Poor public response biggest barrier to healthy nation | Sunday Observer

Poor public response biggest barrier to healthy nation

Reducing sugar and salt prevents diabetes, heart attacks, strokes:

Unhealthy food habits, lifestyles, main cause of obesity, early NCD development:

As the Health Ministry moves forward towards creating a healthy tomorrow , one of the biggest drawbacks they face is the lack of adequate response by the general public to help achieve their goals.

The overuse of salt, sugar and fat, and inadequate consumption of vegetables and fruits with physical inactivity, together with smoking and alcohol leading to the spread of Non Communicable Diseases ( NCDs) is one the biggest challenges they face, according to Consultant Community Physician, a specialist in Public Health working for the Non Communicable Disease Unit Dr Virginie Mallawarchchi.

In an interview with the Sunday Observer, she said, preventive strategies had already been introduced mainly targeting vulnerable groups while delivering services to everyone. The most important are schoolchildren and youth who are often exposed to unhealthy lifestyles, especially, unhealthy food habits and physical inactivity. On healthy foods, she said, the average Lankan consumed far more salt and sugar than he/she needed. Citing two studies at different intervals, by the Medical Research Institute, she said, they had revealed that on average, a Lankan adult consumed 8.5 and 12.5 grams of salt per day .” The recommended amount of salt per day is 5 gr per adult which is one level teaspoon.

Gradual process

Too much salt can lead to hypertension and the risk of heart attack and stroke are higher when your blood pressure is higher than normal”, she warned. She charged that it was their unhealthy food habits that were at fault. “ Lankans in rural areas we have found, consume more salt than people in urban areas because they add salt to rice while cooking. Those in urban areas on the other hand, get salt from fast foods. These food habits must be changed . But, they cannot be changed overnight. Any drastic change would defeat its purpose as you can’t change people’s eating habits and tastes immediately. It has to be a gradual process. Once they get used to taking less salt in their food it would become a habit” and people will understand they can enjoy food even with less salt. On the subject of too much sugar consumption, especially, by children, she said , “ Children eat a lot of biscuits containing sugar in the ingredients, due to a lack of knowledge. They also consume carbonated drinks, fruit juices and yogurt drink containing too much added sugar. Even some milk packets contain a lot of added sugar.

Sugar sweetened beverages, such as, carbonated drinks, energized drinks and readymade fruit juices and sweetened milk products merely add to carbohydrates that are converted to starch and glucose leading to obesity and early NCD development. My advice is to empower them to make a healthy choice in an environment where innocent schoolchildren and youth are targeted to be victims of unhealthy behaviours.

We asked her about the current trend of sponsoring sports events by manufacturers of sweetened milk products and carbonated drinks, and companies selling readymade foods fried in oil and batter under the health food tag. Was it ethical to target schoolchildren whose health could be undermined by ingesting these foods and drinks?

“ These advertisements and sponsorship should be stopped, as children are very vulnerable to them”, she said. Furthermore , they are also influenced by television advrtisement of such foods. We have discussed with some television companies who have said they would consider not to use them at the time children are free to watch T.V.”

Fruit juices

She said a Traffic Lights system has been introduced for sugar as a measure for the public to go for healthy choices by giving a criteria to select what they should buy and what they should avoid . “ Traffic light system consisting of red, amber and yellow colour is based on the amount of sugar containing in 100 grams. We cannot force customers to buy these foods, but educate them on the benefits of consuming healthy food. However, if they are clever enough to go for healthy choices it would be an investment for their future”, she said. She stressed the responsibility of parents to pay more attention to see the dietary habits of their children and ensure that they make healthy choices.

What about those sweetened drinks that have flooded most supermakets and food outlets in towns, cities islandwide.? We asked.

“ Plain boiled, cooled water is the best drink, ideally. Other options are, fresh milk with no added sugar or fresh fruit juice with no added sugar,” was her reply.

On charges that the supply of fresh milk is inadequate to meet the demand?, She said,“ That is a myth. We have already had discussions with dairy products and beverage companies who say that unsweetened milk and fruit juices are available to buy. But, according to the manufactures, the demand in the community for healthy choices is low, still.”

So, what is the Ministry of Health doing about this?

“ Booklets, ‘ Api Nirogi Wemu ” were distributed to students in selected classes last year and it is planned to distribute them to all 4 million school going children islandwide . These booklets contain important facts about diet, physical activity, nutrition, what to look out for in a model food plate and how to have a balanced meal.

She noted that school Medical Officers also do regular health assessment of schoolchildren through school medical inspection . In addition, Non Communicable Disease prevention ; NCD corners have been established in selected schools in each district providing facilities for checking the weight, height and Body Mass Index (BMI).

She said, the Health Ministry is working in collaboration with the Education Ministry and the National Institute of Education ( NIE) to ensure that adequate knowledge on healthy lifestyles are included in the school curriculum.

She stressed the importance of promoting healthy lifestyles among youth as well, and mentioned about the success achieved in mobilizing youth or healthy habits through continuous programs conducted in collaboration with the Ministry of National Policies and Economic Affairs.


“But we have a big drawback here. Health Science is not a compulsory subject in our curriculum. It is a basket subject where students can choose between Language, IT and Health Science. Most students choose the two former subjects because it assures them of a job in the future. Very few want to study Health Science”.

So, how will you get over this problem?

“ Today’s children are different from the youth of yesteryear. While they are physically inactive, the majority continue to consume unhealthy food, making them overweight or obese. Such children are more likely be overweight or obese during adulthood and have a higher risk of developing Diabetes early in life. Also, many children are vulnerable to smoking, alcohol and drugs. We need to protect them by empowering them with life skills that would help them to say “ No” even when they are tempted or forced to do wrong things. “

She also says parents have a vital role in regulating and monitoring children’s behaviour and eating habits. “ Mothers should spend some time cooking a healthy meal at home . We have asked our Medial Officers (NCD) in the districts to educate parents and teachers on this.

The Health Ministry has established healthy schools and is taking measures to create a conducive environment in schools by ensuring that only healthy options are available. We have also requested local Municipal Councils to include play areas and walking paths wherever needed and possible.

Also, the Health Ministry is having continuous dialogues with officials of the Ministry of Agriculture at district and grassroots level to create a mechanism to make seasonal fruits and vegetables available at reduced prices and promote home gardening further. “

Lack of healthy menus

She also mentioned that it is a timely need to have tasty and healthy menus available so that children and adults can enjoy different kinds of food without compromising on their desire to eat tasty food . We also need healthy food outlets where people can buy cheap healthy meals.

Customer R. Mendis said he patronised the same night outlet for his dinner because he couldn’t afford fancy prices charged by others. “Where else would I get a meal for 100 rupees . Not in the fancy take away outlets which charge more than double,” said this father of four who says he does not mind if the environment he buys his food is unhygienic and the oil used is twice or thrice used;. “ I know the health impacts. But I have no choice”, he says.

Final solution

“We need to promote healthy lifestyles among schoolchildren, youth and the workforce while taking measures to have conducive environments and health friendly policies. It is time for us to hold hands together to protect especially, the children and youth in the country, because they are our future. It is easier to instil good habits in children rather than wait till they reach adulthood. Once formed they will last for life.”