Transcript Development of Food-Based Dietary Guidelines

Development of FoodBased Dietary Guidelines
Carmen Dardano
Food and Nutrition Officer/ Nutrition
Education and Consumer protection Division
Outline
• What are Dietary Guidelines?
• Process for Developing Food-Based
Dietary Guidelines
• The Way Forward
What are Dietary Guidelines?
Assist population in following nutrition
and related health recomendation
Guide to daily food choices
Guide for healthy eating
A tool for :
nutrition education
Behavior change
Food-Based Dietary
Guidelines
• Convert scientific knowledge into
practical messages
• A major strategy for:
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Promoting healthy behavior and practices
Promoting nutrition education
Helping public make healthy choices
Guiding Food and Nutrition policies
Dietary 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
Guidelines
• 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 FoodBased Dietary Guidelines
Steps for Preparing Dietary
Guidelines
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
PLANNING
• FORMATION MULTI-SECTORAL
National Committee on FBDG
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Ministry of Health
Minsitry of Education
Ministry of Agriculture
Ministry of Social Development
Ministry of Economy
Private sector: university, consumer
group, food industry
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Characterizing the Target Group
• 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 MATRIX
PRIORITIZATION OF FOOD AND NUTRITION PROBLEMS
PROBLEMS
M
V
I
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
S
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Setting Objectives
Objectives 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
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Preparing 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 RECOMMENDATIONS OF
THE NUTRITIONAL GUIDELINES
Problem 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
NUTRITIONAL GUIDELINES FOR THE CUBAN POPULATION
Health Problem
Cardiovascular
and brain
diseases
Critical nutrient
Fat saturated
Cho. Refined
Na
Vitamins Ac.
Grs omega 3
Fiber
Critical food
Lards
Oils
Vegetable and
fruits
Salt
Sugar
Fish
Grains and
cereals
Practices/ Habits/
Beliefs related
X's of fried food
Little availability
vegetables/fruits
 Habit
vegetable/fruits
consumption
 Habit fish
consumption
Use of table salt
X's use of sugar
Bad distribution of
foods during the day
Sedentary lifestyle
Alcoholism
Smoking
Technical
Recommendation
 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
RECOMMENDATIONS
Technical Recommendation
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.
Number of times that
repeats
7
6
6
5
5
4
4
4
4
3
2
2
2
RECOMMENDED INTERVALS OF ENERGY INTAKE FOR DIFFERENT
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
1,000
Category A
1,300 CAL
1,500
2,000
Lactating pregnant
woman
2,500
Category B
2,200 CAL
3,000
3,500
Category C
3,000 CAL
CALCULATION OF THE CONTENTS OF NUTRIENTS
THAT EACH DIET WILL CONTRIBUTE
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 LEVELS
OF ENERGY
1,300 CAL
2,200 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
GROUPS
3,000 CAL
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Testing the Feasibility of the
Recommendations
• Behavioral Field Tests
• Population’s willingness and ability to
meet recommendations
• Identify appropriate language to be
used
• Identify graphical representation
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Preparing Food-Based Dietary
Guidelines
• Recommendations to population
through messages
• Messages must be:
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Positive
Clear
Comprehensible
Culturally appropriate
“Doable”
Preparing Food-Based Dietary
Guidelines
• 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
Guidelines
Use of pictures or diagrams
– Attractive
– Culturally acceptable
– Give idea of variety and proportions
FIGURE PROPOSAL–GUATEMALA
CRITERIA: CULTURALLY ACCEPTABLE VARIETY, PROPORTIONALITY
NUTRITIONAL GUIDELINES FOR GUATEMALA
• Include in all meals grains, cereals,
or potatoes, because feed, and are
Sugar and fats
Milk
economic and delightful.
Meats
(at least
• Eat every day tortillas and beans. (at least once
twice a
Per one tortilla eat a tablespoonful a week)
week)
of beans so it is more substantial.
• Eat every day herbs or vegetables
to benefit your organism.
Fruits
• Eat every day any kind of fruit, Herbs and
(every
because they are healthy, digestive vegetables
day)
(every day)
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
Grains, cereals,
milk.
and potatoes
(every day)
• Eat at least once a week a piece of
liver or of meat.
To maintain your health, wash your hands,
• Eat varied of food as it shown in
cover food and the water
the family pot.
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Testing and Validating the FBDG
• Field-tested on people representative
of target population
• Testing should be conducted in three
phases:
– Messages alone
– Graphic alone
– Messages and graphic together
Dominica: testing messages 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
36
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Correcting and Adjusting the
FBDG
• Based on test results
• Additional technical review
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Promotion 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
Planning
Characterizing
Target Group
Setting
Objectives
Testing the
Feasibility of the
Recommendations
Evaluation
Implementation
Preparing Technical
Guidelines
Correction and
Adjustment
Validation
Preparing FoodBased Dietary
Guidelines
Evaluation
• Periodic evaluation in terms of
– Implementation process
– Impact on target population
• Evaluation methodology and
instrument designs
– Systematic, objective, and timely
evaluation
• 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.
Conclusions
• 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 Guide
Visual
representations to
help consumers
apply guidelines in
their daily lives
Food Guide
Food Guide
PYRAMID OF
PHYSICAL ACTIVITY
REDUCE
•TV
•JUEGOS DE VIDEO
•MUCHO TIEMPO
SENTADO
PASATIEMPOS
•JUEGUE
BOLICHE
•BAILE
•PATINE
•JUEGUE GOLF
EJERCICIO
AEROBICO
FLEXIBILIDAD Y
RESISTENCIA
2-3 TIMES/WEEK
•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
ACTIVIDADES
RECREATIVAS
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
FUENTE: Franklin Community Health Network and the Physical activity Task force of Healthy Community Coalition. Http://www.fchn.org/hcc/hccwinter.htm