Why do we study the consumption of nuts and seeds according to guidelines?

• A balanced diet plays an important role in maintaining and promoting health. The Superior Health Council provides food-based dietary guidelines [2] tailored to the Belgian population, aiming to reduce illness, premature death, and the overall disease burden caused in part by unhealthy eating habits.

• Nuts and seeds mainly contain mono- and polyunsaturated fatty acids, protein, fibre, magnesium, potassium, selenium, zinc, vitamin E and bioactive products such as polyphenols and phytosterols. The composition in terms of these nutrients is very different between types of nuts and seeds.

• Regular nut consumption is associated with reduced risks of cardiovascular disease, total mortality, and cancer mortality, as well as improvements in cardiometabolic factors like body mass index and blood pressure.

• The Superior Health Council recommends that adults eat 20-30 g of unsalted nuts a day. This is about one handful. This recommendation does not include seeds.

How do we study the consumption of sugar-sweetened beverages?

• Trained interviewers conducted two non-consecutive 24-hour dietary recalls to record all the foods and drinks participants had consumed on the previous day. These recalls were carried out in a standardised manner using a specialised computer program (GloboDiet®).
• The intake of nuts and seeds was assessed as habitual intake (also known as usual or long-term intake), representing the average daily intake over the long term. This method accounts for natural day-to-day variations in what and how much people eat, offering a more accurate picture of typical dietary habits over time. This is particularly important when evaluating whether a population meets dietary recommendations. All intakes mentioned in the results below refer to the mean habitual intake, unless stated otherwise.
• The statistical tool Statistical Program to Assess habitual Dietary Exposure (SPADE) was used to estimate habitual intake distributions based on the short-term data collected through the 24-hour dietary recalls.
• In addition to the 24-hour recalls, respondents (or parents in the case of children) completed a food frequency questionnaire: they were asked to indicate how often they consumed a specific food or food group in the last 12 months. The response options were: Never, less than 1 time per month, 1-3 times per month, 1 time per week, 2-4 times per week, 5-6 times per week, 1 time per day, 2-3 times per day, more than 3 times per day.
• The proportion of the population that never eats nuts or seeds was assessed and is presented on this page together with the mean habitual intake. Year comparisons were not possible due to the absence of comparable food groups in the food frequency questionnaire of the previous survey conducted in 2014-2015.
• The mean habitual intakes of nuts and seeds by education, by region and by year are not available due to an insufficient number of participants with intake on both days in certain subgroups.
• The detailed methodology can be found here [3].

What did we include as “nuts and seeds”?

• The habitual intake of nuts and seeds was calculated by including unsalted uncoated nuts and seeds and 100% nut or seed spreads without additives. Salted and shelled nuts or nuts in ready-to-eat foods (such as breakfast cereals or nut bars) were not included.
• However, due to a lack of scientific data on the recommended amount of seeds to eat, only nuts (i.e. unsalted uncoated nuts and 100% nut spreads without additives) were considered when calculating the proportion of the population meeting the guideline.
• The proportion of the population that never eats nuts or seeds, was calculated based on the answers to the following food frequency questionnaire items:
  • Nuts (almonds, peanuts, etc.) and seeds (sunflower seeds, sesame seeds, pine nuts, etc.);
  • Spreads based on nuts and seeds such as peanut butter, tahini, etc.