Sustainable diets and functional foods for the prevention of cardio-metabolic diseases and sustainable development goals of the UNO. An international consensus of scientific statement of the international college of nutrition and 28th world congress on clinical nutrition, Bogor, Indonesia

Abstract

Abstract Background The United Nations Organization (UNO) has proposed achieving specific Sustainable Development Goals (SDGs), including poverty, hunger, health, education, equality, climate change, and the need for sustainable development, while protecting the planet Earth from environmental degradation. The expert group of the International College of Nutrition aims to emphasize the merits of sustainable diets and traditional plant based foods for the primordial prevention of cardio-metabolic Diseases (CMDs) and other chronic diseases in this review, to achieve these goals. Methods A narrative review was conducted to identify articles related to cardiovascular diseases (CVDs), obesity, diabetes, and cancer, using databases from the World Health Organization (WHO), Google Scholar, MEDLINE (PubMed), Web of Science, and EBSCO, along with additional secondary sources and a search of grey literature. Opinions of experts were also sought, and views of all authors were obtained as outlined in this document. Results It seems that education, in particular health education and motivation, apart from cultural factors, are crucial for achieving total health, and the SDGs of the UNO. The prevalence of unhealthy behaviours and risk factors for most of the CMDs and other chronic diseases is rapidly increasing in low- and middle-income countries, due to the ongoing economic development, leading to rapid changes in diet and lifestyle. There is some decline in cardiovascular disease (CVD) mortality in high-income countries due to education and learning of preventive strategies, resulting in a reduction in mortality due to these diseases. However, CMDs and cancer remain the significant causes of morbidity and mortality. During and after World War II, food scarcity persisted from 1940 to 1965 in most countries, accompanied by a low risk of cardiovascular disease (CVD) and diabetes. The rapid increase in industrialization and urbanization has been linked to environmental degradation on planet Earth, a decline in fertile, healthy soil, and sustainable, functional farming practices, resulting in a decrease in the production of nutritious foods. These alterations in food availability are associated with an increased production of unhealthy, energy rich foods and Western-type dietary patterns, which in turn increased the risk of non-communicable diseases (NCDs). The health of the planet and its people is at risk. There is a deterioration in the global standard of natural systems that support life on Earth, which is exacerbating energy, food, and water insecurity, and increasing the risk of disease, disaster, displacement, and conflict. Recent advice about the safe corridor on the planet can enhance research on planetary boundaries and Earth-system aspects of the SDGs. It appears that poverty, lack of education, and inadequate health education and motivation, possibly due to ineffective policies by national and local governments, are significant determinants of the increased risk of these diseases. In urban areas of lower and middle-income countries, as well as in immigrant populations in high-income countries, CMDs and other chronic diseases are significantly higher than they are in some of the high-income populations. Improvements in soil and the promotion of functional farming, along with an emphasis on the food industry, are urgently needed to support plant-based, low-animal food traditional food diets. Traditional foods are feasible and affordable in every country. The use of high-protein substitutes for animal-derived foods, such as soybean products such as tofu and tempe, millets, beans, lentils, peas (400 g/day), green vegetables, fruits, and nuts (400 g/day), as well as vegetable oils, low-fat dairy products, and culinary spices, with low meat (sea-foods) may be beneficial in promoting health and preventing NCDs. Health education and promotion of healthier lifestyles and behaviours during the preconception period, in utero life, and the postnatal development and infancy stages may lead to healthy eating patterns, contributing to primordial prevention of NCDs. A wild-type omega-6/3 diet rich in flavonoids, folate, and other nutrients, along with other interventions may mitigate epigenetic risk variations at the individual level across all subgroups, from the preconception period to the elderly stages. Conclusions These findings may necessitate revisions to the existing guidelines proposed for sustainable functional farming and sustainable plant based diets. Eating 400 g/day of vegetable, fruits, and nuts and another 400 g/day of whole grains, with spices (20-50 g/day) and meat as condiment (50 g/day), along with 30-50 g/day of vegetable oils, can prevent CMDs and other chronic diseases, and promote health to serve the SDGs of the UNO. Cohort studies and randomized trial in each country may be necessary to confirm the role of our advice in the prevention of diseases.