Food-based dietary recommendations

Individuals with health challenges or certain illnesses may need more specific advice and support for their eating habits. Nonetheless, the recommendations can likely support treatment for the most common non-communicable diseases (e.g., cardiovascular diseases, certain cancers, and type 2 diabetes).

More specific dietary recommendations are given for pregnancy and breastfeeding, for children under the age of 2, and for older adults The recommendations may also need to be adjusted due to unusual stress factors, such as illness, elite sports participation, allergies, and intolerances. In some cases, individuals are advised to seek personalized nutrition counselling from a licensed nutritionist or dietitian.

FBDG and DRV´S for nutrients serve various purposes, including:

• Guidelines for planning menus for groups of people, e.g. school meals or at workplaces, for food producers and those in charge of nutrition education.

• Criteria for evaluating the intake of nutrients among groups or nations.

• Serving as a basis for policymaking in food and nutrition, such as public health strategy and health promotions in the communities.

• Following dietary guidelines helps ensure that your body receives the nutrients it needs and contributes to good health and well-being. Following dietary recommendations can also reduce the likelihood of chronic diseases and contribute to a healthier body weight.

• No single food or food group can provide all the nutrients your body needs, and there is no need to exclude certain foods. Dietary guidelines emphasize the importance of a varied diet and offers guidance on which foods to prioritize and which to limit. Most people should be able to adapt the recommendations to their own needs and preferences.
  

• Dietary guidelines, also known as food-based dietary guidelines, translate scientific knowledge about the need for individual nutrients into simple advice on food choices. Since people consume foods containing a mix of nutrients rather than individual nutrients, these guidelines are designed to simplify food choices.

• Consumers do not eat individual nutrients but rather foods that contain a variety of nutrients. Therefore, they should not have to count specific nutrients but instead follow simple guidelines for food selection.

• By following dietary guidelines, there is a good chance that the need for individual nutrients will be met.

The recommendations are based on the Nordic Nutrition Recommendations from 2023 along with other research on the relationship between nutrition and health. They also take into account results from national dietary surveys of Icelanders, both children and adults.

Experts from the Directorate of Health, in collaboration with an advisory group of professionals, have developed these recommendations.

Dietary guidelines from other countries:

Denmark

• De officielle kostråd

• DTU – Publikationer om ernæring

Norway

• Dette bør du spise – nye nasjonale kostråd fra Helsedirektoratet i Norge

• Plakater og annet materiell (imageshop.no)

• Informasjon til befolkningen på helsenorge.no

Sweden

• Dietary guidelines are under revision, see on Swedish Food Agency website: Livsmedelsverket

• The recommendations are based on strong scientific evidence that shows that a high consumption of a wide variety of vegetables, fruits and berries reduces the risk of cardiovascular diseases, various types of cancer and overall mortality.

• If the current consumption is low, aim to reach 500 grams per day can be set.

• People who already consume about 500 grams daily can gain additional health benefits by increasing their intake to 800 grams per day.

However, the following items are not included in the recommended 5–8 servings per day: potatoes, fruit juices, nuts, and dried fruits. Below, you can find explanations of this:

• Potatoes - Although potatoes are not included in the "5-8 a day" recommendation, they can still be part of a healthy diet. Potatoes are often consumed as a side dish, like barley, rice, or pasta, and are more frequently classified as grains as shown in the Dish model and the food circle.

• Legumes - Are classified as sources of protein as they are high in protein and can replace meat.

• Fruit juice: A small glass (100 ml) of pure fruit juice can be part of a healthy diet for individuals aged two years and older, but it is not included in the recommendations for fruits, vegetables, and berries. Eating whole fruit is preferred over drinking juice because juices contain little or no fiber, causing the natural sugars to enter the bloodstream more quickly. This results in less satiety compared to consuming whole fruits. The same applies to homemade juices. "Smoothies" and "boosts" made from fruits and vegetables, where the fiber is retained and all nutrients are included, can, however, be considered part of the recommended intake of vegetables, fruits, and berries.

• Nuts and dried fruits – Nuts are now classified as sources of healthy fats (unsaturated), which is preventive for cardiovascular diseases. It is recommended to consume 20–30 grams of unsalted nuts daily. Both dried fruits and nuts serve as excellent alternatives to candy and other sweet treats. However, they are energy-dense foods, containing significantly more energy than fresh fruit.

• No not exactly. Children are also encouraged to eat 5–8 portions per day, similar to adults, but there is no standardized portion size defined for children. The rule is that a child's handful is considered one portion for children under 10 years old.

• Coarse vegetables include examples such as broccoli, cauliflower, cabbage, kale, and root vegetables like carrots and beets. They are naturally high in fiber and have a long shelf life.

