Development of Food-Based Dietary Guidelines

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Development of Food-Based Dietary Guidelines

• Carmen Dardano
• Food and Nutrition Officer/ Nutrition Education
  and Consumer protection Division

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Outline

• What are Dietary Guidelines?
• Process for Developing Food-Based Dietary
  Guidelines
• The Way Forward

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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
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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

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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
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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

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Process for Developing Food-Based Dietary
Guidelines
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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
Correction and Adjustment
Implementation
Validation
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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

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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Characterizing the Target Group

• Situation health and nutritional status of the
  group
• Groups 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

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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

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DECISION MATRIXPRIORITIZATION OF FOOD AND
NUTRITION PROBLEMS
PROBLEMS M V I S
1.
2.
3.
4.
5.
6.
7.
10.
11.
Note Qualify the problems on scale of 0less
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
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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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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

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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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

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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



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DEFINITION OF TECHNICAL RECOMMENDATIONS OF THE
NUTRITIONAL GUIDELINES FOR THE CUBAN POPULATION
Health Problem Critical nutrient Critical food Practices/ Habits/ Beliefs related Technical 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 sugar Bad 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.
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TABLE ANALYSIS OF THE TECHNICAL RECOMMENDATIONS
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
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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 gt 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
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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
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PARTS NECESSARY FOR COVERING THE THREE LEVELS OF
ENERGY
GROUPS 1,300 CAL 1,300 CAL 2,200 CAL 2,200 CAL 3,000 CAL 3,000 CAL
GROUPS 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
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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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Testing the Feasibility of the Recommendations

• Behavioral Field Tests
• Populations willingness and ability to meet
  recommendations
• Identify appropriate language to be used
• Identify graphical representation

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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Preparing Food-Based Dietary Guidelines

• Recommendations to population through messages
• Messages must be
• Positive
• Clear
• Comprehensible
• Culturally appropriate
• Doable

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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

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Preparing Food-Based Dietary Guidelines

• Use of pictures or diagrams
• Attractive
• Culturally acceptable
• Give idea of variety and proportions

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FIGURE PROPOSALGUATEMALA CRITERIA CULTURALLY
ACCEPTABLE VARIETY, PROPORTIONALITY
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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
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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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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

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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

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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Correcting and Adjusting the FBDG

• Based on test results
• Additional technical review

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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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

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Preparing Technical Guidelines
Characterizing Target Group
Planning
Setting Objectives
Testing the Feasibility of the Recommendations
Evaluation
Preparing Food- Based Dietary Guidelines
Correction and Adjustment
Implementation
Validation
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Evaluation

• Periodic evaluation in terms of
• Implementation process
• Impact on target population
• Evaluation methodology and instrument designs
• Systematic, objective, and timely evaluation

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• 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
• COMMUNICATIONS STRATEGIES FOR DISSEMINATING
• THE GUIDELINES.

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Food Guide
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Food Guide

• Visual representations to help consumers apply
  guidelines in their daily lives

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Food Guide
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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/hccwi
nter.htm
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THANK YOU