Sunday, March 14, 2010

Opinion Article:

Dear all,

"As a special series of the PHN blog post, we invite young researchers from developing countries to provide a personal view on public health nutrition in their country and how the YPHN can make a difference. A first contribution comes from Asia, from your blogger / news editor Sangeetha Shyam. If you wish to contribute to this section, please contact us. We hope you enjoy the reading."-The Young Public Health nutrition Network. "

Public Health Nutrition in Asia

The Asian Challenge
Asia is a continent that is best defined by its diversity and this reflects in all aspects of life in Asia, public health nutrition included. Nutritional challenges posed to public health nutritionists in Asia are as diverse as the continent itself. On one side, impoverished regions in Asia struggle to eradicate malnutrition and under-nutrition compounded by the existing illiteracy and poverty. At the other end of the spectrum are the problems associated with over nutrition and obesity. Rapid changes in life style and environmental conditions, and loss of traditional food habits have paralleled an increase in the prevalence of obesity. Therefore Asia’s public health nutrition concerns include a wide spectrum of issues that include ( but is not limited to): decreased purchasing power in the rural and semi-urban areas, food security issues propagated by the distancing of urban population cluster from the food production areas and additional healthcare measures that need to parallel the increasing life expectancies .
There is also the need to ensure gender equality in terms of healthcare, nutrition and education. The fabric of joint-families is unravelling and increasingly the society is getting to see the establishment of nuclear families and with this crumbles the support system for older adults who are getting to live longer. Today’s socio-economic changes have brought in more women into the workforce. The rapidly transitioning Asian society raises more demands and initiatives to maintain healthy lifestyles.

Recognition of Medical Nutrition Therapy

The increasing realization and acceptance of diet in the prevention and treatment of diseases has given “Nutrition” recognition as an allied health science. Nutrition and dietetic courses are offered at various levels at various institutes and universities and are sought after by students. Local print and electronic media often carry articles and columns on food and diet. Issues ranging from weight maintenance to carcinogens in utensils are discussed and deliberated upon. Nutritional knowledge is disseminated to the sections of the society with adequate financial resources and literacy levels that allows them to seek and make use of the available information. There is in essence a definite acceptance of the importance of nutrition in health.

Realizing the Scope for Public Health Nutrition

While nutrition or diet therapy has been recognized as an (optional) adjunct to medical therapy, its application is generally restricted to treatment. It should be noted that there is at present no course that specializes in Public Health Nutrition or "Community Nutrition" as most people know it here, even at post-graduate levels. Opportunities for nutritionists or dieticians are currently restricted to hospital settings or "pseudo"- health care centres- and not enough of these jobs exist for the hundreds of students who pass out every year. Sometimes even these existing positions are under duress because physicians or medical consultants double up as nutritionists since the general feeling is that they are equipped to do so. Research and academic vacancies are still few and rare. The lack of opportunities has driven many nutrition and dietetic students to migrate to other lucrative fields that find increasing “demand” in this geographical region and beyond.

Today, the increased strain on public health care systems caused by genetic predisposition to gestational diabetes, Type 2 DM, and CHD etc. and the increasing health care demands caused by the socio economic issues discussed earlier have led governments to look more into the role of public health nutrition. Results published from various nutritional epidemiological studies conducted here and elsewhere in the world, that identify diet-disease links, and life style modification studies that aim to prevent or delay the onset of chronic diseases, have increased general interest in preventive nutrition, nutritional epidemiology and public health nutrition. Universities and research institutes are increasingly undertaking research projects in public health nutrition. The research projects include cross-sectional studies (that study current trends and assess knowledge, attitude and beliefs related to food consumption, nutritional and physical activity status) and the translational research (with lifestyle intervention that target populations for risk prevention).

Therefore the current climate calls for capacity building among public health nutritionists in Asia to step up to the challenge that is now posed to them and improve their employability in the public health nutrition sectors. Networking among individuals, groups and societies creates effective forums that facilitate exchange of information, and provides windows of opportunities to learn from each other’s experience. Moreover such an interaction builds up recognition and creates an identity for the public health nutritionist. Internet is an economical and effective medium through which such capacity building could be effected. YPHN network has all the elements to be that platform and the link for all public health nutritionists in Asia.