Objective: Food-based dietary guidelines (FBDGs) are globally promoted as an important part of national food and nutrition policies. They are presented within policy as key features of the strategy to educate the public and guide policymakers and other stakeholders about a healthy diet. This paper examines the implementation of FBDGs in four countries: Chile, Germany, New Zealand and South Africa -diverse countries chosen to explore the realities of the FBDG within policy on public health nutrition. Design: A literature review was carried out, followed by interviews with representatives from the governmental, academic and private sector in all four countries. Results: In all four countries the FBDG is mainly implemented via written/ electronic information provided to the public through the health and/or education sector. Data about the impact of FBDGs on policy and consumers' food choice or dietary habits are incomplete; nutrition surveys do not enable assessment of how effective FBDGs are as a factor in dietary or behavioural change. Despite limitations, FBDGs are seen as being valuable by key stakeholders. Conclusion: FBDGs are being implemented and there is experience which should be built upon. The policy focus needs to move beyond merely disseminating FBDGs. They should be part of a wider public health nutrition strategy involving multiple sectors and policy levels. Improvements in the implementation of FBDGs are crucial given the present epidemic of chronic, non-communicable diseases. Chronic, non-communicable diseases (NCDs), especially cardiovascular diseases, cancers, obesity and type 2 diabetes mellitus, kill more people every year than any other cause of death 1 . Four factors in the epidemiology of these diseases -poor diet, physical inactivity, tobacco and alcohol use -are of overwhelming importance to public health.To educate the public and inform policy-makers about a healthy diet, for many years food-based dietary guidelines (FBDGs) have been globally promoted as an important part of national food and nutrition policies. The Plan of Action endorsed at the 1992 International Conference on Nutrition called on governments to provide to the public 'qualitative and/or quantitative dietary guidelines relevant for different age groups and lifestyles and appropriate for the country's population' 2 . Based on this call, many countries have developed FBDGs for the population and/or subgroups of the population. More recently, the 2004 World Health Organization (WHO) Global Strategy on Diet, Physical Activity and Health 3 encouraged governments to provide FBDGs in order to advise national nutrition policy, nutrition education, intersectoral interventions and collaborations. Effective implementation of FBDGs at population level and in policies is needed in order to contribute to halting the current NCD epidemic.
MethodThe information in the present paper is based on a systematised literature review of FBDGs which shaped questions to be asked of key informants responsible for their implementation in di...