Trends and perspectives in global Food-Based Dietary Guidelines: a narrative review

Food-Based Dietary Guidelines (FBDGs) are key public health tools intended to promote healthy eating and prevent non-communicable diseases. Many countries have recently revised their guidelines, but cross-country comparisons remain limited.

To compare the latest national FBDGs in selected countries and identify common and divergent approaches in their development and communication.

A comparative document review was conducted for eight countries with publicly accessible and recently updated FBDGs: the United States, United Kingdom, Australia, Germany, Italy, Denmark, China, and Korea. Official FBDG documents, scientific background reports, and implementation resources were reviewed and compared using a structured narrative approach with attention to governance structure, visual models, food group classification, evidence sources, and sustainability integration. This structured narrative review focuses on selected national FBDGs and does not constitute a comprehensive systematic review of all existing global guidelines.

All eight countries adopted periodic revisions and strengthened alignment with updated nutrition science. Many transitioned from pyramid-style graphics to simplified visual models, with expanded digital engagement and practical consumer resources. Cultural specificity remained visible, such as the Mediterranean pattern in Italy, a plant-forward model in Denmark, and incorporation of fermented foods and rice staples in East Asia. Differences in food grouping and nutrient emphasis reflected national dietary challenges and data availability. Integration of environmental sustainability varied considerably, ranging from explicit inclusion throughout the guidance to minimal or no mention. Public communication strategies increasingly emphasized practicality through consumer testing, targeted messaging, and alignment with food service guidelines.

Contemporary FBDGs show convergence toward improved scientific rigor, cultural appropriateness, and enhanced communication, whereas adopting sustainability occurred at varying levels. Continued evaluation of development processes and public implementation is warranted to strengthen real-world dietary improvement.