New national health guidelines: Children under 2 should not eat foods with added sugar

According to the latest advice from the Estonian National Institute for Health Development (TAI), honey is not recommended, potatoes should be eaten after peeling them and there is no safe level of alcohol consumption. According to the TAI's guidelines, children under the age of two should not be given any foods containing added sugar, nor should they be allowed to spend time in front of screens.
The TAI has published updated version of its national recommendations for best practice regarding diet, physical activity and sleep.
In particular, the TAI recommends children under the age of two should not be given any foods containing added sugar.
Children aged 3 to 6 are recommended to eat a maximum of two pieces of chocolate or one candy bar a day, though on the proviso that no other sweet or savory treats or sweetened dairy products will be consumed. From the age of 11 years onwards, children can eat a maximum of four biscuits, three chocolates or candies or drink 400 milliliters of sweetened drink per day.
Tagli Pitsi, an expert at the TAI's nutrition and physical activity department, as well as head of the working group for updating the recommendations, told ERR that there have been some changes from those the TAI published in 2015.
The recommended daily intake of nuts has increased for example. Previously it was considered reasonable to eat one to two tablespoons of nuts a day, while now that amount has been revised to two to three tablespoons.
However, the advice is stricter for jams and honey.
"It's not quite the case that you can't eat them at all. These are all the kind of added-sugar products that should be off limits for children under two, but from then on you just have to be very moderate. On the one hand, there is the added sugar, which should be cut down in order to reduce its impact on health, and on the other hand, when it comes to products with a lot of sugar in them, they have been heavily processed and heated," explained Pitsi.
He added that foods like this are very low in vitamins and minerals but do provide energy. He recommends putting berries in the freezer instead of using them to make jam.
TAI recommends gradual improvement in diets
Asked whether overly strict dietary advice might have the opposite effect on people if they see it as too difficult to implement, Pitsi said a better approach is to make gradual improvements
"It doesn't mean that tomorrow I'm going to change my whole diet, but I'm going to look at what the things are I can manage. Can you replace your soft drink, your juice, with water? Can you put a few more vegetables and berries on your table, can you cut down a bit on the amount of sausages or ham?"
Pitsi added that instead of having huge portions, people could limit themselves to a smaller amount and also make changes to recipes, such as reducing the amount of sugar, or replacing some of the flour with oatmeal or adding nuts.
He also pointed out that a gradual change can make things more palatable and that no one can be forced to follow the TAI's guidelines. However, doing so will certainly ensure better health for individuals in the long term.
Mayonnaise is also rated badly in the TAI's dietary recommendations, despite mostly consisting of oil and eggs, both of which are considered fine in moderate amounts. The reason given by Pitsi is that mayonnaise is generally industrially produced and therefore considered to be an over-processed food, which can be high in additives.
Whereas in the past it has been said that potatoes can be eaten with their skins on, the new guidelines state that potatoes ought to be peeled.
"This is more to avoid microbiological contamination. Maybe also the fact that sometimes the potatoes have turned a bit green, so [peeling ] might take a bit of the solanine layer from them," said Pitsi.
At the same time, that advice does not apply to French fries. The reason for this, Pitsi said, is that preparation is crucial. However, eating 100 grams of deep-fried fries means someone has already almost reached entire recommended daily fat intake.
Pitsi stressed that there is no direct instruction to stop eating French fries, but people should exercise restraint and instead look to get their necessary fat from other food groups where possible.
Afternoon naps recommended for over 55s
The TAI's recommendations for meat consumption have not changed: it is still considered best to eat meat as little and as rarely as possible. However, as a supplement, the TAI points out that when consuming such products, preference should be given to those with a higher protein content and a lower saturated fat and salt content. The same advice applies to fish products.
"We continue to emphasize the need to reduce the intake of red meat and meat products, for health reasons in particular. On the other hand, as more and more of the recommendations are also trying to take into account environmental sustainability, our red meat recommendations are being made with this in mind, but we make sure that, on the other hand, people's health does not suffer because red meat and meat products in general are also an important source of iron and protein. We cannot make a recommendation beneath the lower limit," said Pitsi.
When it comes to alcohol, the TAI's recommendations are resolute. "There is no safe level of alcohol consumption," the document states.
Pitsi pointed out however, that work on the alcohol chapter is still ongoing, as so far only a table book has been published. A book of recommendations with additional explanations that is set to be published later this year will include more specific information on alcohol.
"Therefore, we couldn't come up with highly accurate numbers that could be released, but there are definitely two overriding messages: there is no safe level of alcohol consumption from a health point of view, and alcohol should definitely be avoided by minors, as well as women who are pregnant or breastfeeding," said the TAI representative.
The institute also highlighted recommendations regarding safe amounts of screen time. Sedentary workers ought to take a break for stretching at least once an hour and lift their eyes away from their computer screens.
"This is very important. Exercise should be regular, which doesn't mean that I am able to meet my exercise recommendations if I sit for a whole week and then go to the gym at the weekend. Instead, we would like to see this recommended amount spread out relatively evenly over the week, so that there is at least some kind of brisk walking every day and there could be about 150 to300 minutes of moderate intensity activity or 75 to 150 minutes of high intensity activity over the course of a week," said Pitsi.
The recommendations suggest that people over 55 should take a half-hour nap during the day. However, Pitsi pointed out that this is only a recommendation and employers cannot be required to provide the option to do so. Regarding daytime naps for children, the TAI says that for three to five-year-olds, the individual needs of the child ought to be taken into account.
For children up to the age of two, the TAI believes screen time should be avoided altogether. The recommendations apply to any type of screen time, including the use of mobile phones, televisions, computers, tablets and more. From the age of two up until children attend school, the maximum amount recommended is 60 minutes of screentime a day, though less is always better.
The 2024 dietary recommendations are common to all Nordic and Baltic countries and, as in previous years are derived from the recommendations prepared by the Nordic Working Group.
In addition to the Nordic recommendations, the Estonian national dietary recommendations have also been developed based on, among other things, the eating habits of the Estonian population, the availability of food and the sustainability of the environment. Estonia's updated national dietary recommendations are also based on the World Health Organization (WHO) 2020 guidelines.
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Editor: Karin Koppel, Michael Cole