Dietary diversity for a healthier society | Daily News


 

Dietary diversity for a healthier society

Motorbikes parked on the bunds of the paddy fields Ampara

Upon first glance, Sri Lanka’s rankings on the Global Hunger Index (GHI) and the Human Development Index (HDI) appear to be quite similar: 84th place in the former and 73rd place in the latter. When closely examined, however, it becomes clear that the rankings are startlingly different, as the 2016 GHI includes only 118 countries within the developing world. The HDI, on the other hand, put forth a ranking of 188 nations in 2015, and positioned Sri Lanka between Turkey and Mexico, in the thick of countries with “high human development.”

The island’s closest analogues in the GHI are Nigeria and Côte d’Ivoire, two nations that score very poorly in the HDI.

Whereas Sri Lanka scores highly in the HDI’s areas of concern, such as life expectancy, education, and per capita income, it still records high levels of undernourishment and child wasting, or acute malnutrition.

Indeed, the GHI reports that 22% of Sri Lankans are undernourished, while 21.4% of children under five suffer from wasting. This is especially concerning given that under nutrition leads to decreased growth, inhibited cognitive development and increased vulnerability to disease.

It would appear somewhat strange that Sri Lanka, comfortably in the top third of nations in terms of development, would occupy such a comparatively low position with regard to nutrition and hunger.

This discontinuity is confounding, as there is a distinct correlation between high development and low hunger. It is also troubling that Sri Lanka is one of two countries that have recorded the lowest improvements in GHI composite scores since 2000, going from 27.0 to 25.5. In the same period, Nepal improved its score from 36.8 to 21.9.

While the GHI ranking is not a reflection of food security, the Index does provide a snapshot of various nutritional issues that plague many developing countries. The rankings are determined by analyzing a country’s food supply, child mortality rate, and child under nutrition factors like wasting, as defined above, and stunting, or reduced growth rate due to malnutrition.

South Asia, overall, has made great leaps, as Nepal, India, Bangladesh, Pakistan, and even Afghanistan have drastically cut their scores and moved from rankings in the ”alarming” range to those in the “serious” range over the past sixteen years.

So, what factors could be responsible for Sri Lanka’s comparatively slow progress?

Nutrition in Sri Lanka

Though Sri Lanka’s GHI ranking could be interpreted as an indication that the country is facing food shortages, this is simply not the case.

Sri Lanka has plenty of food, but the food that many are consuming is deficient in nutrients.

“The concern used to be a full belly, but now many countries have access to more calories. The issue in Sri Lanka now, however, is that people eat a diet heavy in rice and lacking in other nutrients,” said Dr. Pramod K. Joshi, Director of the International Food Policy Research Institute South Asia, the research center responsible for publishing the GHI.

“Sri Lankans need to eat more diverse foods. It is important for people to eat a balanced diet that includes vegetables, proteins, and vitamins. Eating mostly rice will not make you healthy,” continued Joshi.

Sri Lanka cultivates a large quantity of rice, and many use the crop as their main staple, oftentimes without supplementing their diets with other sources of nutrition. Because chicken and beef are relatively expensive and dried fish, which is a central source of protein for inland populations, is not as nutritious as fresh varieties, many people find themselves lacking in protein intake. The relative dearth of milk consumption also hurts the population’s protein levels.

Furthermore, vegetables can be prohibitively expensive for low-income citizens. Even subsistence farmers will sell the vegetables they grow and use the money to buy rice to eat. Many of these farmers have small plots of land, and they cannot generate enough income to buy nutritious food.

“Accessibility to fruits and vegetables is a problem. For those earning little, the prices can be too exorbitant. The seasonal nature of fruit and vegetable production, as well as the increasing effects of climate change, are also hurting people’s access to fruits and vegetables,” said Dr. Manoj Thibbotuwawa, a Research Fellow at the Institute of Policy Studies. “People should eat about 400 grams of fruits and vegetables per day, but the actual amount many are consuming is between 100 and 200 grams,” said Visakha Tillekeratne, President of the Nutrition Society of Sri Lanka.

Additionally, the ebbs and flows of the markets can impact agricultural production.

“Farmers cultivate crops based on prices. So, if a certain crop is selling for a high price, many farmers will grow this crop. This creates a glut, and the price drops, hurting the farmers,” said B. Wijayarathne, Secretary to the Ministry of Agriculture.

