development of food- based dietary guidelines carmen dardano food and nutrition officer/ nutrition...
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Development of Food-Development of Food-Based Dietary GuidelinesBased Dietary Guidelines
Carmen Dardano Carmen Dardano
Food and Nutrition Officer/ Nutrition Food and Nutrition Officer/ Nutrition Education and Consumer protection DivisionEducation and Consumer protection Division
OutlineOutline
• What are Dietary Guidelines?• Process for Developing Food-Based
Dietary Guidelines• The Way Forward
What are Dietary What are Dietary Guidelines?Guidelines?
Assist population in following nutrition and related health recomendation
Guide to daily food choices
Guide for healthy eating
A tool for :nutrition educationBehavior change
Food-Based Dietary Food-Based Dietary GuidelinesGuidelines
• Convert scientific knowledge into practical messages
• A major strategy for:– Promoting healthy behavior and
practices– Promoting nutrition education– Helping public make healthy choices– Guiding Food and Nutrition policies
Dietary RecommendationsDietary Recommendations
RDAs: Nutritional and energy requirements and recommendations– Developed for specific populations based
on scientific knowledge
– Speak to nutrients- Calories, Protein, Fat
Form the basis for Dietary Guidelines
Food-Based Dietary Food-Based Dietary GuidelinesGuidelines
• Developed for the general population
• Directed towards the healthy segment of the population
• Not directed to persons already afflicted with health conditions
Process for Developing Food-Process for Developing Food-Based Dietary GuidelinesBased Dietary Guidelines
Steps for Preparing Dietary Steps for Preparing Dietary GuidelinesGuidelines
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
• FORMATION MULTI-SECTORAL National Committee on FBDG– Ministry of Health– Minsitry of Education– Ministry of Agriculture– Ministry of Social Development – Ministry of Economy– Private sector: university, consumer
group, food industry
PLANNING
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Characterizing the Target Characterizing the Target GroupGroup
• Situation health and nutritional status of the group
• Group’s access to food, eating habits, socio-cultural characteristics
• Based on review of existing surveys, reports, publications
• Problems prioritized in terms of scope, feasibility of solving, and impact
TABLE OF CONTENTS OF THE DIAGNOSIS
DOCUMENT
I. INTRODUCTION
II. RISK FACTORS AND PROBLEMS ASSOCIATED WITH DIET
A. Epidemiological Profile
1. Changes in morbidity rates
2. Nutritional status
B. Education of the population
C. Foods
1. Availability
2. Accessibility
3. Consumption
4. Composition
D. Eating habits
1. Distribution
2. Classification
3. Acquisition
III. CONCLUSIONS
IV. PRINCIPAL PROBLEMS IDENTIFIED
DECISION MATRIXDECISION MATRIXPRIORITIZATION OF FOOD AND NUTRITION PRIORITIZATION OF FOOD AND NUTRITION
PROBLEMSPROBLEMSPROBLEMS M V I S
1.
2.
3.
4.
5.
6.
7.
10.
11.
Note: Qualify the problems on scale of 0=less to10= more
M: Expresses Magnitude of the problem
V: Represents Viability = feasibility to solve the problem, through an educational intervention
I: Represents Importance = impact that if the problem is solved
S: Is the total of the results of the three considered factors
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Setting ObjectivesSetting ObjectivesObjectives of the nutritional guidelines
– Preventing and reducing priority risks and problems
– Promoting healthy diets and lifestyles– Promote consumption of an adequate diet
in vitamin A and iron
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Preparing Technical GuidelinesPreparing Technical Guidelines• Work of nutritionists and dietitians• Technical document:
– Defines the Nutritional goals, behavior to promote, knowledge to , skill to develop, change in environment.
– Converts nutritional goals into types and quantities of food that the population should eat
– Defines of Nutrient recommendations– Outlines the recommended food groups
FORMULATION OF TECHNICAL FORMULATION OF TECHNICAL RECOMMENDATIONS OF THE NUTRITIONAL RECOMMENDATIONS OF THE NUTRITIONAL
GUIDELINESGUIDELINESProblem of Health and Nutrition
Critical Nutrient
Critical Food Practices/ habits/ beliefs
related to the health/
nutrition problem
Technical recommen
dation
DEFINITION OF TECHNICAL RECOMMENDATIONS OF THE DEFINITION OF TECHNICAL RECOMMENDATIONS OF THE NUTRITIONAL GUIDELINES FOR THE CUBAN NUTRITIONAL GUIDELINES FOR THE CUBAN
POPULATIONPOPULATIONHealth Problem Critical nutrient Critical food Practices/ Habits/
Beliefs relatedTechnical
Recommendation
Cardiovascular and brain diseases
Fat saturated Cho. Refined
Na
Vitamins Ac.
