HEALTHY PERSONS HEALTHY NATION Organizers PFNDAI Collaborator- Indian Dietetics Association (Mumbai Chapter)

Transcription

1 HEALTHY PERSONS HEALTHY NATION Organizers PFNDAI Collaborator- Indian Dietetics Association (Mumbai Chapter) Dr. Jagmeet Madan National Vice President, Indian Dietetic Association Principal, Professor Sir Vithaldas Thackersey College of Home Science, (Autonomous) SNDT Women s University, Juhu, Mumbai dr.jagmeetmadan@gmail.com

2 Mortality From NCD-India DEATHS Injuries 12% CVD 28% Cancer 26% CRD 12% Diabetes 2% 13% 7% Other NCD NCD s are estimated to account for 60% of Total Deaths World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2014.

3 Rural Vs Urban Urban (%) Urban Slums (%) Rural (%) URBAN URBAN SLUMS BMI (kg/m2) RURAL < > Heart Disease No Yes Diabetes No Yes Raghav.G et al, Affluence, Obesity and Non-Communicable Diseases in India, 2010

4 NCD Prevalence In India Vs Per Capita Consumption Of Fat & Sugar 30% 60 25% 50 20% 40 15% 10% HTN Obesity Diabetes Total fat Sugar 5% 10 0% > >2013 Narendra K. et al, Whole-of-society monitoring framework for sugar, salt, and fat consumption and noncommunicable diseases in India, Annals of the New York Academy of Sciences, 2014; Vol 10, 1331

5 Madan et al, Body fat percentage and its correlation with dietary pattern, physical activity and lifestylre factors in schoolgoing children of Mumbai, India, JOMR, 2014

6 Prevalence Of Metabolic Syndrome In Mumbai City, India Key Findings 82% : Overweight & Obese Prevalence of MetS : 40% 70.3% : Waist Circumference of 90 cm The study highlights the need 36% for : Prehypertensives intervention to lower the risk markers predisposing 40% :Dysglycemia the urban population to noncommunicable diseases 34% : TG 26% : TC 64% : serum LDL-C 66% : serum HDL-C

7 Maternal Nutrition: Conceptual Framework Of Stages Of Pregnancy Affected By Nutrition Interventions Early Points Outcomes Maternal Mortality Adolescence School Girls Out-Of School Food LBW Preconception Newly-Weds Premature Delivery First Pregnancy Micronutrient Supplementation Poor Child Growth & Development Preconception Inter-pregnancy Interval Maternal Nutrition Status Subsequent Pregnancies Nutrition Education Maternal Underlying Factors Nutritional Status BMI/ Fat Stores Height Micronutrient Status Age at 1 st Pregnancy U. Ramakrishnan et al., Effect of Women s Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review, Paediatric and Perinatal Epidemiology, 2012, 26 (Suppl. 1),

8 60% of total health expenditure- paid by common man Current rate in India: 1.86% of GDP; Ideal to meet basic healthcare amenities : 5-6% of GDP Burden of NCD In The 20 th Century 1) Effect on Economy: Productivity Human Resources Weaker economy Inflation, tax revenues cost of medicines & long duration of treatment, government subsidy & healthcare expenditure availability of money for Quality Eating & Wholesome Eating 39 million Indians are pushed to poverty because of ill health yearly availability & intake of foods & beverages high in salt, SFA, TFA, r efined starch & sugar 2) Social Effects: Changes in personal behaviour, ignorance access to basic healthcare amenities & urbanization & westernization 700 million Indians in villages and nonurban areas don t have access to healthcare facilities Output & impots of food food prices farm & non-farm employment & non-food 3) Nutritional & Agricultural Effects: Food prices & ignorance nutrient-dense food consumption Poor Health Status Maternal Nutrition Effect on Kadiyala et al, Agriculture nutrition pathways in India, Ann. N.Y. Acad. Sci (2014) 43 56, NCD ALLIANCE BRIEFING PAPER, Tackling Noncommunicable (healthcare) feotal Diseases to Enhance Sustainable Development, 2011, Addressing non-communicable diseases in India through innovation and multisectoral expenditure approach, Consultation paper, Jointly released by the Partnership to Fght Chronic Disease (PFCD) and Strategic Partners Group nutrition (SPAG Asia), May 2015, Innovative models of healthcare financing For a healthier India, Consultation Paper, Jointly released by the Partnership to Fght Chronic Disease (PFCD) and Strategic Partners Group (SPAG Asia), May 2015 NCD

9 JM

10 WHO "Global monitoring framework on NCDs India: First to adapt the Global Monitoring 10 Targets for India To Framework on Combat non-communicable NCD diseases WHO Global monitoring framework on NCDs,

11 School Canteen : Guidelines By FSSAI Regulate Develop Promotion a Canteen of 'HFSS Policy Food' to provide among School Nutritious, Children Wholesome & Restrict / Limit and the Availability of most common Healthy HFSS Foods in Schools and area within 50 meters Labeling Regulations to enable disclosure of all Relevant Information Colour code Availability Examples Most common HFSS Foods Green Always on the menu( atleast Vegetables & legumes, fruits, Potato fries, Chips, fried foods 80% of available food items) grain foods; preferably Sugar sweetened carbonated wholegrain &/or high in fibre, beverages lean meat, egg, fish, low fat milk, curd, paneer etc. Sugar sweetened non-carbonated Yellow Select carefully beverages Approach should be greening Ready to eat noodles, pizzas, burgers small portion size and reduces frequency Confectionery items Red Restrict/Limit Availabilty in schools Baked vegetable based snacks, ice creams, milk based & dairy deserts etc HFSS foods FSSAI Draft Guidelines for making available, safe and hygeinic food to school children in India, wholesome, nutritious

12 Taxing Sugar Sweetened Beverages(SSB) A 20% SSB tax can reduce overweight and obesity prevalence by 3.0% and type 2 diabetes incidence by 1.6%. Sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations Basu S, et al. (2014) Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study. PLoS Med 11(1): e doi: /journal.pmed

13 Sodium Regulation The Next Agenda: FSSAI to Regulate Fat, Sugar and Salt Content in Indian Food Products A concerted effort to reduce Sodium content in processed foods by MNC s

14 WAY FORWARD NEED OF THE HOUR NUTRITIONIST- INDUSTRY INTERFACE FOOD CHOICES/OPTIONS SCIENCE- TECHNOLOGY INNOVATION GLOBAL TO LOCAL ACADEMIC INDUSTRY PARTNERSHIP FOR TRAINING STUDENTS TOWARDS NUTRITION AND HEALTH SOLUTIONS- PRODUCT DEVELOPMENT BY FUNCTIONALIZING FOODS; SPECIALITY INGREDIENTS; TRADITIONAL PREPERATIONS PRIME FOCUS ON CHILDREN & ADOLESCENTS

15 Lets Join Hands to Make India a Healthy Nation Thank you