Literature about healthy diet and its impact on human health and disease prevention is more extensive now than ever before, yet the incidence of diet-related disease keeps rising. Unhealthy eating patterns, and physical inactivity collectively account for 21% of premature deaths in 2016. That’s more than 11 million deaths.27
Economic development has consequences for the diet and lifestyles of individuals, not all of which are positive. The so-called nutrition transition includes shifts in diet towards energy dense foods, processed foods, more fat and sugar, and reduced intake of dietary fiber, fruit and vegetables. 71, 80
The exact composition of a balanced and healthy diet may vary depending on factors such as age, gender, physical activity, religious restrictions, cultural customs and availability of different foods, but the basic principles of what constitutes a healthy diet remain the same.
Let’s take a look at these principles!
IMPORTANCE OF CALORIE BALANCE
A healthy diet must satisfy our needs for energy and all essential nutrients. Daily energy requirements, or the total number of calories a person needs, depends on several factors, including the person’s age, sex, height, weight, and physical activity.
If energy intake is consistently diverging from a person’s requirement, a change in body energy stores, and weight can be expected. A caloric deficit or surplus may help lose, or gain weight, but if the imbalance continues over longer period of times, physical, mental, emotional, and social health and performance may be adversely affected. 19, 20, 51
BOTTOM LINE: A healthy diet has to provide daily energy requirements, but should not create an unwanted calorie shortage or surplus, except for the period during which specific goals require a calorie deficit or excess.
The best way to determine and control an appropriate level of calories is to regularly monitor weight, and adjust calorie intake or expenditure (via physical activity) based on changes in body weight over time.
It is not only total number of calories that are important, but also the substance from which the calories are taken. One of the most fundamental challenges for nutritionists is how to convert complex scientific knowledge into easily understood and simple messages about healthy eating.
Food-based dietary guidelines or healthy eating guidelines are simple, practical, science-based messages on healthy eating aimed at preventing all forms of malnutrition and keeping people well-nourished and healthy. These guidelines translate healthy eating messages, and nutrient recommendations into simple information that the public can easily understand, and apply in everyday life.
Nutrition guides typically divide foods into several groups, and recommend daily servings of each group. Foods listed in the same group share similar nutritional properties, and provide similar amounts of key nutrients. Each food group is the major contributor of at least one nutrient while making significant contributions of many other nutrients.
BOTTOM LINE: To meet nutrient needs within our individual calorie limits, we should choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.
VEGETABLES AND FRUIT
Adequate consumption of vegetables and fruit are vitally important to human health as sources of nutrients and non-nutritive food constituents. Statistics show that average daily consumption of vegetables and fruits is far below the recommended daily amounts.1, 7, 17, 24 National Diet and Nutrition Survey in the UK showed that only 31% of adults and 37% of older adults met the “5-a-day” recommendation. 24 In the U.S., just 1 in 10 adults meet the federal fruit or vegetable recommendations, according to CDC’s Morbidity and Mortality Weekly Report. 43
Low consumption of vegetables and fruit contributed to more than 3.8 million deaths in 2016!27
A comprehensive review, that combines the results of 95 studies, found that there was a 16% reduction in the risk of heart disease, a 28% reduction in the risk of stroke, a 22% reduction in the risk of cardiovascular disease, a 13% reduction in the risk of cancer, and a 27% reduction in the risk of all-cause mortality for an intake of 500 g of fruits and vegetables per day, compared to 0–40 grams per day. 1, 55, 56, 70, 80
BOTTOM LINE: Fruit and vegetables should make up over a third of the food we eat each day. The World Health Organization (WHO) recommends eating at least five 80 g portions of fruit and vegetables every day (total 400 grams per day). 55, 56, 80
This amount should be the minimum quantity. Note that in the WHO recommendation potatoes, sweet potatoes, cassava and other starchy roots are not classified as vegetables, and not included in the “400 grams per day” limit. 55, 56, 80
Current recommendations are even higher in Sweden (500 g/day), Denmark (600 g/day), Norway (650–750 g/day), the U.S. (675-800 g/day), and Australia (675-750 g/day). 4, 32, 50, 70
Studies suggest that these increased levels may exert a higher protective effect against adverse health conditions. In the review mentioned above, the lowest risk for all types of cancer was observed at an intake of 600 grams per day (7,5 servings/day). For heart disease, stroke, cardiovascular disease and all-cause mortality, the lowest risk was observed at 800 grams/day (10 servings/day). 4, 32, 50, 55, 56, 70, 80
The grains food group includes grains as single foods, as well as products that include grains as an ingredient, such as breads, pasta, cereals, crackers etc. Foods in this group come from cereal grains like wheat, millet, fonio, maize (corn), sorghum, barley, oats, rice, wild rice, rye, spelt, teff, triticale, and pseudocereal grains such us amaranth, buckwheat, quinoa, kañiwa, kiwicha.
