New guidelines for how to 'eat' in China

The starting point and goal of the "Big Food concept" is to ensure that people eat safe, healthy and balanced nutrition. So, what is more nutritious to eat? How to eat healthier? After a lapse of six years, the "Dietary Guidelines for Chinese residents", known as the Chinese people's dietary handbook, has been updated again recently, and there are new guidelines on how to "eat".

Since the first release of the Dietary Guidelines for Chinese Residents in 1989, China has revised and issued three times in 1997, 2007 and 2016. Recently, the Chinese Nutrition Society officially issued the "Dietary Guidelines for Chinese Residents (2022)" (referred to as the "Guidelines"). The guidelines, which took nearly three years to revise and complete by nearly 100 experts organized by the Chinese Nutrition Society, are applicable to healthy people aged 2 and above, and will play a positive role in guiding residents to improve their nutritional health status and prevent chronic diseases through balanced diets.

Balanced diet, the cornerstone of immunity

"There are three conditions that determine the strength of a person's health quality: heredity, nutritional intake, and acquired learning or training, including physical exercise." "Genetics is difficult to change in the short term, but changes in lifestyle, especially dietary patterns, physical activity, can have a huge impact on our health." Professor Yang Yuexin, chairman of the Chinese Nutrition Society and director of the Expert Committee on the revision of dietary guidelines, pointed out that strengthening basic nutrition plays an important role in improving immunity.

Each dietary guideline is a targeted guide based on the principles of nutritional science and the new problems and characteristics of Chinese residents' diet. The guidelines revised the six "core recommendations" of the 2016 edition into eight "dietary guidelines." Among them, "food variety, cereal based" has been adjusted to "food variety, reasonable mix."

"A balanced diet is the basic principle to protect human nutrition and health, food diversity is the basis of a balanced diet, and reasonable collocation is the guarantee of a balanced diet." Yang Xiaoguang, vice chairman of the Chinese Nutrition Society and deputy director of the Expert Committee for the revision of dietary guidelines, pointed out that a balanced diet should be diversified, with an average intake of more than 12 kinds of food per day and more than 25 kinds of food per week, and only diverse foods can be reasonably matched. In a balanced diet, carbohydrates provide about 50%-60% of the body's energy, protein provides 10%-15% of the energy, and fat provides 20%-30% of the energy.

Does changing "food variety, cereal based" to "food variety, reasonable mix" mean that we no longer insist on cereal based? "No. Grain-based is an important feature of a balanced dietary pattern, and this revision emphasizes the holistic role of dietary patterns and highlights the importance of proper mix." Yang Yuexin said.

A lot of people are resistant to carbohydrates these days, but is that right? Domestic and foreign studies have found that too high and too low carbohydrate intake is not conducive to human health, and the best balance is achieved when the carbohydrate energy supply ratio is 50%-60%. Therefore, the guidelines advocate a higher intake of whole grains.

Why the particular emphasis on eating more whole grains? "Because we eat too many refined grains in our current diet, this directly leads to an increased risk of obesity and diabetes." Chang Cuiqing, vice chairman of the Chinese Nutrition Society and deputy director of the Expert Committee for the revision of Dietary Guidelines, pointed out that whole grain foods are an important source of B vitamins and dietary fiber, and play an important role in preventing chronic diseases and promoting human health. Studies have shown that whole grains are also beneficial for regulating gut flora, so it is recommended to eat more whole grain foods appropriately.

"A balanced diet is fundamental to improving immunity." Yang Yuexin stressed that countless cells in the human body continue to metabolize, including the cells in the immune system, all cells need adequate and reasonable nutrition to achieve the best function, balanced nutrition is the fundamental of human immunity to maintain vitality. Domestic and international studies have also shown that following a balanced dietary pattern can significantly reduce the risk of cardiovascular disease, hypertension, rectal cancer, type 2 diabetes, etc.

Two guidelines, new highlights

Compared with the 2016 version of the Dietary guidelines, the guidelines added two new guidelines: "Eat regularly, drink enough water" and "choose when cooking and read the label."

"The reason for the increase in 'regular meals' is that the proportion of people who eat regularly is declining year by year, and we must be vigilant about this." Yang Yuexin warned that irregular meals may increase the risk of overweight, obesity and diabetes.

Data from the China Health and Nutrition Survey show that from 2000 to 2018, the proportion of people over 2 years old who regularly eat three meals a day dropped from 84.3 percent in 2000 to 80.4 percent in 2018. The "Guide" reminds that regular meals need to be three meals a day, a regular quantity, and a balanced diet, and breakfast should be eaten every day, and appropriate adjustments should be made according to the rest time and labor intensity.

