The Food Based Dietary Guidelines (FBDGs) and its messages for correct eating will tell people what to eat (variety), how often (right time), and how much (right quantity) to result in a healthy population, which is active and productive. Country specific Food-Based Dietary Guidelines for the masses are one of the FAO/WHO recommended tools to improve healthy eating habits and lifestyles of individuals and populations. FBDGs were also endorsed by countries including Sri Lanka in the Framework for Action agreed at the Second International Conference on Nutrition.
Sri Lanka embarked on formulating and communicating the FBDG messages as far back as the year 2000. Currently the FBDGs are being revised by the Ministry of Health and partners based on the situational analysis of health and nutrition of the country, a task supported by the Food and Agriculture Organization of the United Nations (FAO) and the Nutrition Society of Sri Lanka.
It would not be possible for people to eat food in the manner set out in the FBDGs unless these foods are locally available, accessible, affordable, safe, fresh and easy to prepare. Successful use of the FBDGs have to be ensured through various means such as far-reaching policy support, advocacy, communication and awareness and dissemination in diverse settings through practitioners.
What are these key policies and legislation to facilitate the successful implementation of the FBDGs? In Sri Lanka, the Nutrition Division of the Ministry of Health is in charge of the Food Based Dietary Guidelines implementation. The Ministry of Health is the prime mover in many policies, which are related directly, or indirectly to enable FBDGs. These are the Nutrition, Health, Non Communicable Diseases (NCDs), Reproductive Health and Health Promotion, which are easily put into practice. The Health Policy usually includes actions on getting the public to exercise, reduce or eliminate smoking, screen everyone for NCDs and push the Ministry of Environment to reduce indoor and outdoor pollution. The Health Policy gives a high priority to NCDs especially in recent times when these are increasing rapidly. Healthy diets are mentioned as one of the main actions to reduce NCDs. The NCD Policy too mentions the importance of uniformed messages on diets for all, in a way that is understood by the people. Health Promotion is the key to the dissemination of messages through multiple modes of communication and includes the formulation of behavior change strategies for improved nutrition status in the Health Promotion Policy. The importance of nutrition and getting it right for better reproductive health is mentioned in the Adolescent and Reproductive Health Policy.
The Nutrition Policy will inform decision makers and practitioners on which groups of people are particularly vulnerable with regard to nutrition status. This Policy would also set out objectives to be achieved such as targets for reduction of percentages of people who are under and over nourished. The Food Based Dietary Guidelines are usually stated as part of a strategy for communication in the Nutrition Policy, focusing on the allocation of financial, material and human resources to achieve behavior changes among the population.
Policies and plans in agriculture, environment, information and communications and related fiscal policies are also essential to facilitate this supportive environment.
1. The right elements of an agricultural policy would ensure optimum quantities of a variety of foods especially plant based to make diets diverse and sustainable and provide the resource base to follow the FBDGs. The Agriculture Policy usually talks about productivity of land, cost effectiveness of planting and safety of the food produced. It also states the types of assistance to be given to farmer groups and how producers would be organized for trading. Underutilized crops, which very often are indigenous too would be supported for increased production. The same aspects would be covered in animal production through the relevant Ministries such as Fisheries, Livestock and Aquaculture.
2. The Environmental Policy would include environmental safeguards protecting bio diversity.
3. The Fiscal Policies of the country would determine the financial arrangements for inputs into food production, ease of trading locally as well as internationally and food price determination in relation to inputs and other variables.
4. Information and Communication policies and strategies in sending food-based messages far and wide are most important. Helping to measure behavior change among the population before and after disseminating the FBDGs is an important role for the Ministry of Information.
Actions resulting from these directly related policies are key to enabling and driving the Food Based Dietary Guidelines forward. These policies should be implemented in tandem for best effect of changed food related behavior. These policies cannot be formulated or activated without political will nor management expertise.
What are the important settings and practitioners to disseminate the guidelines?
These are mainly the health setting, at the primary, secondary and tertiary care stages where the FBDGs can be actively disseminated through multiple means. Another is the education sector at both school and higher education institutes. There are several communities that can be reached in this setting for behavior change: the school community of teachers, parents, children and education administrators through a number of interesting activities. The education curriculum is also a space for including FBDGs and their scientific basis. The third setting to be mentioned here is food service. This includes canteens, shops, restaurants, snack bars, hotels, bakeries etc. The role of this sector is manifold. They can be settings for communicating the FBDGs through programs or displays. Their meals and foodstuff sold should be in line with requirements of FBDGs.
The fourth most important setting are the fruit and vegetable farmers as well as the fisheries and the livestock producers. This platform too could be used in a number of ways. To address the farmers in order to change their nutrition related behavior through the internalization of the guidelines, but also to produce safe and varied food in the correct quality and quantity in a timely manner and at a reasonable price. The fifth setting could be the workplace, both by way of disseminating the FBDGs to the workforce and management as well as converting workplace canteens into a source of healthy and safe food with the right kind of menu planning. If the work place is a factory processing food, a new perspective of healthy food production and processing could be introduced. Finally, the community setting could involve an interactive platform required for community interaction in following the guidelines at the household level.