Comparison of International Dietary Guidelines and Food Guides in Twelve Countries across Stages of the Nutrition Transition

Evaluating dietary guidelines from various countries can help identify their strengths and limitations, yet such assessments are lacking. This study aimed to qualitatively compare current population‐level dietary recommendations and pictorial food guides issued by government or nutrition agencies in 12 countries across nutrition transition stages (early, ongoing, transitioned) and the World Health Organization. The examined content included general and specific recommendations for consumption of foods or dietary practices within main categories of food groups, nutrients, or beverages; additional advice on lifestyle, nutritional, cooking, or eating habits; and specific food examples depicted in food guides. Food group categories varied considerably by country (especially for legumes), but general and serving‐specific recommendations were mostly consistent, except for servings of Cereals and Grains, and Alcohol. All countries included physical activity recommendations, as well as advice pertinent to their culture or needs within nutrition transition stage. Food guides were generally plate‐ or pyramid‐shaped, and depicted culturally‐appropriate healthy options but also unfavorable foods. Recommended proportions of macronutrients or food groups were largely for carbohydrates or cereals/grains and vegetables. In summary, international dietary guidelines across nutrition transition stages are consistent and generally health‐promoting, but they could be strengthened with additional evidence‐based food depictions and advice on beneficial dietary and eating habits.