2011版飲食指標修訂研議之回顧與前瞻

Establishment of The 2011Taiwan dietary guideline--Review and Perspective

『飲食綱領』（Dietary Guideline），為國民營養最重要之指導原則，也是國民營養政策制定中最重要的一環。在台灣分為「每日飲食指南」及「國民飲食指標」。在進行2011版之飲食指標/指南修訂與研議時，我們遵循WHO/FAO頒佈『以食物為基礎之飲食綱領』的制訂與使用原則，以及「實證營養學」之精神。首先收集各國與國際組織之飲食綱領，進行比較研析，瞭解最新之健康飲食建議之潮流。其次，根據2005～2008 年台灣營養健康變遷調查結果及主要衛生統計數據，確認影響國人健康之主要飲食營養問題。再針對這些問題，經專家會議凝聚共識，擬出專業版「飲食綱領」。再由健康傳播學者，據以擬出「飲食指標」之條文。經公開報告，收集意見，修改後，將研議之草案提供衛福部作為修訂之參考。修訂草案之特色包括：1）提出因應國人熱量失衡之多種策略，2）由保健與環境永續發展的觀點強調飲食應以未精製植物性食物佔大部分，3）針對國人蔬果奶類攝取普遍不足與仍有微量營養素瀕臨缺乏現象提出加強之建議。4）強調母乳哺餵。衛福部，於2011年，將此專業版「飲食綱領」改成簡版口訣，發表於其官方網站。由於飲食指標不只用於一般民眾之個人營養教育，亦作為營造良好的「飲食營養環境」之重要參考原則；建議未來政府亦能公開專業版之「飲食綱領」，作為推動營造良好「飲食營養環境」政策擬定之指導原則。

The 2011 Taiwan Dietary Guidelines were developed by taking into consideration the WHO report Preparation and Use of Food-based Dietary Guidelines as well as principles of evidenced-based nutrition. The underlying principles and messages of dietary guidelines of many countries and international organizations were analyzed and compared. The most up-to-date vital statistics and results from a nutrition and health survey in Taiwan(NAHSIT 2005-2008)were also referenced. Diet-related chronic diseases, increasing prevalences of overweight/obesity and metabolic syndrome, and inadequate intakes of dairy, fruits, and vegetables were identified as major problems. The guidelines were drafted through in-depth discussions of an expert panel primarily consisting of nutrition scientists. The draft was then discussed and revised, and a consensus was achieved by a separate committee composed of food scientists, agronomists, educators, health communicators, and representatives of health-related non-government organizations and minority groups. The draft was then opened for public comments, revised, and submitted to the Ministry of Health. In order to tackle the challenge of excess caloric intake and high prevalences of metabolic diseases, the developed dietary guidelines made calorie level-specific recommendations on the distributions of six food groups in the food guide, along with more nutrient-dense foods and less energy-dense foods and appropriate portion sizes as well as 30 min of moderate physical activity a day. Unrefined (whole) plant-based diets were recommended for health and sustainability. Adequate consumption of whole grains, legumes, fruits, dairy, and nuts was emphasized. Exclusive breast feeding for at least 6 months was included in the dietary guidelines for the first time. The proposed guidelines were subsequently adopted, and associated educational materials were developed and published by the government. Derivation of food distribution suggestions in the food guide is addressed in a separate article in the same issue of this journal.