Hell is not lakes of burning oil or chains of ice! It is poor health. And it is a hard, hard life. What perverted imagination has fed man the lie that Hell festers in the bowels of the Earth? There is only one Hell and that is poor health. However hopefully all of that will change for us islanders. The Health, Nutrition and Indigenous Medicine Ministry with support from the Food and Agriculture Organization of the United Nations (FAO) recently launched the Sri Lanka Food Based Dietary Guidelines (FBDGs). The Daily News brings to you the FBDGs that will save us islanders from this earthly purgatory that is ill health.
We are nothing without our health. We suffer when our health deteriorates. This also directly affects our mindset. Our mental health instantly suffers. What rapture we experience when we are in good health, mentally and physically!
Health depends on a proper diet and exercise. If the contents of your diet are deficient and you are physically inactive then your health suffers. Your diet is a critical component of your lifestyle. Diet is crucial when it comes to leading a lifestyle that is satisfactory and full of happiness.
Acting Director Nutrition Division of the Health Ministry Dr. Lakimini Magodarathna stated that the launch of these guidelines is a reason for jubilance, for all those who made this historic occasion a reality.
“Working on these FBDGs has been a labour of love for everyone involved. We are all very passionate about it and we have done it for all our fellow Sri Lankans. The Buddha once said – “When wealth is lost, little is lost. When health is lost, ALL is lost! Your health is your greatest asset, take care of it, like you would take care of your biggest possession.” The food that we put in ourselves can boost our immunity and prevent non-communicable diseases. The food we eat can ensure physical, social, mental and spiritual well-being for all of us. What you put into yourself is what comes out. If you eat fruits and vegetables in large quantities then your life will be a success and along with other health-conscious individuals society itself will thrive,” said Dr. Magodarathna.
She further pointed out that this information needs to be disseminated throughout society so that everyone will know the importance of cultivating healthy eating habits and having healthy lifestyles. The revised Sri Lanka Food-Based Dietary Guidelines will be published and is available to the public on the website of the Nutrition Division of the Health Ministry.
Country-specific FBDGs are one of the FAO/WHO recommended tools to improve healthy eating habits and lifestyles of individuals and populations. Sri Lanka is one of the countries to endorse the FBDGs in the framework for action agreed at the Second International Conference on Nutrition. The FBDGs are intended to establish a basis for public food and nutrition, health and agricultural policies and nutrition education programmes to foster healthy eating habits and lifestyles. The guidelines provide advice on foods, food groups and dietary patterns to provide the required nutrients to the public to promote overall health and prevent chronic diseases.
According to the message sent by the Secretary, Health Ministry, Sanjeewa Munasinghe:
“It is well established that food-based approaches provide sustainable solutions to many nutrition problems. Hence, the FBDGs have been developed. Sri Lanka first published food-based dietary guidelines in 2002 and a revised version was launched in 2011.”
“There have been constant changes in food patterns and the lifestyles of the people. It is also important to note that there is a rising trend of overweight and obese people in the Sri Lankan population. Micronutrient deficiencies have also become a public health burden in our country. Hence it is time that a revision of FBDGs is carried out. A positive behaviour change which will result in healthier diversified diet patterns through correct food choices is the ultimate goal. In order to achieve this, a certain method has been adopted targeting different population groups.”
“As the first step, the key dietary messages have been formulated taking the latest scientific evidence into account. This will be followed by the FBDG manual. I have no doubt that these FBDG formulated by the Nutrition Division of the Ministry of Health will contribute to better health habits.”
Additional Secretary, Public Health Services Dr. L. Somatunge emphasized the idea that diet is the wellspring of a successful lifestyle. She pointed out that life is a series of challenges. However, life is more than that. Life is a series of choices and you need to make the right choices in life.
“Your diet has to be in the correct proportions. Diet and physical inactivity are the cause of many diseases. I took part in some research in 2008 and we found that 72 percent of the population did not consume enough vegetables and fruits. This is very disconcerting. And it is also alarming. After and before meals it is very important to have some fruits at the table. There are so many varieties of fruits in Sri Lanka. We have a paradise of fruits and vegetables here in our island. But unfortunately, Sri Lankans are not taking adequate amounts of these fruits and vegetables. In Sri Lanka we have a problem when it comes to non-communicable illnesses. One-third of our population is under an unhealthy diet. In the past our ancestors were very active but today physical inactivity is an aspect of modern lifestyles. This also contributes to major non-communicable diseases. Therefore, developing these FBDGs is very important,” said Dr. Somatunge.
Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy.
Somatunge pointed out that this is where the policy-makers come in. She said the policy-makers need to take all of this very seriously and take quick action. Fruits and vegetables improve the quality of life. It is vital that we educate the masses about the importance of having a healthy diet in our country.
FAO Program Specialist Tina Jayaratne read out the message of FAO Representative for Sri Lanka and the Maldives Dr. Xuebing Sun:
“I wish to commend the efforts taken by the government in fighting the Corona Virus. I also wish to commend the efforts of the Sri Lankan government when it comes to taking care of the health concerns of the Sri Lankan people. FAO is very pleased to be part of this important and landmark occasion. FAO assists member countries to develop, revise and implement food-based dietary guidelines and food guides in line with current scientific evidence. We are very pleased to partner with the Ministry of Health and make the FBDGs a reality. In today’s context these FBDGs are vital to development,” said Dr. Sun.
In his message he went on to say that Sri Lanka is a country that is facing a triple burden of malnutrition – from staggering rates of stunting and wasting among children, micronutrient deficiencies and obesity especially among women of the reproductive age. The causes of malnutrition are complex and multi-layered. Diet is one of the single most important contributors to malnutrition. These food-based dietary guidelines can favourably impact diets and the food systems in Sri Lanka, from production to consumption.
