Health and Nutrition Information needed for the Preparation

Health and Nutrition Information needed for the Preparation of Food Based Dietary Guidelines Lalita Bhattacharjee, NFPCSP, FAO Biplab K.Nandi, FAO RAP Food and Agriculture Organization of the United Nations Nutrition and Health are an integrated component and cannot be separated. Nutrition - Link between food, health and agriculture  Availability and accessibility to food of adequate quality,quantity & safety  Meeting human nutrient and nonnutrient requirements during the life cycle Nutrition is a link … … … FOOD HEALTH LIFESTYLE ICN, WFS and Millennium  The World Declaration on Summit Nutrition adopted at ICN (1992), affirmed that”access to nutritionally adequate and safe food” is a right of every individual The Rome Declaration on World Food Security at WFS (1996) & WFS 5:YL reaffirmed access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger”   Millennium Summit 2000 - children at the heart of poverty reduction, to halve proportion of people living on < 1 dollar/d Major nutrition related issues to be addressed  Poverty alleviation Ensuring food security Combating illness and burden of disease Overcoming gender disparity Attaining healthy environments Improving political climate Strategies for prevention and control of malnutrition based approaches  Nutrition education and communication  Food fortification  Supplementation  Community based actions  Food Importance of Micronutrients Evidence for life course approach to chronic disease prevention diets, physical inactivity and smoking are confirmed risk behaviours  Biological risk factors of HT, obesity and dyslipidemia established as risk factors for CHD, stroke and diabetes  Risk factor trends rising (especially obesity)  Unhealthy Evidence for life course approach to chronic disease prevention  Major biological risk factors emerge and act early in life  Continue to have negative impact throughout life  Affect health of next generation  Adequate/appropriate postnatal nutritional environment is important  Interventions effective, must extend beyond individual risk factors, continue throughout life Understanding of macronutrient functions (traditional and emerging) Nutrient Protein Traditional Need for indispensable and dispensable amino acids for protein synthesis Energy needs Associated with dietary fibre Emerging Bioactive peptides Carbohydrate Fermentable in large bowel; regulation of nutrient metabolism rate; associated with risk of NCDs Functions of n-3 and n-6 fatty acids; Cholesterol lowering effects of unsaturated fatty acids Fat Energy source Essential fatty acid requirements Understanding of vitamin and mineral functions (traditional and emerging) Folate Prevents macrocytic anemia Toxicity; interaction with Vitamin E Prevents night blindness, required for eye sight, growth, immunity Prevents cancer, heart disease, stroke, birth defects Antioxidant; cancer prevention Cell differentiation Embryonic development; carotenoids and health Selenium Vitamin A Zinc Poor growth Catalytic function Impaired reproduction Structural function Regulation of gene expression; anti toxicity functions Understanding of phytochemicals Food component Traditional Emerging Polyphenols Anti nutrient ↓ digestive enzyme activity ↓ protein digestion Anti oxidant Protease inhibitors Control of food intake Cancer prevention Binds bile acids; lowers plasma cholesterol Cancer prevention Saponins Anti nutrient Phytic acid Binds minerals γ- tocopherol Low vitamin E activity Not converted to α tocopherol, other antioxidant function FOOD BASED DIETARY GUIDELINES MAINTENANCE OF HEALTH DISEASE PREVENTION Rationale Address the problem solving nutrition related public health issues through culturally appropriate strategies FBDGs Translating nutrients into foods through Science Physical Activity Exercise (Deliberate, often strenuous) Activity (Unintentional) INTENT FOR DEVELOPMENT OF FBDGs Eliminate or reduce nutrition –related health problems  Practical way to reach nutritional goals of a population  Consider habitual dietary pattern  Universal tool in national food and nutrition policy development  Nutrition education for public and specific groups  Promote nutritional well being  INTENT FOR DEVELOPMENT OF FBDGs (contd.) Assist consumers in making dietary choices for promotion of well-being and disease prevention Assist governmental agencies in development of policies to guide the implementation of nutrition interventions and educational programmes Assist agencies at national and local levels in the formulation and implementation of regulatory policies and programmes that relate to food, nutrition and health Assist health care providers in primary disease prevention efforts Guide the implementation of food, nutrition, and health goals by national and international agencies Nutrition throughout the Life Cycle is vital Target population for establishing FBDGs  General : Adults  Specific : Pregnant and lactating women  Infants, young children  Elderly  Vegetarians  Disease conditions : Diarrhoea, CVD,Liver disease, renal disease  Population characteristics: Food preferences, food consumption behaviours, religious prohibitions, culture, access to food Foods to seen in total perspective  More than mere nutrients  Complex mixture of compounds with unique chemical, physical and textural properties.  Understanding of food patterns and procedures for handling foods  Understanding contribution of foods to meet dietary recommendations.  Understanding methods for evaluating the contribution of foods to meet dietary recommendations Key components of FBDGs     Emphasis on: Balance Moderation Variety of food choices  Food safety Nutrition information nutrition data-bases  Nutritional status of the population  Epidemiological and prevailing dietary intake  Dietary practices to be made available to identify current lacunae  Suggest suitable modifications  Appropriate Steps in development diet related health patterns/diseases/mortality  Review food consumption patterns  Identify linkages between diet and health/disease  Verify extent to which problem is diet related  Review Steps in development (contd.) national and population frameworks that affect occurrence and prevention of problems  Determine health conditions, disease patterns, nutrient deficiencies/imbalances  Define content and target groups for FBDGs  Define purpose/goals/targets of FBDGs  Examine Aspects related to chronic disease chronic diseases will be manifested in later stages of life  Absolute benefit for ageing individuals/populations : in changing risk factors  Adopting health promoting behaviours (exercise, healthy diets)  Maximize health by avoiding /delaying preventable disability  Most FBDGs to address 3 mutually reinforcing strategies and most immediate impact is to address risk factors in adulthood and elderly  Need to be expanded as an integral part of any intervention (e.g. reduce intake of soft drinks, high energy diets)  Targeted and potentially more costly ( addresses burden of disease, vulnerable groups, etc.)  Greatest Consumer education : FBDGs Food Based Dietary Guidelines should be used to teach the population about the importance of dietary variety and micronutrient-rich foods Consumer education : FBDGs  The combination at the same meal of vitamin C rich foods and iron-rich vegetable-based foods needs to be encouraged;  Consumption of animal foods, even in small quantities, needs to be promoted;  Drinking coffee and tea only between meals Food Safety Concerns and FBDGs Contaminants  Contaminants entering the food chain from the environment  Residues of substances used in agricultural production and processing systems  Microbiological Food Safety Concerns in Developing Countries and FBDGs food control systems  Lack of basic hygiene in food handling  Food adulteration is widely practiced  Uninformed consumer  Limited participation in international standard setting work  Difficulty in meeting international standards or standards of importing countries  Inefficient Substantiation of nutrition/health claims Policy implications FBDGs need to be integrated & implemented as a component of national developmental multi sectoral policies Issues :  Agriculture  Environment  Trade  Health  Nutrition Technical solutions Multisectoral solutions Accessible solutions The technical solutions  SUPPLEMENTATION: side effects and compliance problems  FORTIFIED FOODS: costs for manufacturing, labelling, distribution and monitoring;  IRON-RICH (NON-FORTIFIED) FOODS: limited bioavailability of Fe in many foods  INTEGRATED approaches: all the above, linked together with Food Based Dietary Guidelines and consumer education programmes THANK YOU FOR YOUR ATTENTION !