Grs omega 3
Fiber
Lards
Oils
Vegetable and fruits
Salt
Sugar
Fish
Grains and cereals
X's of fried food
Little availability vegetables/fruits
Habit vegetable/fruits
consumption
Habit fish consumption Use of table salt X's use of sugarBad distribution of foods during the day Sedentary lifestyle Alcoholism Smoking
Varied diet. Fried food consumption. Prefer use of oil instead of lard.
Consumption of vegetables/fruits. Grain and cereal consumption. Fish consumption. Salt consumption. Sugar consumption. Alcohol consumption. Maintain healthy weight. Physical activity. Diminish energy intake in the night.
TABLE ANALYSIS OF THE TECHNICAL TABLE ANALYSIS OF THE TECHNICAL RECOMMENDATIONSRECOMMENDATIONS
Technical Recommendation Number of times that repeats
Reduce alcohol consumption.Consume a variety diet.Increase consumption of vegetables and fruits.Reduce fried food consumption.Increase grain and cereal consumption.Equitable distribution of energy intake.Increase physical activity.Maintain weight healthy.Reduce sugar consumption.Increase consumption of fish.Consumption of oil vrs lard.Increase milk product consumption.Reduce salt consumption.Reduce smoked food consumption.Reduce coffee consumption.Combination consumption of sources of iron and vitamin C.Hand washing.Adequate food handling.Improve dental hygiene.
7
6
6
5
5
4
4
4
4
3
2
2
2
1
1
1
1
1
1
RECOMMENDED INTERVALS OF ENERGY INTAKE FOR RECOMMENDED INTERVALS OF ENERGY INTAKE FOR DIFFERENT GROUPS OF AGE AND SEXDIFFERENT GROUPS OF AGE AND SEX
Preschool children 2-5 years
Schoolchildren 6-12 years
Adolescents 13-17 years
Adults 18-65 años
Elderly persons > 65 years
Lactating pregnant woman
1,000 1,500 2,000 2,500 3,000 3,500
Category A 1,300 CAL
Category B 2,200 CAL
Category C 3,000 CAL
CALCULATION OF THE CONTENTS OF CALCULATION OF THE CONTENTS OF NUTRIENTS THAT EACH DIET WILL NUTRIENTS THAT EACH DIET WILL
CONTRIBUTECONTRIBUTE
ENERGY 1,300 CAL 3,200 CAL 3,000 CAL
Protein 39 g 66 g 90 g
Fat 36 g 61 g 83 g
Carbohydrates 205 g 346 g 472 g
Vitamin A 390 ER 650 ER 900 ER
Iron 6-9 mg 11-15 mg 15-21 mg
Vitamin C 32 mg 55 mg 75 mg
PARTS NECESSARY FOR COVERING THE THREE PARTS NECESSARY FOR COVERING THE THREE LEVELS OF ENERGYLEVELS OF ENERGY
GROUPS
1,300 CAL 2,200 CAL 3,000 CAL
1 2 1 2 1 2
Milk and alternatives
1 2 0 1 0 1
Vegetables 1 2 1 3 3 2
Fruits 2 1 3 1 2 3
Sugar 7 7 11 11 17 16
Grains 7 7 14 15 20 19
Meat and alternatives
3 2 5 6 8 8
Fat 4 5 8 8 11 11
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Testing the Feasibility of the Testing the Feasibility of the RecommendationsRecommendations
• Behavioral Field Tests• Population’s willingness and ability to
meet recommendations• Identify appropriate language to be
used• Identify graphical representation
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Preparing Food-Based Dietary Preparing Food-Based Dietary GuidelinesGuidelines
• Recommendations to population through messages
• Messages must be:– Positive– Clear– Comprehensible– Culturally appropriate– “Doable”
Preparing Food-Based Dietary Preparing Food-Based Dietary GuidelinesGuidelines
• Criteria for selecting guidelines:– Objectives and potential for
implementation by target group– Ideal number of messages is 6-8
– To facilitate dissemination and population memory
Preparing Food-Based Dietary Preparing Food-Based Dietary GuidelinesGuidelines
Use of pictures or diagrams– Attractive– Culturally acceptable– Give idea of variety and proportions
FIGURE PROPOSAL–GUATEMALA FIGURE PROPOSAL–GUATEMALA CRITERIA: CULTURALLY ACCEPTABLE VARIETY, CRITERIA: CULTURALLY ACCEPTABLE VARIETY,
PROPORTIONALITYPROPORTIONALITY
NUTRITIONAL GUIDELINES FOR GUATEMALANUTRITIONAL GUIDELINES FOR GUATEMALA
• Include in all meals grains, cereals, or potatoes, because feed, and are economic and delightful.
