06% Veg; P = 0.10), systolic BP (-5.5 ± 2.7 mmHg H-US, -3.2 ± 2.5 mmHg Med, -2.4 ± 2.9 mmHg Veg; P = 0.70), diastolic blood pressure (-5.2 ± 1.8 mmHg H-US, -2.0 ± 1.7 mmHg Med, -3.4 ± 1.9 mmHg Veg; P = 0.41), or HEI (7.1 ± 3.2 H-US, 15.2 ± 3.1 Med, 4.6 ± 3.4 Veg; P = 0.06). Post hoc analyses showed that the Med group had significantly greater improvements in HEI compared to the Veg group (difference = -10.6 ± 4.6; 95% CI: -19.7, -1.4; P = 0.02).
The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However, none of the outcomes were significantly different between groups. This trial was registered at clinicaltrials.gov as NCT04981847.

Poor dietary habits are common and lead to significant morbidity and mortality. However, addressing and improving nutrition in various cardiovascular settings remain sub-optimal. This paper discusses practical approaches to how nutritional counselling and promotion could be undertaken in primary care, cardiac rehabilitation, sports medicine, paediatric cardiology, and public health.
Nutrition assessment in primary care could improve dietary patterns and use of e-technology is likely to revolutionize this. However, despite technological improvements, the use of smartphone apps to assist with healthier nutrition remains to be thoroughly evaluated. Cardiac rehabilitation programmes should provide individual nutritional plans adapted to the clinical characteristics of the patients and include their families in the dietary management. Nutrition for athletes depends on the sport and the individual and preference should be given to healthy foods, rather than nutritional supplements. Nutritional counselling is also very important in the management of children with familial hypercholesterolaemia and congenital heart disease. Finally, policies taxing unhealthy foods and promoting healthy eating at the population or workplace level could be effective for prevention of cardiovascular diseases. Within each setting, gaps in knowledge are provided.
This clinical consensus statement contextualizes the clinician\'s role in nutrition management in primary care, cardiac rehabilitation, sports medicine, and public health, providing practical examples of how this could be achieved.