Table 2

Optimal consumption levels of key foods related to non-communicable diseases risk*

Foods† (standardised serving size)Related disease outcomesObserved consumption levels associated with lowest disease risk in meta-analyses‡Observed mean national intakes (top or bottom 3 countries) in 2010§Recommended intakes by major dietary guidelines¶Optimal population intake (mean±SD)**
Fruits (100 g/serving)↓ CHD, ↓ stroke,
↓ oesophageal cancer, and
↓ lung cancer
4.4 servings/day (ischaemic stroke)
3.0 servings/day (total stroke)
2.8 servings/day (lung cancer)
2.4 servings/day (CHD)
1.7 servings/day (ESCC)
2.4 servings/day (EAC)
Top 3 countries:
Barbados: 418.6 g/day
Jamaica: 402.4 g/day
Jordan: 302.2 g/day
USDG 2010: 2 cups/day
AHA 2020: ≥4.5 cups/day (including vegetables)
300±30 g/day
Vegetables, including legumes (100 g/serving)↓ CHD, ↓ stroke,
↓ oesophageal cancer
5.3 servings/day (MI)
3.7 servings/day (CHD)
1.5 servings/day (ESCC)
1.8 servings/day (EAC)
Top 3 countries (vegetables):
Lebanon: 316.2 g/day
China: 305.0 g/day
Jordan: 302.3 g/day
Top 3 countries (legumes):
Brazil: 182.1 g/day
Colombia: 126.2 g/day
Mexico: 94.5 g/day
USDG 2010: 2½ cups/day (including legumes and starchy vegetables)
AHA 2020: ≥4.5 cups/day (including fruits)
400±40 g/day
Nuts/seeds (1 oz (28.35 g)/serving)↓ CHD, ↓ diabetes4 times/week (CHD)
4 servings/week (diabetes)
Top 3 countries:
Malaysia: 57.2 g/day
Lebanon: 30.6 g/day
UK: 14.9 g/day
USDG 2010: 4 oz/week (113.4 g/week) (including soy products)
AHA 2020: ≥4 (1 oz) servings/week (113.4 g/week) (including legumes)
4 (1 oz=28.35 g)±0.4 servings/week (113.4±11.3 g/week)
Whole grains (50 g/serving)↓ CHD, ↓ diabetes2.5 servings/day (CHD)
2.5 servings/day (diabetes)
Top 3 countries:
Germany: 149.4 g/day
Barbados: 111.7 g/day
The Netherlands: 98.3 g/day
USDG 2010: 3 (1 oz) servings/day (85 g/day)
AHA 2020: ≥3 (1 oz) servings/day (≥85 g/day)
2.5 (50 g)±0.25 servings/day (100±12.5 g/day)
Seafood (100 g/serving)↓ CHD, ↓ stroke3 servings/day (fatal CHD)
≥5 servings/week (total stroke)
Top 3 countries:
Japan: 104.2 g/day
Iceland: 76.6 g/day
South Korea: 73.7 g/day
USDG 2010: 8 oz/week (226.8 g/week)
AHA 2020: ≥2 (100 g) servings/week (≥200 g/week)
3.5 (100 g)±0.35 servings/week
(350±35 g/week)
Red meats, unprocessed (100 g/serving)↑ diabetes, ↑ colorectal cancer0.19 servings/day (diabetes)
0.29 servings/day (colorectal cancer)
Bottom 3 countries:
Armenia: 15.0 g/day
Georgia: 15.0 g/day
Malaysia: 15.8 g/day
USDG 2010: 26 oz/week (737 g/week) (including meat (red and processed), poultry and eggs)
AHA 2020: none set
1 (100 g)±0.1 serving/week
(100±10 g/week)
Processed meats (50 g/serving)↑ CHD, ↑ diabetes,
↑ colorectal cancer
0.07 serving/day (CHD)
0.11 serving/day (diabetes)
0.12 serving/day (colorectal cancer)
Bottom 3 countries:
South Korea: 3.0 g/day
Iran: 3.7 g/day
China: 3.9 g/day
USDG 2010: as low as possible
AHA 2020: ≤2 (50 g) servings/week (≤100 g/week)
0
  • *For each dietary factor, the optimal consumption level was identified based both on observed levels at which lowest disease risk occurs and observed mean consumption levels in nations. We also considered whether such identified levels were consistent with major dietary guidelines.10 ,48

  • †Foods for which we identified probable or convincing evidence for aetiological effects on chronic diseases including CHD, stroke, type 2 diabetes or cancers.19 ,23 For cancers, we based our assessments on the WCRF/AICR report27 and subsequent updates.29 Based on available evidence, we identified evidence for aetiological effects on CHD of fruits, vegetables, nuts/seeds, whole grains, seafood and processed meats;3136 on stroke of fruits, vegetables and seafood;31 ,37 on diabetes of nuts/seeds, whole grains, unprocessed red meats and processed meats;32 ,38 ,39 and on cancer of fruits, vegetables, unprocessed red meats and processed meats.27 ,29

  • ‡Observed median consumption levels in population subgroups (eg, top or bottom quartile or quintile) associated with lowest disease risk in meta-analyses of prospective cohort studies and/or randomised controlled trials.

  • §Observed mean national consumption levels in the top (for protective factors) or bottom (for harmful factors) three countries as identified in our global data sources.24 ,25

  • ¶Recommended intake levels based on the USDG 2010 for a 2000 kcal/day diet,48 and on the AHA 2020.10

  • **Because not all individuals within a population can have precisely the same exposure level, the plausible distribution (SD) of optimal consumption was calculated from the average SD for all metabolic risk factors in the GBD study (10% of the mean).

  • AHA 2020, 2020 American Heart Association Impact Goals; CHD, coronary heart disease; EAC, oesophageal adenocarcinoma; ESCC, oesophageal squamous cell carcinoma; GBD, global burden of disease; MI, myocardial infarction; USDG 2010, US Department of Agriculture 2010 Dietary Guidelines for Americans; WCRF/AICR, World Cancer Research Fund/American Institute for Cancer Research.