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Development of Food-Based 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?.
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Development of Food-Based 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: • 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
Steps for Preparing Dietary Guidelines Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
PLANNING • 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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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 • INTRODUCTION • RISK FACTORS AND PROBLEMS ASSOCIATED WITH DIET • Epidemiological Profile • Changes in morbidity rates • Nutritional status • Education of the population • Foods • Availability • Accessibility • Consumption • Composition • Eating habits • Distribution • Classification • Acquisition • CONCLUSIONS • PRINCIPAL PROBLEMS IDENTIFIED
DECISION MATRIXPRIORITIZATION OF FOOD AND NUTRITION PROBLEMS 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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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
DEFINITION OF TECHNICAL RECOMMENDATIONS OF THE NUTRITIONAL GUIDELINES FOR THE CUBAN POPULATION
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 Lactating pregnant woman 1,500 1,000 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 NUTRIENTS THAT EACH DIET WILL CONTRIBUTE
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
Preparing Food-Based Dietary Guidelines • Recommendations to population through messages • Messages must be: • 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 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 fats Milk (at least twice a week) Meats (at least once a week) Herbs and vegetables(every day) Fruits(every day) Grains, cereals, and potatoes(every day) To maintain your health, wash your hands, cover food and the water
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
Correcting and Adjusting the FBDG • Based on test results • Additional technical review
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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
Preparing Technical Guidelines Characterizing Target Group Planning Setting Objectives Testing the Feasibility of the Recommendations Evaluation Preparing Food- Based Dietary Guidelines Implementation Correction and Adjustment Validation
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. • THE IMPORTANCE OF ESTABLISHING CONSENSUS AND • BUILDING PARTNERSHIPS THAT PROMOTE THE • IMPLEMENTATION OF THE GUIDELINES. Conclusions • THE NEED TO SELECT THE MOST APPROPRIATE • COMMUNICATIONSSTRATEGIES FOR DISSEMINATING • THE GUIDELINES.
Food Guide Visual representations to help consumers apply guidelines in their daily lives
PYRAMID OF PHYSICAL ACTIVITY REDUCE • TV • JUEGOS DE VIDEO • MUCHO TIEMPO • SENTADO FLEXIBILIDAD Y RESISTENCIA PASATIEMPOS 2-3 TIMES/WEEK • JUEGUE BOLICHE • BAILE • PATINE • JUEGUE GOLF • LEVANTE PESAS • EJERCICIOS DE • ESTIRAMIENTO • ABDOMINALES 3-5 TIMES/WEEK ACTIVIDADES RECREATIVAS EJERCICIO AEROBICO • 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 FUENTE: Franklin Community Health Network and the Physical activity Task force of Healthy Community Coalition. Http://www.fchn.org/hcc/hccwinter.htm