In response to a call from the 58th World Health Assembly (May 2005), the World Health Organization (WHO) established the Guidelines Review Committee (GRC) in 2007 with the purpose of developing and implementing procedures to ensure that WHO guidelines are developed in ways consistent with internationally recognized best practices, emphasizing the appropriate use of systematically reviewed available evidence. The robust guideline development process being implemented by WHO is described in detail in the WHO Handbook for guideline development (2014).
In accordance with the Organization-wide transformation in strengthening WHOs role in developing evidence-informed public health guidance, the Department of Nutrition for Health and Development (NHD) has strengthened its role and leadership in providing evidence-informed policy and programme guidance to Member States for promoting healthy diets and nutrition throughout the life course, in partnership with relevant internal departments and partners, and guided by the new WHO guideline development process. This normative mandate was reaffirmed through a request from the 63rdWorld Health Assembly (May 2010) to strengthen the evidence base on effective and safe nutrition actions to counteract the public health effects of the double burden of malnutrition, and to describe good practices for successful implementation. More recently WHOs commitment to strengthen its normative work was reiterated in the13thGeneral Programme of Work (2019 2023)was endorsed by the 71stWorld Health Assembly (May 2018). It states that Setting norms and standards is a unique function and strength of WHO and further noted that WHO will reinforce its science- and evidence-based normative work.
To implement the strengthening of evidence-informed nutrition guidance, NHD established in 2010 theWHO Nutrition Guidance Expert Advisory Group (NUGAG)guided by theWHO Steering Committee for Nutrition Guidelines Development, which includes representatives from all Departments in WHO with an interest in the provision of recommendations in promoting healthy diets and nutrition. Membership in NUGAG is usually for three to four years and NUGAG includes experts from various WHO Expert Advisory Panels as well as experts from a larger roster including those identified through open calls for experts, taking into consideration a balanced mix of genders, breadth in areas of expertise, and representation from all WHO Regions.
The NUGAG will provide advice to WHO on the following:
In 2010 2011, the NUGAG consisted of four subgroups: 1) micronutrients; 2) diet and health; 3) nutrition in life course and undernutrition; and 4) monitoring and evaluation. However, due to organizational changes implemented in NHD in January 2012 and in an effort to reduce the administrative burden of managing multiple subgroups, the number of NUGAG subgroups were reduced to two: 1) diet and health; and 2) nutrition actions which were subsequently renamed as the guideline development group (GDG) on nutrition actions. In 2018, the NUGAG Subgroup on Policy Actions was also established.
Updating of the dietary goals for the prevention of obesity and diet-related noncommunicable diseases (NCDs) has been the focus of the work of the NUGAG Subgroup on Diet and Health. After completing the work on updating the guidelines on sodium and potassium intakes (published in 2012) and on sugars intake (published in 2015), the NUGAG Subgroup on Diet and Health had been working on the updates of the WHO guidelines on the intake of total fat, saturated fatty acids, trans-fatty acids, polyunsaturated fatty acids, non-sugar sweeteners and carbohydrates including dietary fibre. The draft guidelines on saturated fatty acids and trans-fatty acids were completed, launched for public consultation in May 2018, and are currently being finalized for release in 2019. The draft guidelines on intake of total fat, polyunsaturated fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), non-sugar sweeteners and carbohydrates are being prepared for public consultation in late 2019 early 2020. Over the past several years, the NUGAG Subgroup on Diet and Health also began reviewing the issues related to dietary patterns, in which interest and concern are growing as a result of rapidly changing food environments.
Updating of these dietary goals and developing guidance on dietary patterns are important elements of WHOs efforts in implementing the NCD agenda and achieving the triple billion targets set up by the 13th General Programme of Work (2019 2023), including one billion more people enjoying better health and well-being. This will also contribute to the implementation of the Political Declaration of the UN High-level Meeting on NCDs held in New York in September 2011 and the outcome document of the high-level meeting of the UN General Assembly on NCDs (A/RES/68/300) held in New York in July 2014 as well as the implementation of the NCD Action Plan for 2013 2020 which was adopted by the 66th World Health Assembly held in May 2013. Furthermore, it had also provided inputs to the work of the highlevel Commission on Ending Childhood Obesity established by the WHO Director-General in May 2014.
In November 2014, WHO organized, jointly with the Food and Agriculture Organization of the United Nations (FAO), the Second International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration on Nutrition and the Framework for Action, which recommends a set of policy options and strategies to promote diversified, safe and healthy diets at all stages of life. Subsequently, the 136th Session of the WHO Executive Board (EB) held in January 2015 and the 68th World Health Assembly held in May 2015 endorsed the Rome Declaration and Framework for Action and called on Member States to implement the commitment of the Rome Declaration across multiple sectors, by expanding WHOs evidence-informed guidance.
Furthermore, in April 2016, the UN General Assembly (UNGA) declared a UN Decade of Action on Nutrition (2016-2025), recognizing the role of nutrition in achieving the 2030 Agenda on Sustainable Development and the Sustainable Development Goals (SDGs). The Decade calls for eradicating hunger and preventing all forms of malnutrition worldwide, particularly stunting, wasting, and overweight in children under five years of age; and anaemia in women and children among other micronutrient deficiencies; as well as for reversing the rising trends in overweight and obesity and reducing the burden of diet-related NCDs in all age groups. Therefore, the goal of the Decade is to increase action at the national, regional and global levels in order to achieve commitment of the Rome Declaration adopted at ICN2, through implementing policy options included in the Framework for Action and evidence-informed programme actions.
Updating of the dietary goals being carried out by the NUGAG Subgroup on Diet and Health contributes not only to the implementation of the ICN2 commitments but also to the achievement of the goals of the Decade. But further prompted by the increasing requests from various Member States for WHOs guidance on effective policy measures to develop enabling food environment for promoting healthy diets and nutrition, NHD initiated in 2017 the establishment ofthe WHO Nutrition Guidance Expert Advisory Group (NUGAG) Subgroup on Policy Actions, which works alongside the NUGAG Subgroup on Diet and Health.
The Safe, Healthy and Sustainable Diet Unit (CC Healthy Diets) of the new Department of Nutrition and Food Safety (NFS) established in the beginning of 2020 as part of the WHOs transformation process serves as the Secretariat of the NUGAG Subgroup on Diet and Health and also now the NUGAG Subgroup on Policy Actions. The NUGAG Subgroups are generally expected to meet annually, but due to the COVID-19 pandemic, it is very unlikely to hold any physical meetings, including those of the NUGAG during 2020. Therefore, it is planned to hold a series of virtual meetings to progress the work of the NUGAG on Diet and Health with a view to finalize pending guidelines. The first virtual meeting was held on 15 16 June 2020.
1. Finalize the recommendations on saturated fatty acid andtrans-fatty acid intake, including drafted rationale and remarks, taking into consideration:
2. Review and identity implications for future research, taking into account on-going research and any existing controversies; and
3. Review and identify challenges for implementation of the guidelines.
Theexpected outcome of the meeting is, therefore, to finalize the recommendations and accompanying rationale and remarks on saturated fatty acid andtrans -fatty acid intake.
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Second virtual meeting of the WHO Nutrition Guidance Expert Advisory Group (NUGAG) - subgroup on Diet and Health - World Health Organization