Grains may be either whole or refined.
- Whole grains contain the entire kernel, including the endosperm, bran, and germ, and are valuable sources of nutrients including fiber, vitamin A, vitamin E, vitamin B1, B2, B6, niacin, selenium, zinc, copper and magnesium. 66
- Refined grains are modified from their natural state. Generally it involves removal of the bran and germ, which decreases nutrients and fiber.
Studies support the notion that whole grains may protect against cancer (especially gastrointestinal cancers such as gastric and colonic cancer), cardiovascular disease and the development of type 2 diabetes. 2, 23, 47, 62, 65, 72
A comprehensive review, that analyzes the results of 19 individual studies found that the risk of all-cause mortality decreased by 21% with increasing intake of whole grains up to 90 grams per day compared with no consumption of them. 61 But, studies indicate that average consumption of whole grains is far less than recommended levels. 57, 66
BOTTOM LINE: Healthy eating includes whole grains, and limits the intake of products made with refined grains, especially those high in saturated fats, added sugars, and/or sodium such as cookies, cakes, and snack foods. At least half of all grains eaten should be whole grain.
NOTE: This group (beside of starchy vegetables, fruits, and legumes) represents one of the main sources of carbohydrates in our diet. It is recommended that 45 to 65% of daily calories should come from carbohydrates. The recommended number of servings varies depending on the different calorie needs.37, 70, 89 Increase the consumption of whole grains at the expense of refined grains in accordance with your daily calories limits, and carbohydrate needs.
Despite of the individual variances, nutritional guide of health organizations may contain recommendation for this food group also. For example:
- MyPlate recommend 5-7 ounce-equivalents of grains per day for adults, with at least half being whole grains. (1 ounce-equivalent equals a half cup cooked or 1 ounce (28g) dry rice, oats, bulgur, or other grain, half cup cooked or 1 ounce (28g) dry pasta, 1 regular slice or 1 small slice (French) of bread, 4 snack-size slices rye bread, half English muffin, 1 mini bagel)70
- The Australian Guide to Healthy Eating suggests at least 4-6 servings of grain per day for adults. (1 serving is equivalent to 1 slice (40g) bread, half a medium (40g) roll or flat bread, a half cup (75-120g) of cooked rice, pasta, noodles, barley, buckwheat, semolina, polenta, bulgur or quinoa, porridge, 1/4 cup (30g) muesli, 3 (35g) crispbreads, 1 (60g) crumpet, 1 small (35g) English muffin or scone.)50
Dairy products have been part of the human diet for some 8000 years. Due to their nutritional properties, they are included in the nutritional guides of most of health authorities. 60
Dairy products provide a wide range of nutrients that may be difficult to obtain with limited or no dairy consumption. Aside from protein, nutrients concentrated in dairy foods include calcium, magnesium, zinc, phosphorus, and vitamin D. 10, 31, 33, 60 In balanced omnivore diets, dairy products contribute around 52–75 % of the reference intake of calcium. 12, 22, 64, 67, 73, 76
Using data from the National Health and Nutrition Examination Survey (NHANES), researchers concluded that adequate calcium intake cannot be met with dairy-free diets in adolescents, while meeting other nutrient recommendations. 26
BOTTOM LINE: Recommendations include the consumption of 2 to 3 servings of dairy products (500-750 ml of milk, or equivalent dairy products) per day – an amount that provides three-quarters of the recommended daily intake of calcium for the general population.50, 55,56, 70
Individuals who are lactose intolerant may choose lactose-free dairy products. Those who are unable, or unwilling to consume dairy products should be aware of which foods provide the range of nutrients generally obtained from dairy. The nutrients most at risk in dairy-free diets are calcium, and magnesium. 10, 26, 60, 76
Non-dairy sources of calcium, including green leafy vegetables and legumes, may contain compounds such as oxalic acid and phytic acid, that inhibit calcium absorption. For example, cooked spinach contains about 115 mg of calcium per serving, but only 5 % of this is absorbed. Spinach contains a high level of oxalates which bind calcium and form insoluble salt compounds.76
Foods with high levels of oxalic acid include spinach, collard greens, sweet potatoes, rhubarb, and beans. Fiber-containing whole-grain products, wheat bran, beans, seeds, nuts, and soy isolates are high in phytic acid. 38
PROTEIN – MEAT, FISH, EGGS, SOY, NUTS, SEEDS, BEANS AND LEGUMES
Aside from dairy, which may provide 11-15% of our daily protein consumption 34, 53, this food group represents the main protein source in human diet.
