The Rasch-transformed gastrointestinal symptoms rating scale in myotonic dystrophy type 1 (RT-GSRS-DM1).

A healthy dietary pattern plays a key role in the prevention of diet-related non-communicable diseases (NCDs) and the protection against micronutrient deficiencies and their complications [,]. It is well established that these diet-related diseases and conditions derive, at least in part, from excessive intakes of some nutrients and inadequacies in others [,]. Consumers seeking evidence-based information on nutrition are often confused by the breadth of information and advice provided by different sources and sometimes even by the contradictory nature of this information []. Acknowledging that the promotion of healthy dietary patterns, instead of specific nutrients or foods, helps improve public understanding and adoption [,], the World Health Organization (WHO) and the Food and Agricultural Organization (FAO) of the United Nations advocated since 1996 for the development and implementation of food-based dietary guidelines (FBDGs) [,]. FBDGs are key tools for providing comprehensive, evidence-based recommendations for healthy eating using simple and understandable holistic diet approaches [,,]. Beyond diet, FBDGs incorporate a wider scope of dimensions, including the promotion of healthy lifestyle habits and upholding the cultural appropriateness of the recommendations [,,]. Since they serve as educational tools for diverse audiences, including the general public and policymakers [,,], FBDGs are designed to be simple, easy to understand, and practical to implement [,]. Such guidelines should also be tailored to the nutritional and health status of the targeted population and ought to be updated regularly to reflect the heterogeneity in dietary patterns observed between different countries and sometimes within the same country [,,]. Globally, more than 100 countries have developed or are currently in the process of developing FBDGs, with several having updated their FBDGs at least once []. Acknowledging the urgent need to shift to more sustainable diets and recognizing the policy and programmatic implications of FBDGs, the FAO has called for the development of FBDGs that promote healthy as well as environmentally sustainable diets []. In this context, more countries have started to incorporate sustainability considerations within their FBDGs, integrating recommendations that promote specific food practices and choices []. Such recommendations include an emphasis on mostly plant-based diets, seasonal and locally produced foods, reduction of food waste, and consumption of sustainably sourced fish, coupled with a reduction in the consumption of red meat, processed meat, and ultra-processed foods and beverages [].