Brazil’s New Dietary Guidelines: Cook and Eat Whole Foods, Be Wary of Ads

Brazilian homes

By Mia MacDonald and Judy Bankman

This blog originally appeared on the Civil Eats website.

What if your national dietary guidelines advised you to cook and enjoy fresh, whole foods, and serve them with friends and family while thinking critically about advertising? Hard to imagine, isn’t it?

Well, that’s exactly what Brazil’s Ministry of Health is recommending with the “food based” dietary guidelines it issued recently.

Unlike the U.S. dietary guidelines (or “MyPlate”), which focus on reducing solid fats and added sugars, and pinpoint a long list of nutrients to consume or reduce, Brazil’s guidelines keep it simple by encouraging people there to eat more fresh, unprocessed foods.

Here are the guidelines in full:

1. Prepare meals from staple and fresh foods.

2. Use oils, fats, sugar and salt in moderation.

3. Limit consumption of ready-to-consume food and drink products.

4. Eat regular meals, paying attention, and in appropriate environments.

5. Eat in company whenever possible.

6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for consumption.

7. Develop, practice, share and enjoy your skills in food preparation and cooking.

8. Plan your time to give meals and eating proper time and space.

9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food chains.

10. Be critical of the commercial advertisement of food products.

“I think it’s terrific that [Brazil’s guidelines] promote real foods, cooking, and family meals, rather than worrying about the nutritional quality of processed foods or dealing with single nutrients,” Marion Nestle, a professor in the Department of Nutrition, Food Studies, and Public Health at New York University, told us recently.

Like many developed and developing countries, Brazil has seen recent spikes in the numbers of overweight and obese people. In 2011, nearly half of Brazilians were overweight, and about 16 percent were obese. Carlos Monteiro of the University of Sao Paolo attributes this widespread increase in body mass index (BMI) to the transition from unprocessed or minimally processed foods such as rice, fruits, and vegetables to “ultra processed foods.”

Like the U.S., Brazil is a major agricultural producer. Brazil-based JBS is the world’s largest processor of animal protein, and the nation tops the world in exports of beef and chicken. It’s also a leading player in the global soybean boom, and miles and miles of Brazil’s rainforest and savannah have been bulldozed in recent decades to grow livestock feed. In addition to their thriving export trade, Brazilians have begun eating more meat, dairy products, and eggs. And as the Brazilian middle class has grown, transnational food companies like McDonald’s, KFC, and Coca-Cola have expanded their operations and marketing in Brazil, spreading U.S.-style fast food culture further.

But these new guidelines are pointing in the opposite direction: They advocate slower food. By focusing on the importance of taking the time to prepare meals and eat in good company, the new Brazilian dietary guidelines prioritize food culture and the environment in which meals are eaten. This is extremely important: Research by the U.S. Department of Agriculture (USDA) has shown a link between eating outside the home and increased obesity.

Brazil’s new dietary guidelines are especially illuminating when we compare them to the ones we’ve been told to follow here in the U.S. Our latest guidelines, dating from 2010, focus entirely on specific nutrients. They include statements like “reduce daily sodium intake” and “consume less than 300 mg per day of dietary cholesterol.” While these are clearly good recommendations, their specificity makes it difficult to know exactly what foods to consume. This complicates and can even obscure the fundamentals of a truly healthy diet.

Critics have also pointed out that the U.S. guidelines implicitly protect the food industry by leaving out a recommendation to eat less of specific food products. They also complicate individual decision-making. For example the guidelines state, “Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oil.” For those well-versed in nutrition, this statement might mean, “replace red meat with plant proteins.” But for many others, it’s hard to know for sure what you’re being encouraged to do (or not do).

As the U.S. Dietary Guidelines Committee works on the 2015 guidelines, they’ve also been accepting public comments. Some commenters have suggested the Committee use Brazil’s new guidelines as a model. “It’s clear from the questions the Committee is asking that its members are increasingly concerned about cultural and environmental influences,” says Nestle. “This is a good sign.”

The tenth and final recommendation, “Be critical of the commercial advertisement of food products,” is particularly unusual in the world of dietary guidelines. This indicates the Brazilian government is aware of the harmful effects of advertising and is actively trying to combat food industry manipulation through its policy statements (and actions).

There’s a history here. In 2013, the city of São Paulo, Brazil’s largest city, fined McDonald’s $1.6 million for using toys and other inducements to appeal to children. São Paulo also was the first city in Brazil to adopt Meatless Mondays (“Segunda Sem Carne” in Portuguese), which has now expanded to 15 cities across the country. Brazil’s government has also mandated healthier school food.

In contrast, our dietary guidelines mention food marketing to kids just once, on page 59 of a 95-page document. And while non-profit groups like the Center for Science in the Public Interest (CSPI) are working to combat junk food marketing to kids, most government agencies are silent on the issue. First Lady Michelle Obama did announce a new proposal to regulate the marketing of junk food in schools, but it is yet to be seen whether any such language will make it into the 2015 dietary guidelines.

Perhaps the drafting Committee will look south, and Brazil’s pioneering food guidelines will encourage our own policymakers to put more value on a critical-thinking, home-cooking, socially vibrant culture of real food than on the interests of the food industry.