The wide variety of foods in this group includes lean meats, poultry, fish, eggs, nuts, seeds, legumes and beans, including soy products. Due to their quality protein content, dairy foods are also considered protein foods, but are treated separately in most of healthy eating guides, because of dairy’s unique nutrient profile.
Aside from protein, the foods in this group are a good source of many nutrients, including B vitamins, iron, zinc and other minerals. Nutrient profile, however, can vary between sources.
- Meat includes all forms of beef, pork, lamb, veal, goat, and non-bird game, while poultry includes all forms of chicken, turkey, duck, geese, guineafowl, and game birds. Along with eggs, these foods are our main source of Vitamin B12. They also provide zinc, and heme iron, which is more bioavailable than the non-heme iron, found in plants.
- Eggs are a good source of protein, vitamin D, vitamin A, vitamin B2, B12 and biotin. Eggs provide the most choline, a nutrient critical for brain development and function. Most people may be lacking in choline. 39, 84, 85 Eggs are high in lutein and zeaxanthin, antioxidants that reduce your risk of eye disorders like macular degeneration and cataracts. 11, 15, 25, 28
- Seafood provides the most vitamin D. Fish and seafood, especially cold-water oily fish such as salmon, herring, mackerel, anchovies and sardines, are the most valuable source of long chain omega-3 polyunsaturated fatty acids.
Studies have shown the benefits of omega-3 fatty acids in protecting against cardiovascular disease, dyslipidaemia (abnormal level of lipids in the blood including triglycerides, cholesterol), atherosclerosis, diabetes, insulin resistance, obesity, inflammation and inflammatory diseases, neurological, and neuropsychiatric disorders, osteoporosis, eye diseases. 3, 5, 6, 9, 13, 18, 21, 28, 36, 43, 44, 45, 46, 48, 68, 69, 74, 77, 78, 82, 83, 86
Aim for at least two servings of fish per week, including at least one portion of oily fish. Oily fish includes salmon, fresh tuna, sardines, mackerel and kippers.55, 56
A variety of plants provide significant protein. According to the American Dietetic Association “plant protein can meet protein requirements when a variety of plant foods is consumed and energy needs are met.” 81
- Nuts and seeds are good source of protein, as well as fatty acids and a range of minerals, vitamins and phytochemicals, but their concentrated energy and fat content have to be taken into account when consuming.
- Legumes including all types of beans, lentils, chickpeas, split peas, and soy products. Aside from protein, they are rich sources of carbohydrates, beta-carotene, vitamin C, folate, and dietary fiber. Consumption of a variety of legumes can play a role in prevention of a number of health conditions. A comprehensive review, that analyzes the results of 17 studies found that the risk of all-cause mortality decreased by 16% with increased intake of legumes up to 150 grams per day. 61
The amount consumed from this group depend on our daily protein requirements.
BOTTOM LINE: According to your individual protein needs, select a variety of protein foods, including at least 2 servings of seafood per week. Eat no more than 70 grams of processed meat and processed poultry a day, and no more than 450 grams of red meat per week.