• Fine vegetables, on the other hand, include examples like tomatoes, lettuce, cucumbers, and peppers which contain less fiber.

• Yes, there is a distinction between fruit juice and whole fruit in dietary recommendations.

• Fruit juice is not included in the recommended intake of vegetables and fruits. Eating whole fruit is preferred over drinking juice because juices contain little or no fiber, causing the natural sugars to enter the bloodstream more quickly. The fructose in fruit juice is classified as free sugar, which is associated with health risks such as metabolic disorders, hyperlipidemia, and obesity.

• However, a small glass (100 ml) of pure juice per day can be part of a healthy diet for individuals aged two years and older. This does not apply to other fruit drinks that contain added sugars or sweeteners.

Whole grain products refer to products where all parts of the grain, are used in the production process, i.e., bran (husk), endosperm (seed white or starch), and germ. The grain may either remain whole or ground into a coarse flour but cannot be sifted. In whole grain products, all parts of the grain are present in the same proportions as in the original grain. Therefore, whole grain products contain all the nutrients of the grain.

High consumption of whole grains and whole grain products reduces the risk of cardiovascular diseases, type 2 diabetes, and colon and rectal cancer.

Examples of whole grain products include

• Whole grains such as wheat, rye, barley, oats, and maize, either whole or ground

• Various types of bread, such as rye bread, whole wheat bread, whole grain flatbreads, and crispbread

• Porridges, such as oatmeal and barley porridge

• Whole wheat pasta

• Whole grain rice

• Whole grain bulgur

• Certain types of muesli and breakfast cereals

Examples of how to meet the recommendation for whole grain

• One serving of oatmeal (1 dl of oats) and 2-3 slices of whole grain bread or whole grain pasta (75 g dry weight).
  
  

The health effects of carbohydrates in the diet are related to the quality and source of the carbohydrates. It is recommended that we get carbohydrates primarily from whole grain products, whole fruits, vegetables, legumes (beans and lentils), nuts, and seeds. Research on diet has shown that total carbohydrate intake between 45-60% of energy, is associated with a lower risk of chronic diseases and lower mortality rates, especially if the quality of carbohydrates is good (fiber-rich carbohydrate sources). The appropriate range for total carbohydrates depends on various factors such as the quality of carbohydrates, and the quantity and quality of fatty acids in the diet. Just as the quality of fat is important, it is also important to consider the quality of carbohydrates and the amount of dietary fiber. Recommendations for fiber and carbohydrate intake (with low consumption of free sugars, including added sugars) should be met with a diet rich in plant-based foods high in fiber and whole grains.

Dietary Fiber

• Adults: At least 3 g/240 kcal (3 g/MJ). Based on reference values for energy, this corresponds to at least 25 g/day for women and 35 g/day for men.

• Children: A consumption corresponding to 2-3 g/240 kcal is recommended for children from the age of two years.

When children reach school age, fiber intake should gradually increase, aiming to meet the adult recommendations by the teenage years.

• A high intake of fish is associated with a reduced risk of cardiovascular diseases, Alzheimer's disease, cognitive decline, and premature mortality. These benefits are among other things due to the rich omega-3 fatty acid content found in fatty fish. Fatty fish is also a good source of vitamin D. Fish, is also a good source of protein and provides essential nutrients, including selenium and vitamin B12. White fish, in particular, is known to be iodine rich.

• When choosing fish products, it is advisable to select those with a high fish content and low salt levels. For salt-rich processed fish products, such as smoked, salted, or cured fish, it is recommended to consume them in moderation.

• Fatty fish, such as salmon, trout, mackerel, or herring, contains a high amount of polyunsaturated fats that are beneficial for health and can reduce the risk of cardiovascular diseases, particularly long-chain omega-3 fatty acids like EPA and DHA.

• For most people, it is generally safe to consume the fish available in Iceland.

• However, pregnant women are advised to avoid eating raw fish; see the booklet Diet during pregnancy. It is also important to note that certain marine products can accumulate contaminants, such as heavy metals and persistent organic substances like PCB’s. Pregnant women, breastfeeding mothers, and women planning to have children are advised to avoid these specific products, see the booklet Diet during pregnancy. Pregnant and breastfeeding who follow a vegan diet can access recommendations on the web.

• Red meat refers to meats such as lamb, beef, pork and horse meat.

• Processed meat refer to meat products that are smoked, salted or preserved with nitrate or nitrite. Examples include salted meat, bacon, pepperoni, sausages, salami, smoked meat and ham.

• Red meat and processed meat products are a risk factor for colon and colorectal cancer. Processed meat products have been classified as carcinogens and red meat is classified as a probable carcinogen.

• High consumption of red meat and processed meat products has also been linked to an increased risk of cardiovascular disease.

