Dietary Guidelines for Bangladesh - Food and Agriculture ...

1 Dietary Guidelinesfor BangladeshBangladesh Institute of Researchand Rehabilitation in Diabetes, Endocrineand Metabolic Disorders (BIRDEM)With the supportofNFPCSPN ational Food Policy Capacity Strengthening ProgrammeUSAIDFROM THE AMERICAN PEOPLED ietary Guidelines for BangladeshQuamrun Nahar, PhDSenior Research Officer, BIRDEMS ubhagata Choudhury, MBBS, MPhil, FCPSD irector and Professor, Laboratory Services, BIRDEMMd. Omar Faruque, PhDSenior Research Officer, BIRDEMS yeda Saliha Saliheen Sultana, MScAssoc Prof. Home Economics College, DhakaMuhammad Ali Siddiquee, PhDHead, Grain Quality & Nutrition Division, BRRIT echnical ContributionsMohammad Abdul Mannan, PhDNational Food Utilization & Nutrition AdvisorNational Food Policy Capacity Strengthening Programme, FAOL alita Bhattacharjee, PhDNutritionistNational Food Policy Capacity Strengthening Programme, FAOThis study was financed under the Research Grants Scheme(RGS) of the National Food Policy Capacity StrengtheningProgramme (NFPCSP) Phase II.

2 The purpose of the RGS is tosupport studies that directly address the policy research needsidentified by the Food Planning and Monitoring Unit of the Ministryof Food. The NFPCSP is being implemented by the Food andAgriculture Organization of the United Nations (FAO) and the FoodPlanning and Monitoring Unit (FPMU), Ministry of Food with thefinancial support of EU and designation and presentation of material in this publication donot imply the expression of any opinion whatsoever on the part ofFAO nor of the NFPCSP, Government of Bangladesh , EU orUSAID and reflects the sole opinions and views of the authors whoarefully responsibleforthecontents,findingsandrec ommendations of this.

3 978-984-33-7492-9 IllIIIIIIIH'IIBIRDEM, DHAKA, June-2013ii1111 1 IIll1I11 ContentsAbbreviationsivPrefaceIntroducti on1 Policies and strategies2 Current nutrition situation2 Goals of Dietary guidelines3 Population nutrient intake goals4 Dietary Guidelines for the Bangladeshi population5 Description of Dietary guidelines6 Guideline 1:Eat a well-balanced diet with a variety of foods ateach meal7 Guideline2:Consume moderate amount of oils and fats13 Guideline3:Limit salt intake and condiments and use onlyiodized salt16 Guideline4:Take less sugar, sweets or sweetened drinks18 Guideline 5:Drink plenty of water daily20 Guideline 6:Consume safe and clean foods and beverages21 Guideline7:Maintain desired body weight through balanced foodintake and regular physical activity22 Guideline8:Practise healthy life style with right cooking andhealthy eating25 Guideline 9:Eat additional food during pregnancy and lactation27 Guideline 10.

4 Practise exclusive breastfeeding for six months andstart appropriate complementary foods in time28 Food guide pyramid for Bangladeshi population29 Physical activity pyramid31 Self evaluation of food based Dietary guidelines32 Standardization of weights and measures for foods33 Food exchange list34 Desirable diet for Bangladesh35 Menu planning36 Nutrient requirements38 Glossary42111100 KAbbreviationsAlAdequate intakeBBSB angladesh Bureau of StatisticsBDHSB angladesh Demographic and Health SurveyBMIBody Mass IndexBNNCB angladesh National Nutrition CouncilBIRDEMB angladesh Institute of Research and Rehabilitation inDiabetes.