"Drinking water is mainly for adults, with light physical activity requiring 1,700ml of water for men and 1,500ml for women per day." Yang Yuexin introduced. Surveys show that about two-thirds of Chinese residents do not drink enough water. Not drinking enough water can reduce the body's ability to move and cognitive ability, but also increase the risk of urinary diseases. Therefore, the Guide advocates sufficient drinking water, active drinking water, a small number of times, and recommends drinking plain water or tea, drinking less or no sugary drinks.

"Take the initiative to drink water, can not drink thirsty, thirst is already a clear signal of the body's lack of water." Yang Yuexin said that everyone should learn to determine whether they are dehydrated, and can help judge by the amount of urine and the color of urine. When the water intake is sufficient, the normal urine color is transparent yellow or light yellow, when the urine color is deepened, it indicates that the body may ingest less water, should be supplemented in time.

Cook, Choose, Read Labels advocates healthy eating planning at all stages of life.

"Nowadays, eating out and buying take-out finished dishes are more and more in people's lives. This time put forward the "cook will choose, will read the label" principle, on the one hand, I propose that everyone reduce the number of dining out, do a reasonable diet, improve immunity; On the other hand, I want to mobilize people to cook at home, buy food reasonably, experience the fun of cooking, and promote family happiness." Yang Yuexin introduced, to understand the nutritional characteristics of all kinds of food, select fresh, high nutrient density food, learn to read food labels, by comparing food nutrition labels, buy healthier packaged food, "I hope everyone in the family practice balanced diet, carefully plan three meals a day, better reduce salt, reduce oil, reduce sugar, achieve balanced nutrition, promote health." When ordering meals outside, we should also take the initiative to put forward nutritional and health appeals, such as asking for light, whole grain foods, less fried foods, and create a healthy environment for all."

One old and one young, nutrition first

In order to give guidance on the special problems of special groups, the Guidelines also specially formulated dietary guidelines for nine groups, including pregnant women, nursing mothers, and infants. Yang Yuexin reminded that in the nine specific groups, special attention should be paid to the dietary nutrition of the elderly and infants, the "one old and one small" group.

With the continuous growth of the average life expectancy of Chinese residents, the proportion of elderly people aged 80 and above has gradually increased. Most of the elderly people's various system functions decline significantly, often suffer from a variety of chronic diseases, need more professional, fine and individualized dietary guidance.

For the "one old" population, the Guide pointed out that the elderly should pay attention to a variety of food and encourage a variety of ways to eat. In the choice of food, choose soft texture, high energy and nutrient density of food. Eat more fish, poultry, meat, eggs, milk and beans, an appropriate amount of vegetables with fruit. Weight monitoring, nutritional assessment and dietary guidance should be carried out frequently.

There is a folk saying that "money is difficult to buy old people to be thin", and many elderly people also recognize this, believing that thin represents good health. However, scientific research shows that this view is not true. Yang Yuexin introduced a number of domestic and foreign research results show that the elderly body too thin will lead to reduced resistance and increase the risk of death. Moreover, the body mass index (BMI) of the elderly is not the same as that of young and middle-aged people, and the basic consensus formed by experts and scholars is that the weight of the elderly should not be too low, and its BMI is more appropriate at 20.0-26.9.

"Older people need to monitor their weight regularly. Very low weight or a BMI of less than 20 should be of particular concern. A medical nutritional assessment should be done to see what causes the weight loss and to assess for frailty and malnutrition." Yang Yuexin said that whether they are too fat or too thin after entering old age, extreme measures should not be taken to make a large change in weight in a short period of time.

Experts remind that in addition to the elderly, children in the growth and development stage, their BMI can not be used to judge the standard of adults. Children at different stages of growth and development should be judged according to different ages and genders.

For a "small" group of people, the guidelines point out that breastfeeding is the best way to feed babies after birth, should adhere to 6 months of exclusive breastfeeding, infants at 6 months of age must add complementary foods, starting with iron-rich mushy foods, and adhere to breastfeeding until 2 years of age or older.

"Exclusive breastfeeding until the first six months of life is something we have repeatedly stressed. This edition of the guidelines expresses in stronger language the importance of breastfeeding infants and young children." Breast-feeding can not only reduce the risk of infectious and allergic diseases in infants, but also help reduce the risk of chronic diseases in adulthood, Yang said. It is recommended to open milk within 1 hour after birth, attach importance to early sucking, promote responsive feeding, appropriate vitamin D supplementation, and consult a doctor or other professional to help make a decision once there is any idea and action to shake breastfeeding.

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