• Yes, it is okay to replace milk and dairy products with plant-based drinks that are fortified with calcium and preferably also vitamin D, B12, riboflavin and iodine.

• It is important for older people to ensure sufficient protein intake, so the best option for plant-based milk in such cases is vitamin- and mineral-fortified soy milk.

• It is not recommended to give rice milk to children under six ears old due to its arsenic content.

• Not everyone needs to drink milk. Instead of drinking milk, you can consume fermented dairy products and also cheese, as well as plant-based milk, which is fortified with vitamins and minerals. About 15 grams of cheese equals about 100 millilitres (1 dl) of milk. One slice of cheese in a cheese package weighs about 20 grams.

• If milk and dairy products are not part of the diet, you need to make sure you get enough calcium, iodine and vitamin B12. Older people need to ensure sufficient protein intake.

• Healthier fats refer to soft or unsaturated fats found in the diet. Increasing the proportion of these fats at the expense of hard or saturated fats can help reduce the risk of cardiovascular diseases. This can be done by limiting the consumption of biscuits, cakes, sweets and snacks, replacing fatty meat and fatty dairy products with lower-fat products and using liquid vegetable oils instead of margarine and butter when cooking.

• It is possible to increase the proportion of softer fats in the diet by eating fatty fish, (such as salmon, trout, halibut, mackerel and herring), nuts and seeds, among other foods. However, it is not desirable to replace foods high in saturated fat with refined carbohydrates, such as sugar and white flour.

• Soft fats are primarily found in plant-based foods and fatty fish. The softer the fat is at refrigerator temperature; the more unsaturated fat is in the product. Soft or unsaturated fats can be either monounsaturated or polyunsaturated. Hard fat mainly refers to saturated fatty acids.

• The quality of the fat is important, and the risk of cardiovascular disease can be reduced by replacing some saturated fat with monounsaturated and polyunsaturated fatty acids.

• This can be done by limiting the consumption of biscuits, cakes, sweets and snacks, replacing fatty meat and dairy products with low-fat products and using liquid vegetable oils instead of margarine and butter in cooking.

• The proportion of unsaturated fats can be increased by eating oily fish, nuts, and seeds regularly. In general, Icelanders consume more than enough saturated fat, and most people should consider moderating their intake.

• In general, nutritional requirements can be fulfilled by a varied and well-balanced diet. However, Icelanders are advised to take vitamin D as a food supplement, such as fish oil, fish oil pearls, vitamin D tablets, vitamin D drops, or vitamin D sprays. Certain groups of people may need supplements; for example, women who may become pregnant are advised to take folate and continue to do so until week 12 during pregnancy.

• Individuals with very low energy intake may be in need of supplements. Very low energy intake is defined as energy intake below 1500 kcal/day and is associated with a significant risk of vitamin and mineral deficiencies.

• Similarly, those who, for various reasons, exclude certain food groups from their diet might also need supplementation. For example, those who exclude animal products from their diet need to take vitamin B12. Additionally, some nutrients may be necessary when undergoing treatment with specific medications, as prescribed by a doctor.

• There is no conclusive evidence that consuming nutrients in supplement form reduces the risk of chronic diseases. On the other hand, numerous studies indicate that excessive intake of certain supplements, particularly antioxidants, may have adverse health effects. Upper intake limits have been established for many vitamins and minerals, based on the amount that is considered safe for daily consumption over a long period and is unlikely to have negative health effects.
  

• Vitamin D is found in only a few common foods. It is most abundant in fish oil, fatty fish, egg yolks, vitamin D-fortified dairy products and other vitamin D-fortified products. The body also produces vitamin D in the skin through exposure to ultraviolet (UV) rays from the sun. However, in Iceland, sunlight is insufficient for vitamin D production during the winter months. To maintain good vitamin D levels, it is essential to take vitamin D as a supplement, such as fish oil, fish oil capsules, vitamin D tablets, vitamin D drops, or vitamin D sprays.

• See more information about vitamin D and information about dietary reference values for vitamins and minerals.

• Research findings suggests that the current recommended intake is optimal, and that there is no need to change it.

• Yes, you still need to take additional vitamin D as a supplement. One glass of vitamin D-fortified low-fat milk or Fjörmjólk per day provides 2 micrograms of vitamin D, and one 200 grams serving of salmon per week provides about 22 micrograms, or a total of 3,4 micrograms in average of vitamin D per day.

• For individuals aged 10–70 years, the recommended daily intake of vitamin D is 15 micrograms (600 international units, IU) per day. This recommended intake is based on maintaining adequate blood vitamin D levels, not on correcting a deficiency. According to the results of a national dietary survey from 2019–2021, Icelanders get an average of 4–5 micrograms of vitamin D from food per day, depending on age.