5 Endocrine and Metabolic DisordersBRRIB angladesh Rice Research InstituteCHDC oronary Heart DiseaseCVD Cardiovascular DiseaseDDPD esirable Dietary PatternFAO Food and Agriculture OrganizationFPMUFood Planning and Monitoring UnitHDLHigh Density LipoproteinHIESH ousehold Income and Expenditure SurveyIDFI nternational Diabetes FederationINFSI nstitute of Nutrition and Food ScienceIPHNI nstitute of Public Health and NutritionLDLLow Density LipoprotcinMgMagnesiumMoHFWM inistry of Health and Family WelfareNCDNon Communicable DiseaseNFPCSPN ational Food Policy Capacity Strengthening ProgrammeNPNLNon Pregnant Non LactatingPgMicrogramPhosphorusPALP hysical Activity LevelPEMP rotein Energy MalnutritionPUFAP olyunsaturated Fatty AcidsRDIR ecommended Dietary IntakeRERetinol EquivalentsRIRecommended IntakeTEET otal Energy ExpenditureTFAT rans Fatty AcidUSA1 DUnited States Agency for International DevelopmentWHOW orld Health OrganizationivPrefaceA balanced diet provides energy and nutrients for optimalgrowth, development and body maintenance.

6 To achieve abalanced diet, you must eat a variety of foods from each ofthe food groups. This requires an understanding of how toimprove Dietary diversity and quality as well as wise foodselection in planning meals. The most important step is toeducate yourself about what your body needs and followdietary Guidelines which convert the scientific knowledge ofnutrient requirements and food composition into practicalmessages so as to facilitate proper meal planning andconsumption for nutritional well the prevalence of under nutrition in the largersegments of the population and emerging problems of noncommunicable diseases in Bangladesh .

7 The preparation ofthese Guidelines is guide is an attempt todevelop food based Dietary Guidelines for the general publicand propose practical suggestions for better nutrition Guidelines have been developed based on an analysis ofthe Dietary and nutrient adequacy of the food consumptionof households using data from the 2010 Household IncomeExpenditure Survey. Many different sources of diet relatedinformation as well as regional Guidelines have beenreviewed and considered. The Dietary Guidelines have alsobeen followed up from the Guidelines published in 2000 bythe Bangladesh National Nutrition Council, Ministry ofHealth and Family Welfare.

8 The previous qualitativemessages have been updated and quantitative messageshave been included incorporating latest scientific evidencebased information while at the same time, keeping themessages simple and easy to Dietary Guidelines developed by BIRDEM and otherstakeholders will serve as an educational tool to expressnutrition principles in terms of foods and Dietary practicesthat promote health and lower the risk for diet ,theywillcontributetotheimprovement of nutrition behavior in the population andserve as a tool to guide health, Agriculture and food ,WaharDirector General, BIRDEMviAt the heart of good nutrition are Dietary guidelinesIntroductionAlthough Bangladesh has made considerable progress infood (cereal) production, household and individual dietarydiversity, child and maternal nutritional status continue topose as challenges.

9 The consumption of an ill balanced dietis known to play a key role in malnutrition and as a riskfactor in chronic disease. Chronic diseases are largelypreventable. Although, more research is needed on someaspects of the mechanisms that link diet to health, availableevidence provides a basis to justify taking preventive Guidelines promote the concept of nutritionallyadequate diets and healthy life style from conception to oldage. This has been highlighted at many national andinternational levels and there was a general consensus that allcountries should adopt food based Dietary Guidelines suitablefor the Dietary Guidelines published by Bangladesh NationalNutrition Council (BNNC) and other regional guidelineshave been reviewed in the preparation of these Guidelines .

10 In2000 BNNC, MoHFW in collaboration with multiplestakeholdersformulatedasetof qualitativedietaryguidelines. The present Dietary Guidelines have beendeveloped after extensive analysis of the HIES 2010 data,the food and nutrient intake pattern as well as the nutritionsituation of this document, food based approaches, using qualitativeand quantitative messages have been incorporated. Emphasisis on positive recommendations which can maximizeprotective effects through the use of a variety of foods intune with traditional habits. The goals set with respect tofood itemssuchaspulses,meat, fish,milk andvegetables/fruits are intended to encourage appropriatepolicy decisions.