SPECIAL NOTE FOR EGG CONSUMPTION: Studies concluded that regular consumption of eggs, up to 6 per week may not be associated with increased risk of heart disease, myocardial infarction or stroke in healthy individuals. 7 or more eggs per week, however, may be associated with a modest increased risk of total mortality, especially among diabetic patients, where frequent egg consumers (1 or more egg daily) are 69% more likely to have cardiovascular disease.16, 41, 59, 63
SPECIAL NOTE FOR RED MEAT CONSUMPTION: There is a lot of debate about whether it is healthy to consume red meat. EPIC (European Prospective Investigation into Cancer and Nutrition) shows a slight J-shaped positive association between red meat consumption and all-cause mortality. The lowest risk was among individuals with low to moderate consumption. 58, 61 According to the Australian Guide to Healthy Eating, consumption of no more than 450 grams per week of lean red meat may be recommended, as regular consumption of greater amounts may be associated with an increased risk of colorectal cancer. 50
SPECIAL NOTE FOR PROCESSED MEAT CONSUMPTION: The protein group includes processed meats and processed poultry, such as sausages, bacon, cured meats or reformed meat products. Processed meats are generally high in sodium and saturated fats, and intake of these products is acceptable as long as sodium, saturated fats, and total calories are within limits in the whole diet. It is recommended that no more than 70 grams of processed meat/poultry be consumed per day. A comprehensive review, that combines the results of 7 individual studies found that the risk of all-cause mortality increased by 60% with increasing intake of processed meat up to 200 grams per day. 61
Food guides of health authorities and organizations usually incorporate both the written food advice and a graphic model, e.g. a pyramid, plate or rainbow, developed to communicate the key healthy eating messages. Some examples are listed below.
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- Anderson JW.: Whole grains protect against atherosclerotic cardiovascular disease. Proc Nutr Soc. 2003 Feb;62(1):135-42.
- Appel LJ, Miller ER 3rd, Seidler AJ, et al. Does supplementation of diet with ‘fish oil’ reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med 1993;153:1429–38.
- Dagfinn Aune Edward Giovannucci Paolo Boffetta Lars T Fadnes NaNa Keum Teresa Norat Darren C Greenwood Elio Riboli Lars J Vatten Serena Tonstad : Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies, International Journal of Epidemiology, Volume 46, Issue 3, 1 June 2017, Pages 1029–1056, https://doi.org/10.1093/ije/dyw319
- Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J.: Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis. 2006 Nov;189(1):19-30. Epub 2006 Mar 10.
- Belluzzi A, Brignola C, Campieri M, et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn’s disease. N Engl J Med 1996;334:1557–60.
- Boeing H, Bechthold A, Bub A, et al. Critical review: vegetables and fruit in the prevention of chronic diseases. European Journal of Nutrition. 2012;51(6):637-663. doi:10.1007/s00394-012-0380-y.
- Calder PC: n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr. 2006 Jun;83(6 Suppl):1505S-1519S.
- Calder PC: The role of marine omega-3 (n-3) fatty acids in inflammatory processes, atherosclerosis and plaque stability. Mol Nutr Food Res. 2012 Jul;56(7):1073-80. doi: 10.1002/mnfr.201100710.
- Caroli A, Poli A, Ricotta D, Banfi G, Cocchi D.: Invited review: Dairy intake and bone health: a viewpoint from the state of the art. J Dairy Sci. 2011 Nov; 94(11):5249-62.
- Carpentier S, Knaus M, Suh M.: Associations between lutein, zeaxanthin, and age-related macular degeneration: an overview. Crit Rev Food Sci Nutr. 2009 Apr;49(4):313-26. doi: 10.1080/10408390802066979.
- Chevalley T, Bonjour JP, Ferrari S, Rizzoli R. High-protein intake enhances the positive impact of physical activity on BMC in prepubertal boys. J Bone Miner Res. 2008;23(1):131–142. doi: 10.1359/jbmr.070907.
- Chong EW, Kreis AJ, Wong TY, et al. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol 2008;126:826–33.
- Dietary reference values for food energy and nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. Rep Health Soc Subj (Lond). 1991;41:1-210.