• Eat every day tortillas and beans. Per one tortilla eat a tablespoonful of beans so it is more substantial.
• Eat every day herbs or vegetables to benefit your organism.
• Eat every day any kind of fruit, because they are healthy, digestive and nutritious.
• In addition to the beans that eat daily, eat at least twice a week an egg, a piece of cheese or a glass of milk.
• Eat at least once a week a piece of liver or of meat.
• Eat varied of food as it shown in the family pot.
Sugar and fatsMeats
(at least once a week)
Herbs and vegetables (every day)
Milk
(at least twice a week)
Fruits (every day)
Grains, cereals, and potatoes (every day)
To maintain your health, wash your hands, cover food and the water
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Testing and Validating the Testing and Validating the FBDGFBDG
• Field-tested on people representative of target population
• Testing should be conducted in three phases:– Messages alone– Graphic alone– Messages and graphic together
3636
Dominica: testing Dominica: testing messages and food guidemessages and food guide
• Start the day with breakfast
• Always try to eat a variety of foods every day. Use the basket to help you make the choices.
• Use less salt, salted foods, seasonings and salty snacks
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Correcting and Adjusting the Correcting and Adjusting the FBDGFBDG
• Based on test results
• Additional technical review
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
Promotion of FBDGPromotion of FBDG
• Reproduce, disseminate and implement
• Use sound communication strategy• May be directed to specific segments
of population• Schools are effective for reaching
children and parents• Schools cost-effective
PlanningCharacterizingTarget Group
SettingObjectives
Preparing TechnicalGuidelines
Testing theFeasibility of the
Recommendations
Preparing Food-Based Dietary
GuidelinesValidation
Correction andAdjustment
Implementation
Evaluation
EvaluationEvaluation
• Periodic evaluation in terms of– Implementation process– Impact on target population
• Evaluation methodology and instrument designs– Systematic, objective, and timely
evaluation
Conclusions
• POLITICAL WILL IS A KEY FACTOR IN THE DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF NUTRITIONAL GUIDELINES.
• IT IS NECESSARY TO FORM A GROUP TO DIRECT •THE PROCESSTHAT HAS LEADERSHIP CAPACITY AND •THE ABILITY TO BRING GROUPS TOGETHER.
• THE IMPORTANCE OF ESTABLISHING CONSENSUS AND BUILDING PARTNERSHIPS THAT PROMOTE THE IMPLEMENTATION OF THE GUIDELINES.
• THE NEED TO SELECT THE MOST APPROPRIATE •COMMUNICATIONS STRATEGIES FOR DISSEMINATING •THE GUIDELINES.
Food GuideFood Guide
Food GuideFood GuideVisual representations to help consumers apply guidelines in their daily lives
Food GuideFood Guide
PYRAMID OF PHYSICAL ACTIVITY
•TV•JUEGOS DE VIDEO•MUCHO TIEMPO SENTADO
2-3 TIMES/WEEK•JUEGUE BOLICHE•BAILE•PATINE•JUEGUE GOLF
•LEVANTE PESAS•EJERCICIOS DE ESTIRAMIENTO•ABDOMINALES
3-5 TIMES/WEEK•TROTE•MONTE BICICLETA•NADE•HAGA AEROBICOS•HAGA ACUAEROBICOS•SALTE CUERDA• CAMINATA A PASO RAPIDO
• FUTBOL•BALONCESTO•VOLIBOL•TENIS•ARTES MARCIALES•GIMNASIA
EVERY DAY
•ESTACIONE SU CARRO LO MAS LEJOS POSIBLE PARA OBLIGARSE A CAMINAR•USE LAS GRADAS EN VEZ DE ELEVADOR•CAMINE LO MAS QUE PUEDA•HAGA OFICIOS DE LA CASA Y JARDINERIA•CAMINE CON SU MASCOTA
•HAGA VIAJES EXTRA BAJANDO Y SUBIENDO LAS GRADAS•CAMINE A DIFERENTES SITIOS EN VEZ DE MANEJAR•ELIJA ACTIVIDADES QUE REALMENTE DISFRUTE•CONVIERTA LAS ACTIVIDADES EN EVENTOS SOCIALES CON SU FAMILIA
REDUCE
PASATIEMPOSFLEXIBILIDAD Y RESISTENCIA
EJERCICIO AEROBICO
ACTIVIDADES RECREATIVAS
FUENTE: Franklin Community Health Network and the Physical activity Task force of Healthy Community Coalition. Http://www.fchn.org/hcc/hccwinter.htm