“FBDGs tackle so many subjects including nutrition educational policies. FAO in partnership with the Health Ministry has included a formation of a working committee conducting research and uncovering scientific evidence. Ink on paper is not enough. These FBDGs need to reach the public, so that all Sri Lankans can enjoy a healthy and full life. So they may live life to the fullest – continually reaching out for newer, richer, deeper, life-changing experiences. FAO has facilitated the development of an action plan because the implementation of these FBDGs is so important. A monitoring and evaluation framework is necessary so that these guidelines will be periodically reviewed to monitor its progress. It ensures that the guidelines have to be in line with the nutritional situation in the country. Educational awareness is so important when it comes to empowering the public about food systems. We are supporting the Ministry of Health to develop a behaviour change communication strategy when it comes to FBDGs. We also appreciate our partnership with the Health Promotion Bureau the pioneers in the field of public health communication,” stated Dr. Sun.
He went on to say that the Bureau is committed to aligning the FBDG strategy with the national health communication plans. Together with the Health Promotion Bureau, information, education and communication material (IEC), nutrition and education toolkit and a media campaign are being formulated currently.
“Also an FBDG manual and a module are in the plans. The module will be used to train master trainers and be used in capacity building programmes in order to disseminate and share messages to the public. The successful implementation of the FBDGs depends on the will of the Sri Lankan people as they cannot be forced. FBDGs will be a guideline to the Sri Lankan people and all people involved in the health sector,” said Dr. Sun.
Dr. Sun concluded that the FAO wishes to continue its partnership with the Health Ministry.
In her address, Public Health Services, Health Ministry Deputy Director General, Dr. Susie Perera said that she was speaking from her heart.
“These FBDGs have been the result of dedication, passion, desire, and commitment. It is amazing and humbling. So many experts have been involved in this endeavour. Because of Covid-19 there were setbacks but I also think that in relation to Covid-19 we have done well. I must say that the FAO also responded which was really great. This initiative is one that will have a far-reaching impact. We need to disseminate this work in the spirit of which it was created in. I am not talking out of a script, but I am talking from the bottom of my heart. A lot of work has happened here and I would like to see that this work is implemented. We need to appreciate that. I feel that we all need to make full use of this. This is a massive window of opportunity that we have with us though Covid-19 casts a shadow. I feel that change we are looking for has to come from the youth. It needs to go to the many communities in Sri Lanka. So reaching out and empowering is important. Let this not be a document to be shelved,” said Perera.
Consultant Community Physician, Nutrition Division, Health Ministry Dr. Anoma Basnayake stated that uninformed choices and bad eating habits are injurious to our health. Health is very much dependent on our habits and behaviour. This is why food-based dietary guidelines are paramount.
“These guidelines have been carefully planned and a lot of thinking has gone into it. These guidelines are based on hard facts and evidence, and not hearsay. It has scientific basis. We know that attitudes are hard to change but they must change if we are to cultivate proper eating patterns. This culturally sensitive approach and information will help Sri Lankans to make the choices they need to make when eating. It is important that we are robust and healthy in order to lead happy lives,” said Dr. Basnayake.
She then outlined the work that went into making these FBDGs. As mentioned by the other speakers, Sri Lanka for the first time ever launched food based dietary guidelines in 2002 and a revised version was launched in 2011. So in 2020 this year they have revised it again. It has been almost a decade after the second revision. Requesting assistance from the FAO was a pivotal move and they selected a consultant to review the FBDGs. Then they formed the FBDG steering committee and a technical working group and the review of the FBDG was done by the Nutrition Society of Sri Lanka as consultants. They then submitted a technical recommendation report. The technical recommendations were field tested to see if those recommendations hold water.
“After that, consultative meetings were held with multi-sector working groups and all the relevant nutrition-related sectors such as the health sector, education, agriculture, livestock, fisheries and trade. “There were several rounds of consultative meetings and we drafted the FBDGs 2020. Then we translated the FBDGs agreed by experts into easily understood messages for the public. Some creative young people from a PR agency also helped out. The Health Promotion Bureau also supervised and helped out with all these messages,” said Dr. Basnayake.
Dr. Basnayake said that these messages need to be disseminated and for that they need all the support they can get. She points out that as responsible community members it is our social responsibility to spread the knowledge but more importantly spread the love! The response needs to come from the community.
“Our recommendation is to take at least two fruits daily which amounts to 14 fruits a week. Unfortunately, many Sri Lankans do not come even close to this. Also, I wish to highlight the fact that 27 percent of adults in Sri Lanka are constantly eating processed food. This is very unhealthy. One-fourth of males and one-third of females in Sri Lanka are obese and overweight,” pointed out Dr. Basnayake.
In an adolescent health survey done in 2016, it was found that 20.4 percent of adolescents had not had their breakfast before going to school. Another recommendation by Dr. Basnayake is that we should all take green leafy vegetables during every meal. Thirty-seven percent of adolescents watch TV for more than two hours which is an example of sedentary behaviour. Therefore, they are inactive and may get non-communicable diseases in the future. Among adults more than 50 percent of our population add salt to rice when they are cooking. It is highly unhealthy and may cause high blood pressure. Also, only 46 percent of married women have normal BMI.
“So these guidelines are valuable to healthcare professionals when they treat their patients. These are one of the many benefits. The reason for this is that non-communicable diseases are very real and frightening. Also in these guidelines are the recommended food groups for Sri Lankans. It also details the recommended servings of these food groups and what foods should be limited and what foods should be increased in our diet,” added Dr. Basnayake.