- Delcourt C, Carrière I, Delage M, Barberger-Gateau P, Schalch W; POLA Study Group.: Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study. Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2329-35.
- Djoussé L, Gaziano JM. Egg Consumption and Cardiovascular Disease and Mortality The Physicians’ Health Study. The American journal of clinical nutrition. 2008;87(4):964-969.
- Elmadfa I, Meyer A, Nowak V, Hasenegger V, Putz P, Verstraeten R, Remaut-DeWinter AM, Kolsteren P, Dostálová J, Dlouhý P, Trolle E, Fagt S, Biltoft-Jensen A, Mathiessen J, Velsing Groth M, Kambek L, Gluskova N, Voutilainen N, Erkkilä A, Vernay M, Krems C, Strassburg A, Vasquez-Caicedo AL, Urban C, Naska A, Efstathopoulou E, Oikonomou E, Tsiotas K, Bountziouka V, Benetou V, Trichopoulou A, Zajkás G, Kovács V, Martos E, Heavey P, Kelleher C, Kennedy J, Turrini A, Selga G, Sauka M, Petkeviciene J, Klumbiene J, Holm Totland T, Andersen LF, Halicka E, Rejman K, Kowrygo B, Rodrigues S, Pinhão S, Ferreira LS, Lopes C, Ramos E, Vaz Almeida MD, Vlad M, Simcic M, Podgrajsek K, Serra Majem L, Román Viñas B, Ngo J, Ribas Barba L, Becker V, Fransen H, Van Rossum C, Ocké M, Margetts B..: European Nutrition and Health Report 2009. Forum Nutr. 2009;62:1-405. doi: 10.1159/000242367. Epub 2009 Sep 21.
- Eslick GD, Howe PR, Smith C, Priest R, Bensoussan A.: Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009 Jul 24;136(1):4-16. doi: 10.1016/j.ijcard.2008.03.092. Epub 2008 Sep 6.
- World Health Organization, Food and Agriculture Organization of the United Nations, United Nations University: Energy and protein requirements. Report of a Joint FAO/WHO/UNU Expert Consultation, World Health Organization Technical Report Series 724. Reprinted 1987, 1991 ISBN 92 4 120724 8, World Health Organization, Geneva 1985
- World Health Organization, Food and Agriculture Organization of the United Nations, United Nations University: Human energy requirements. Report of a Joint FAO/WHO/UNU Expert Consultation, Rome, 2004, ISBN 92-5-105212-3, ISSN 1813-3932
- Fedor D, Kelley DS.: Prevention of insulin resistance by n-3 polyunsaturated fatty acids. Curr Opin Clin Nutr Metab Care. 2009 Mar;12(2):138-46. doi: 10.1097/MCO.0b013e3283218299.
- Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77(2):504–511.
- Flight I, Clifton P.: Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. Eur J Clin Nutr. 2006 Oct;60(10):1145-59. Epub 2006 May 3.
- Food Standards Agency (FSA), Department of Health (DoH): National Diet and Nutrition Survey: headline results from years 1, 2 and 3 combined (2008/09 – 2010/11). Survey carried out on behalf of the Department of Health and the Food Standards Agency. Edited by: Beverley Bates, Alison Lennox, Ann Prentice, Chris Bates, Gillian Swan. Published 25 July 2012
- Gale CR, Hall NF, Phillips DI, Martyn CN.: Lutein and zeaxanthin status and risk of age-related macular degeneration. Invest Ophthalmol Vis Sci. 2003 Jun;44(6):2461-5.
- Gao X, Wilde PE, Lichtenstein AH, Tucker KL.: Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years (National Health and Nutrition Examination Survey 2001-2002). J Am Diet Assoc. 2006 Nov; 106(11):1759-65.
- GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic
- Goldberg RJ, Katz J.: A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 May;129(1-2):210-23. Epub 2007 Mar 1.
- Goodrow EF, Wilson TA, Houde SC, Vishwanathan R, Scollin PA, Handelman G, Nicolosi RJ.: Consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations. J Nutr. 2006 Oct;136(10):2519-24.
- Hall JN, Moore S, Harper SB, Lynch JW.: Global variability in fruit and vegetable consumption. Am J Prev Med. 2009 May; 36(5):402-409.e5.
