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Sunday, 9 February 2003  
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Cosmetic surgeons and nutrition policy

by Prof. T. W. Wikramanayake

The purpose of this article is to draw the attention of the general public as well as health professionals to a document-Food Based Dietary Guidelines (FBDG) - that has, at long last, been published by the Ministry of Health. The task of drawing up dietary guidelines for Sri Lankans was given, in the year 2000, by the Ministry to a Consultative Group of more than forty health professionals, food scientists and nutrition policy planners, who appointed a Working Group of nine persons knowledgeable in human nutrition. Although the Working Group completed their task within 6 months, it was only last week that I received a copy.

During the past 50 years the public has been made aware of the need for dietary energy as well as nutrients such as essential amino acids, vitamins, minerals and essential fatty acids and of the quantity of each nutrient that should be consumed daily to maintain good health. Such science-based guidelines were designed to provide guidance on the composition of a healthy diet, and the general public had little information on how much of food available to them should be consumed to provide the requirements of energy and the nutrients.

A powerful influence on nutrient intake is food and nutrient availability, which is determined by distribution and utilization of various foods within the population. A fundamental assumption of Food Based Dietary Guidelines (FBDG) is that consumer knowledge will lead to improved food choices and that food availability will reflect these choices. To be effective in bringing about behavioural changes and achieving health goals, the Working Group has made an effort to be practical and has recommended foods that are readily available, accessible and affordable.

The government, a regulatory environment, a responsible food industry, the co-operation of health professionals and communicators, all have a vital role to play in achieving the objectives of the FBDG. The government must incorporate the guidelines into a permanent nutrition policy that will remain impervious to temporary changes resulting from political and economic situations. The food industry must develop and support the guidelines by responding to the needs of the consumers (and not their wants). The health professionals should impart the information in the FBDG in a meaningful way. When consumers are informed and educated, they will demand healthier foods.

It is hoped that such guidelines will shed light on the confusion created in the minds of the public by opposing recommendations on various foods made by individuals in recent times. Many of these writers rely on information supplied to them by non-scientific publications such as the Readers Digest and publications by individuals or groups promoting sales of particular foods.

The public are advised to rely more on information supplied to them by the Medical Research Institute and the Health Education Bureau, both units of the Department of Health Services. Questions could also be referred to the President of the Nutrition Society of Sri Lanka, C/O The Nutrition Unit, MRI, Borella. The Society has among its membership biochemists, physiologists, nutritionists, clinicians and food scientists who could be called upon to express a considered opinion.

The FBDG should also be able to solve some problems. For instance a recent recommendation by a cosmetic surgeon that one should consume 1000g fish oil daily would not have been made had he been aware that 1 gramme of a fat or oil supplies nine kilocalories and that the recommended energy intake for all persons is well below 3000 kilocalories. His prescription, if adhered to, will make us a very obese population!

It is also hoped that these guidelines will be made available to the general public in all three national languages and in the form of posters, brochures and radio and television messages. Educational materials containing explanations and specific information on serving portions for traditional as well as packaged foods, compared with homemade foods, should supplement the FBDG. Lastly, these guidelines should be reviewed periodically, say once in every five years, in keeping with advances in the knowledge of the physiology and biochemistry nutritional science.

The Focal Point for the FBDG is Director, Nutrition, Department of Health Services.

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