Development and Evaluation of Ethiopian Food-based dietary guidelines and a Healthy Eating Index

Background and Objective: Unhealthy diet is one of the most important factors that need to be addressed to tackle malnutrition and non-communicable diseases (NCDs) in low- and middle-income countries. Developing and implementing country-specific food-based dietary guidelines (FBDGs) is crucial to maintaining healthy eating in a population. This study aims to generate evidence to help develop and evaluate FBDGs for Ethiopia. Method: A multidisciplinary FBDG was established in November 2018. A workshop was organized from May 28 – 31, 2018, "FBDGs development process and countries experiences," to the committee. In the workshop, six research topics were identified. The evidence on the selected topic was generated and presented to the FBDG committee. BASED ON THE EVIDENCE, the FBDG committee set health and nutrition objectives and 11 dietary recommendations. Using qualitative study, the 11 dietary recommendations with tips and food graphics were evaluated for cultural appropriateness, acceptability, consumer understanding, and practicality. After revising the 11 dietary recommendations, they translated them into daily food choices using diet modeling. Finally, the Ethiopian FBDG was compiled and finalized after stakeholders' discussion and officially released on March 15, 2022. Result: The 11 dietary recommendations include dietary diversity 4 times during the meal and 6 times/day, 80-120grams/day consumption of legume, 100-200grams/day fruits, and vegetable, 10 to 20grams/day of nuts and oilseeds; eggs and meat (60grams/day), dairy foods (300 to 400grams/day), 8 to 10 glass of clean water; physically active for at least 30 minutes/day; 15 to 20 grams/day of fats and oils; sugar, sweets and soft drinks to below 30 grams/day; salt intake to below 5grams/day; alcohol intake. The graphics, serving size, and implementation plan are also part of the Ethiopian FBDG. Finally, the for contextualizing, translating into different languages, considering diet cost, engaging the private sector, and using nutrition program, food system roadmap, and the platform also suggested by the FBDG technical committee and stakeholders. Conclusion: The Ethiopian FBDG will be dietary advice to the general public above two years and serve as an entry point to implement the national food system roadmap developed during the 2021 United Nations food system summit.