Introduction
Many countries develop food-based dietary guidelines as a part of their national health policies. These recommendations are usually based on scientific research on food and nutrient intake, cultural habits, and country-specific health issues. While the general messages of such guidelines appear very similar worldwide, the detailed analysis reveals significant differences. This paper aims to analyze the dietary guidelines in Japan and the Netherlands and compare those to the “Choose My Plate” program in the US.
Japan
Japanese dietary guidelines have been active for 20 years and are represented by a graphic model known as Japanese Spinning Top. This guide for the general public was developed using the data from the nutrient-based Dietary Reference Intakes (DRIs) guidelines (Yoneoka et al.). It is well worth noticing that the Japanese are considered a very healthy nation overall with long life expectancy and low disease burden (Yoneoka et al.; Kuriyama et al.). However, Yoneoka et al. note that “unhealthy diets (high in sodium or low in whole grains, fruits, vegetables, and nuts and seeds) are an important modifiable behavioral risk factor of many health conditions in Japan”. Hence, dietary guidelines could prove invaluable in addressing some of the public health issues.
Japanese Spinning Top guide mostly consists of pictures of cooked dishes with the recommended daily servings. The design is simple, and the recommendations are clearly defined. These factors are likely to increase public adherence to the guidelines. However, it fails to address specific issues associated with national cuisine. The popularity of seasonings (soy sauce, miso) in the Japanese diet explains the high intake of Na, which can lead to serious health concerns (Kuriyama et al.). The guidelines also fail to address the increasing percentage of underweight women in Japan who require higher food intakes (Kuriyama et al.). Overall, the research shows that the guide could benefit from more specific recommendations based on national diet and health issues.
The Netherlands
The dietary guidelines in the Netherlands are represented by a graphic model, the Wheel of Five. It displays the foods which are considered to be essential components of a healthy diet. This guide was developed to reduce the health risks among the Dutch population (Kromhout et al. 869). However, unlike the Japanese guidelines, the latest recommendations are entirely based on food intake rather than nutrient intake (Kromhout et al. 869). The researchers state that this approach is more efficient in reducing chronic disease burden than nutrient-based guides (Kromhout et al. 869; Yoneoka et al.). Overall, Dutch dietary guidelines are considered one of the most progressive worldwide.
The Wheel of Five was designed considering the specific dietary habits and health issues of the Dutch population. While the number of premature deaths from cardiovascular diseases has been low for a long time, lung cancer remains a leading case of death in the Netherlands (OECD 2). Kromhout et al. note that “the consumption of red meat and processed meat is associated with a higher risk of colorectal and lung cancers” (870). The research shows that Dutch males eat significantly more meat than the recommended maximum of 500 g/week (Brink et al. 2422). Therefore, red meat is specifically excluded from the graphic model, and the recommendations emphasize the importance of limiting its consumption (Brink et al. 2430). Brink et al. add that the detailed guidelines were developed for different subgroups based on age, gender, and cultural background (2430). Overall, the Wheel of Five represents a perfect example of the holistic approach to the development of national dietary guidelines.
The USA
Dietary Guidelines Advisory Committee (DGAC) report was used to develop the US dietary guidelines. MyPlate program was introduced to increase the adherence of the population to the guidelines. According to DGAC, “117 million American adults had one or more preventable diet-related chronic diseases, two-thirds were overweight or obese, and most of these adults were at increased risk of chronic diseases” (Millen et al. 441). Hence, one of the key goals of the dietary guidelines in the US is reducing obesity levels among the population.
MyPlate program offers several food patterns, which can be adjusted for different subgroups. The website has a user-friendly interface and provides a lot of additional information on healthy eating (ChooseMyPlate). However, many scholars heavily criticize the program and the guidelines, in general. Tseng et al. note that the program largely ignores the negative impact of ultra-processed foods on human health (258). Bero states that two reports of the National Academy of Sciences (NAS) have established that the evidence used to develop the guidelines is biased. Since the current recommendations are based on compromised research, new independent studies should be conducted to ensure the absence of conflict of interest in developing the guidelines.
Conclusion
The analysis of the dietary guidelines in Japan, the USA, and the Netherlands have shown that the methods used to develop the programs vary significantly. Serious shortcomings were discovered in the development of Japanese and American guidelines. Japanese recommendations lack specificity and are based on outdated nutrients intake measurements, and the US guidelines are criticized for the lack of transparency in the research. The Dutch guidelines, on the other hand, are based on solid evidence received from the independent randomized control trials and offer specific programs for different subgroups.
Works Cited
Bero, Lisa. “Developing reliable dietary guidelines”. BMJ, vol. 359, 2017.
Brink, Elizabeth, et al. “Development of Healthy and Sustainable Food-Based Dietary Guidelines for the Netherlands.” Public Health Nutrition, vol. 22, no. 13, 2019, pp. 2419–2435.
ChooseMyPlate. U.S. Department of Agriculture, 2020. Web.
Kromhout, Daan, et al. “The 2015 Dutch Food-Based Dietary Guidelines.” European Journal of Clinical Nutrition, vol. 70, no. 8, 2016, pp. 869–878.
Kuriyama, Nozomi, et al. “Development of a Food-Based Diet Quality Score for Japanese: Associations of the Score with Nutrient Intakes in Young, Middle-Aged and Older Japanese Women.” Journal of Nutritional Science, vol. 5, 2016.
Millen et al. “The 2015 Dietary Guidelines Advisory Committee Scientific Report: Development and Major Conclusions.” Advances in Nutrition, vol. 7, 2016, pp. 438-444.
OECD/European Observatory on Health Systems and Policies. Netherlands: Country Health Profile 2017, State of Health in the EU, OECD Publishing, 2017.
Tseng, Marilyn et al. “Alternative MyPlate Menus: Effects of Ultra-Processed Foods on Saturated Fat, Sugar, and Sodium Content.” Journal of Nutrition Education and Behavior, vol. 50, no. 3, 2018, pp. 258-266.
Yoneoka, Daisuke et al. “Does Japan’s National Nutrient-Based Dietary Guideline Improve Lifestyle-Related Disease Outcomes? A Retrospective Observational Cross-Sectional Study.” PloSONE, vol. 14, no.10, 2019.