Animal products, fruits and vegetables are also excellent sources of micro-nutrients, such as vitamins and minerals. Because there is a lacks of consumption of these products, young children are suffering micro-nutrient deficiencies. According to a 2010 report from the Ministry of Healthcare and Nutrition, 29% of children under five years old are vitamin A deficient and about 30% of them are anemic.

Another central piece of the hunger puzzle is the lack of knowledge people have about nutrition requirements.

“Many Sri Lankans are unaware that they should be eating fruits and vegetables. They do not know that they should be eating a wide range of foods,” said Tillekeratne.

“People need to be taught about the importance of food nutrition, especially in rural areas. When buying food, they make their choices based on cost and taste preferences. They do not seem to take nutrition into account,” said Joshi.

What is being done?

The government is well aware of the aforementioned nutrition problems and has designed and implemented a variety of programmes to fix them.

“We are working with farmers to encourage them to cultivate more diverse crops. More diversity can ensure better nutrition. We also want to make sure that all available farmland is being used to maximize yields. Some lands are abandoned, and we can use these,” said Wijayarathne.

Furthermore, efforts are being made to increase milk production in the country.

“The main cow breed we have does not produce much milk. The animals often do not eat enough nutrients and environmental conditions also make it hard on them. We are importing 15,000 cows from Australia that will hopefully boost our milk production,” said Professor H.W. Cyril, Chairman of the National Livestock Development Board.

As it stands, 40% of the country’s milk is produced locally. The hope is that these imported animals will be able to boost domestic production, thereby lowering the price of milk.

Likewise, the Ministry of Education has plans to expand its already successful school lunch programme in the near future.

“Students are provided with rice and curry lunches and a portion of milk. Protein options vary, but dried fish and eggs are the most common options. In the Northern province we provide canned fish,” said Renuka Peiris, Director of School Health and Nutrition and the Ministry of Education. Micro-nutrient supplements, such as Iron and vitamins A and C are also available to students who need them. The Ministry allocates resources to schools that are in need of help and provides these lunches. Currently, 55% of primary school children receive lunches through this programme. Currently, the Ministry is concentrating its efforts on primary school students, but Peiris acknowledged adolescent students need increased coverage.

Another recent innovation is the addition of classes on nutrition at national schools.

“We have created compulsory courses where students learn how to eat properly and lead healthy lifestyles. Kids are taught about body mass indices and how to identify their own nutritional status,” said Peiris.

While these are significant programmes, national schools are predominantly benefitting from them.

“We are planning to expand our operations in provincial schools starting next year,” she said.

Suggestions

Joshi, who worked on the GHI, thinks that more can be done to combat hunger and malnutrition in Sri Lanka. While he lauded efforts to diversify agricultural production, he also mentioned the advantages of bio-fortification programmes.

“With bio-fortification, farmers can naturally cross plants and create varieties that are richer in nutrition that the original breeds. These are not genetically modified organisms (GMOs), but natural nutrition-enhancers. Farmers have had success with these programmes, creating grains that are high in iron and cauliflower that has a lot of beta-carotene,” he said.

On top of this, Joshi, along with other experts, would like to see a robust nutrition education and awareness campaign take place in the country, not just in schools.

“Sri Lanka should work to educate its people how to cook food and get enough nutrition. A huge amount of the wasting that is currently taking place can be eliminated by a robust awareness campaign,” said Joshi.

Tillekeratne, for her part, concurred, arguing that a behavior change campaign could achieve “marvelous impacts.”

Several experts also called for increased investment in Sri Lanka’s agriculture sector.

“More money needs to be put into researching, developing, and mechanizing agriculture. A lot of money goes into subsidies for farmers. Sri Lanka currently has good food availability, but availability will decrease as the population grows if yields do not improve,” said Thibbotuwawa.

Yet another area of concern is the multi-sectoral approach the country is taking with respect to its hunger and nutrition problems. There were reportedly plans to create a Ministry of Food Security, but this body did not materialize. Instead, a large number of different ministries are responsible for specific aspects of food security.

“Agriculture is under one ministry, nutrition under another, and land under another. The ministries are somewhat fragmented. So many people are working on the same issues but not planning together,” said Tillekeratne.

It is her contention that Sri Lanka’s hunger and nutrition problems stem not from physical factors, such as global warming and water scarcity, but from poor organization.

“Our main trouble is a lack of planning. All countries have environmental troubles, but most people are not going hungry. We can manage this crisis as long as we work together. We need to get all the stakeholders to gather around the table to discuss what should be done,” she said.


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