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- Health Canada: Eating Well with Canada’s Food Guide. Her Majesty the Queen in Right of Canada, represented by the Minister of Health Canada, 2011. HC Pub.: 4651 Cat.: H164-38/1-2011E-PDF ISBN: 978-1-100-19255-0
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- Hodge WG, Barnes D, Schachter HM, et al. The evidence for efficacy of omega-3 fatty acids in preventing or slowing the progression of retinitis pigmentosa: a systematic review. Can J Ophthalmol 2006;41:481–90.
- Hoen WP, Lijmer JG, Duran M, Wanders RJ, van Beveren NJ, de Haan L.: Red blood cell polyunsaturated fatty acids measured in red blood cells and schizophrenia: a meta-analysis. Psychiatry Res. 2013 May 15;207(1-2):1-12. doi: 10.1016/j.psychres.2012.09.041. Epub 2012 Oct 13.
- Institute of Medicine: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. 2005, Washington, DC: The National Academies Press. https://doi.org/10.17226/10490.
- Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011. 2, Overview of Calcium. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56060/
- Jensen HH, Batres-Marquez SP, Carriquiry A, Schalinske KL. Choline in the diets of the US population: NHANES 2003–2004. FASEB J. 2007;21:lb219.
- Koh-Banerjee P, Rimm EB.: Whole grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proc Nutr Soc. 2003 Feb;62(1):25-9.
- Larsson SC, Åkesson A, Wolk A.: Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts. Am J Clin Nutr. 2015 Nov;102(5):1007-13. doi: 10.3945/ajcn.115.119263. Epub 2015 Sep 23.
- Lee-Kwan SH, Moore LV, Blanck HM, Harris DM, Galuska D. Disparities in State-Specific Adult Fruit and Vegetable Consumption — United States, 2015. MMWR Morb Mortal Wkly Rep 2017;66:1241–1247. DOI: http://dx.doi.org/10.15585/mmwr.mm6645a1
- Lee YH, Bae SC, Song GG.: Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Arch Med Res. 2012 Jul;43(5):356-62. doi: 10.1016/j.arcmed.2012.06.011. Epub 2012 Jul 24.
- Miles EA, Calder PC.: Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. Br J Nutr. 2012 Jun;107 Suppl 2:S171-84. doi: 10.1017/S0007114512001560.
- Mori TA, Bao DQ, Burke V, Puddey IB, Watts GF, Beilin LJ.: Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects. Am J Clin Nutr. 1999 Nov;70(5):817-25.
- Muley A, Muley P, Shah M.: ALA, fatty fish or marine n-3 fatty acids for preventing DM?: a systematic review and meta-analysis. Curr Diabetes Rev. 2014 May;10(3):158-65
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- Australian National Health and Medical Research Council (NHMRC) and the New Zealand Ministry of Health (MoH): Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. 2005, ISBN Print 1864962372 ISBN Online 1864962437
- National Health and Medical Research Council: Eat For Health Educator Guide. Australian Dietary Guidelines Educator Guide Canberra: National Health and Medical Research Council. 2013. ISBN Online: 1864965800, ISBN Print: 1864965797
- National Research Council (US) Subcommittee on the Tenth Edition of the Recommended Dietary Allowances. Recommended Dietary Allowances: 10th Edition. Washington (DC): National Academies Press (US); 1989. 3, Energy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK234938/
- National Research Council (US) Subcommittee on the Tenth Edition of the Recommended Dietary Allowances. Recommended Dietary Allowances: 10th Edition. Washington (DC): National Academies Press (US); 1989. 6, Protein and Amino Acids. Available from: https://www.ncbi.nlm.nih.gov/books/NBK234922/
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- Richardson DP.: Wholegrain health claims in Europe. Proc Nutr Soc. 2003 Feb;62(1):161-9.
- Rohrmann S, Overvad K, Bueno-de-Mesquita HB, Jakobsen MU, Egeberg R, Tjønneland A, Nailler L, Boutron-Ruault MC, Clavel-Chapelon F, Krogh V, et al. Meat consumption and mortality–results from the European Prospective Investigation into Cancer and Nutrition. BMC Med 2013;11:63.
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