Review of food-based dietary guidelines in Africa: Opportunities to enhance the healthiness and environmental sustainability of population diets

Abstract

Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently,  more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in highincome countries. However, there are a few  countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were  extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online  repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data  were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in  the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist  was used to extract the evidence in the identified documents. Of the 47 African countries in the WHO Africa region, only eight FBDGs were  identified from seven countries. South Africa had two FBDGs (including a FBDG for young children). Multi-disciplinary technical working groups were  convened in developing majority of the FBDGs. The working groups utilised scientific evidence on diet-related diseases and nutrient  requirements as a basis for recommendations. All the FBDGs were intended as a tool for promoting healthy diets among the lay population. The  FBDGs that were reviewed included between six and sixteen dietary messages. Diet diversification was promoted as the most common  recommendation across African country FBDGs. The recommendations often promoted consumption of four to six food groups communicated  using text as well as images (food guide). Local availability and cultural acceptability were important values promoted as part of an optimal diet in  some of the countries. However, none of the recommendations addressed environmental sustainability. Apart from South Africa, none of the FBDGs  had been evaluated or revised. Across Africa, there is a need for increased focus on developing new FBDGs or revising existing ones as a tool for  meeting the dietary information needs of populations at risk of malnutrition in all its forms.