• See more information about vitamin D and information about dietary reference values for vitamins and minerals.

Yes, vitamin D is a fat-soluble vitamin that can accumulate in the body leading to increased concentration of calcium in the blood. This can cause fatigue, muscle weakness, irregular heartbeat, calcification of soft tissues, kidney stone formation, and impaired kidney function. There is no proven benefit taking doses exceeding 10–20 micrograms per day (400–800 IU) for healthy individuals with sufficient vitamin D levels in their blood. However, these doses are necessary for maintaining bone health and other bodily functions.

The upper intake limits

• 25 micrograms (1000 IU) per day for infants under 1 year of age

• 50 micrograms (2000 IU) per day for children 1–10 years of age

• 100 micrograms (4000 IU) per day for adults.

Doses exceeding these upper limits should only be taken under the supervision of a doctor, nutritionist or dietician.

See more information about vitamin D and information about dietary reference values for vitamins and minerals.

• Vitamin B12 is naturally found only in animal products. The main sources are meat, eggs, dairy products, fish, and liver. If the consumption of animal products is very limited or absent, you should choose plant-based products fortified with B12 and take a B12 supplement. This is especially important for vegans and older adults.

• It is recommended to reduce salt intake (NaCl) intake to no more than 6 grams per day for adults. This corresponds to 2,4 grams of sodium per day.

• For children aged 2 to 9 years, salt intake should be limited to 3–4 grams per day.

• Processed foods are often high in salt, such as processed meat products, packaged soups and sauces, snacks, ready-made meals, fast food, cheese, and bread.

• It is recommended to check nutrition labels and choose lower-salt options whenever possible. As a general guideline, a product is considered high in salt if it contains 1,25 grams or more of salt per 100 grams of the product.

• By choosing minimally processed foods and products with low salt content.

• Limiting the use of salt in cooking and at the table also helps.

• Salt intake can be gradually reduced, and a variety of other spices and herbs can be used to enhance flavour.

• Additionally, it is recommended to choose products labelled with the Keyhole symbol whenever possible, as they contain less salt.

• Sports drinks can be high in salt, as they, contain quite a bit of sodium. Various powders that are dissolved in water can also contain sodium salts. Excessive use of such products should be avoided. However, in certain situations, they can be beneficial, such as during prolonged training or competition, or when exertion is very intense and/or in high temperatures.

• Foods that contain salt can also help replenish sodium lost during intense exercise (soups, various cereals, cheese, etc.)

• Consumption of sugar-rich products, including soft drinks, can increase the risk of obesity cardiovascular diseases and tooth decay.

• Additionally, high consumption of sugary soft drinks can increase the risk of type 2 diabetes.

• Consumption patterns may also play a role, it appears that the body’s metabolism responds differently depending on whether sugar is consumed in small amounts throughout the day or in large quantities over a short period, as can happen when consuming sugary soft drinks.

• Furthermore, sugary soft drinks provide little to no essential nutrients and can replace healthier, more nutritious foods.

• Added sugars refers to sugars that is added into foods and drinks during production. This includes sucrose (table sugar), fructose (fruit sugar), glucose, glucose syrup, and fructose syrup.

• In addition to added sugar, sugars that naturally occur in honey, syrups, fruit juice, and fruit concentrates are classified as free sugars.

• It is not recommended to choose products with non-sugar sweeteners over those with added sugar. Research results indicate that high consumption of drinks containing non-sugar sweeteners can increase the risk of type 2 diabetes and cardiovascular disease. Additionally, like sugary drinks, beverages with sweeteners often contain acids that can erode tooth enamel.

• Dairy products: Unsweetened or low-sugar dairy products are preferable to those containing sweeteners.

• Sodas and energy drinks: Consumption of drinks with sugar or sweeteners such as soft drinks, energy drinks, iced teas, and fruit juices should be limited. Water is the best choice, both with meals and when thirsty. Carbonated water without citric acid (E330) can also be a good option. In moderation, low-fat milk and calcium-fortified plant-based milk are also suitable choices.

The Keyhole is a front of pack labelling that can be used on the packaging of food products that meet specific nutritional criteria:

• Less and healthier fat

• Less sugar

• Less salt

• More fiber and whole grains

The Keyhole label can also be used on unpackaged fruits, berries, vegetables, potatoes, bread, crispbread, cheeses (excluding fresh cheese), vegetable alternatives to cheese, fish, and meat.

This label helps consumers to easily identify healthier food options when shopping. Products with the Keyhole label are healthier than other foods in the same category that do not meet the criteria for the Keyhole.

Keyhole labelled products are suitable for both children and adults and are intended for those who want to make healthier food choices.

For more information, see the questions and answers about the Keyhole label.