From Policy to Practice: A Global Analysis to Identify Factors That Influence the Implementation of Food-Based Dietary Guidelines by Health and Nutrition Professionals.

BACKGROUND

Food-based dietary guidelines (FBDG) are essential tools for promoting healthy, sustainable diets, yet global adherence is low. Health and nutrition professionals are key to translating these policies into practice, but the factors influencing their implementation efforts remain underresearched.

OBJECTIVES

This study aimed to identify factors influencing FBDG implementation from the perspective of health and nutrition professionals and to explore opportunities for strengthening implementation.

METHODS

Using a socioecological framework, this study employed an exploratory sequential mixed-methods design. Phase 1 involved 20 qualitative interviews with professionals across 6 continents. Insights informed phase 2, a quantitative survey (n = 118) of global professionals. Data were analyzed using deductive content analysis and descriptive statistics.

RESULTS

Although 80.5% of professionals use FBDG in practice, 57.6% rate them as only "somewhat" or "slightly" helpful in promoting healthy, sustainable food choices. Major barriers include perceived food industry influence (83.0%) and public misinformation. Facilitators include the "plate" visual format (77.1%) and the inclusion of more plant-based options. Critically, professionals advocate for systemic change, identifying fiscal policies-such as subsidies for healthy foods and tax reductions on vegetables and legumes-as essential to address cost barriers and create supportive food environments. Furthermore, inclusive designs that account for diverse cultural and nutritional philosophies are viewed as vital for increasing professional implementation.

CONCLUSIONS

Health and nutrition professionals encounter multiple barriers and facilitators in implementing the national FBDG. Policymakers and scientific committees should address these barriers and leverage facilitators to improve FBDG development and implementation. Findings provide initial valuable insights for future research and policy efforts aimed at promoting healthy and sustainable diets.