See Brighter Green’s multimedia policy research on climate change, animal agriculture, and natural resources in Brazil here (in English and Portuguese).

Photos courtesy of Gabriel Prehn Britto

India and the Hidden Consequences of Nutrition Transition

By Judy Bankman

Note: This blog originally appeared on the Civil Eats website.

An egg seller talks on his phone

In India today, hordes of people under 30 line up outside McDonald’s to order the Chicken Maharaja Mac: India’s beef-free version of the Big Mac. Fast food and sodas are “all the rage now,” in the country according to public health activist Shobha Shukla.

Ice cream is also becoming much more popular, with Baskin Robbins, Haagen Dazs, and Magnum already vending throughout India. Although many Indians do not eat beef for religious reasons, Muslims, Christians and even some Hindus are eating more cow and buffalo meat.

India’s booming middle class—estimated to number between 50 million and 250 million—is driving demand for meat, eggs, and dairy products like ice cream (milk has long been a staple of most Indian diets). Despite India’s long tradition of ethical vegetarianism, only about 40 percent of India’s 1.2 billion people now call themselves vegetarian.

For many Indians, particularly in urban areas, owning a television, driving a car, wearing Western brand name clothing, or eating meat are symbols of affluence, independence, and modernity.

“We are quick, hygienic, clean, and are seen as part of global culture,” Vikram Bakshi, managing director of McDonald’s India, told Agence France-Presse.

But being part of “global culture” carries enormous health risks. Heart disease is responsible for the majority of deaths in India, and more than 60 million Indians have been diagnosed with diabetes. That’s nearly five percent of India’s people, and this number is expected to rise—and quickly. By 2050, India will have the dubious distinction of being home to the most diabetics of any country in the world (leaping over China).

Like India, many countries in the global South, including South Africa, Mexico, and China, are facing a similar dilemma. As their middle classes grow and rural to urban migration accelerates, more people are moving away from diets high in unprocessed starch, high-fiber vegetables, and plant proteins. Instead they are moving toward a Western-style way of eating, replete with animal protein and fat, refined carbohydrates, and sugar.

A cow walks into an ice cream shop

This phenomenon has come to be known as the “nutrition transition” and it occurs in many developing countries. With more money and easier access to urban centers that provide cheap, tasty, filling food, who wouldn’t want to start eating like an American? But for India and other transitioning countries, there’s a catch.

It’s not just that the standard American diet leads to weight gain and chronic disease. It does, but for those who were undernourished in utero or in early childhood, switching to a diet high in fat, sugar, and salt carries higher risk for developing chronic disease compared to their counterparts who have been affluent for generations.

Poor early-childhood nutrition leads to a host of metabolic and hormonal changes that actually help survival in nutrient-poor environments, according to Barry Popkin, Distinguished Professor of Global Nutrition at the University of North Carolina Gillings School of Public Health. However, when confronted with a calorie-packed environment in later years, these adaptive mechanisms may actually lead to obesity.

An important 1976 study published in the New England Journal of Medicine found that mothers exposed to the 1944-45 Dutch famine during their pregnancies resulted in higher obesity rates among their children.

Similarly, a 2012 study in the European Journal of Clinical Nutrition found that individuals exposed to the Great Chinese Famine (1958-1961) in utero and during early childhood had higher rates of glucose intolerance than individuals born after the famine. The “thrifty phenotype hypothesis” gives an explanation for this paradoxical phenomenon.

Partly because of these biological mechanisms, people in developing countries are particularly at risk for type 2 diabetes and obesity. As in India, many countries are going through a nutrition transition so rapidly that children whose parents and grandparents didn’t have enough food can now eat at fast food restaurants and regularly consume the calorie-dense, nutrient-poor food typical of the Western-style diet.

Sometimes the speed of the nutrition transition results in the “double burden of malnutrition”: When hunger and over-nutrition occur at the same time. Among women in India, almost 27 percent are considered underweight, while 19 percent are considered overweight.

Diabetes trends in India are “absolutely frightening,” says Nikhil Tandon, professor of endocrinology at the All India Institute of Medical Sciences.   “Young people who are the drivers of the economy, who are the protectors of their family, are going to be lost,” according to Prathap Reddy, a cardiologist and founder of a large Indian network of private hospitals.

Researchers have found that in India, income is associated with malnutrition: Richer women who likely have access to a variety of foods tend to be overweight, while poorer women who cannot afford the most basic foods tend to be underweight. And even as a growing number of Indians eat higher up the food chain, under-nutrition remains a stubborn problem. More than 40 percent of Indian children younger than five are malnourished.

Is the nutrition transition an inevitable process? Or could food insecure countries provide calories their people need without gleaning them from saturated fats, sugar, and processed foods? What is clear is that curbing accelerating rates of non-communicable diseases (NCDs) in the global South requires policy changes, and quickly. Here are a few ideas:

Governments could subsidize production of native grains and vegetables to make them cheaper and encourage their renewed consumption. Developing countries should limit the advertising and availability of unhealthy foods to children and teens, whether these are the products of transnational food companies or “home grown” purveyors.

Ultimately, perceptions need to change so citizens of the global South see the Western-style diet for what it is: A recipe for obesity and chronic disease.