Healthy Diet | නිවැරදි ආහාරයකට මඟ

What are the food groups?

Source: www.livestrong.com

There are six food groups. They provide energy and nutrients for you to be healthy.

As different groups give you different nutrients, you need food from each group.

The food groups are:

·      Cereals and yams,

·      Fruits,

·      Vegetables,

·      Milk or milk products,

·      Fish, pulses, meat and eggs,

·      Nuts and oil seeds.

In order to obtain a healthy diet, eat at least from these 6 food groups. That is exactly our customary habit. The diet of many of us lacks variety or adequate amounts of indispensable nutrients. A "Healthy" diet not only supplies all the nutrients but also supplies them in amounts adequate for the individual's daily needs. 

How do you select a healthy diet?

Select the diet on the nutrient content and the quantity of each nutrient in a particular food. The following table shows the 3 main types of food, classified according to their function that will covers the nutrient requirements taken into account in the above six groups of foods.

Function of foods	Major nutrients	Food sources	Other nutrients
Energy giving	Carbohydrate and fats	Cereals - Rice, wheat, bread, kurakkan, meneri, maize, sorghum. Yams - manioc, sweet potato, potato, innala, kiriala, king yam.  Starchy fruits - Jak, bread fruit,	Protein, calcium, iron, B-complex vitamins.
		Fats – coconut, palm oil, gingili oil, soya, olive oil, sunflower oil etc., butter, margarine, ghee. Nuts and oil seeds - coconut, ground nuts, gingili, cashew nuts, kottang Sugars – white and brown sugar, jaggery, treacle, honey.	Fat-soluble vitamins, essential fatty acids. Proteins, vitamins, minerals
Body building	Proteins	Meat – chicken, beef, pork, liver. Fish – sea, fresh water and dried fish  Pulses - green gram, soya bean, cowpea, ulundu, kadala, lentil.	B-complex vitamins, iron, calcium, iodine, fat. B-complex vitamins, fat.
		Milk or milk products – milk, cheese, fermented milk, yoghurt.	Calcium, vitamin A, riboflavin, vitaminB12
Body protective	Vitamins and minerals	Leafy vegetables–kankun, spinach, gotukola, mukunuwenna, sarana katurumurunga (Agathi). Fruit and root vegetables–gourds, brinjals, ash plantains, okra, tomato, innala. Fruits - plantain, mango, papaw, pineapple, oranges, guava, avocado	Carbohydrates, Protein

Please refer to our next article for recommendations 

History of Wheat Flour in Sri Lanka | පාන් පිටි වල ඉතිහාසය දන්නවාද?

Source: www.hiwtc.com

The grain of wheat is a seed with a structure similar to that of the rice grain. The outer coverings, pericarp and testa, are hard, fibrous and indigestible. Beneath them is the aleurone layer, which is rich in B complex vitamins and proteins. These outer layers form about 12% of the grain.

The distribution of nutrients in the grain is not uniform. The germ and the scutellum are rich in protein, B vitamins and the germ, in vitamin E. The scutellum contains about one half of the thiamin in the grain.

Wheat usually eaten as wheat flour. During milling the outer layers are removed. Usually the germ and the varying proportions of the outer layers are separated from the bran and the white flour obtained is nearly all starch, the outer coverings been removed as bran. The nutritive value of the flour will therefore depend on the proportion of the grain that remains in the flour. The proportion of the grain in the flour is referred to as the "extraction rate". The lower the extraction rate the whiter flour and lower its nutritive value.

Before World War II very few person in Sri Lanka ate bread or other preparations of wheat flour, so that little was imported. All four meals eaten by Sri Lankans were based on rice. The morning meal consisted of preparation of rice flour, such as hoppers, string hoppers, pittu, roti and the midday meal and the night meal consisted of rice and curry. Many persons had an afternoon snack, reported to as "tiffin". The richer folk could afford sandwiches of bread and butter, with an occasional potty as a piece of cake, made of wheat flour. Other had various rice flour preparations such as aluwa, kavum, kokis. The only wheat flour preparation available freely was "hulang -viskothu". Dr. Lucian Nicholls, during dietary surveys conducted indifferent parts of the country, found that 16 to 18 ounces (450 to 500 grams) of rice and rice flour preparations were consumed each day by the common people. When other starchy foods were available in season, rice was supplemented with yams such as jak and breadfruit and roots such as manioc, batala, wel-ala and kiri ala. Always the local production of rice was grossly insufficient, the British was able to import rice from Burma to make adequate quantities available to provide each individual adult more than 450 grams per day.

Such imports were not possible during the war and wheat and wheat flour was brought in mainly from Australia. The little rice available was rationed, so that each person received at least 225 grams per day. This was supplemented with grained such as bajra.

After the war, wheat flour continued to be imported from Australia, Europe and North America. Food aid came in the form of wheat flour. Later, wheat was brought in as grain, to be milled locally. In 1976 a Singaporean firm presented to propose to the government that they be allowed to construct a modern flour mill at Trincomalee and to convert all wheat brought into the country to wheat flour. Flour of 70% extraction would be given to the government, and the 30% of bran would be property of the firm.

In 1977 the Flour Mill constructed by the Prima Co. is a very large eight storied building. Wheat grain brought in ships is sucked to the upper floor and undergoes various changes which convert the grain to 74% extraction flour, as it passes from one floor to the next. At the lowest floor flour is packed into bags which then become the property of the Food Commission. At each stage samples were collected and taken to the laboratory for quality analysis. The mill is kept very clean and mill maintained and the workers are well disciplined. An officer of the Sri Lanka Standards Institute, who spent a few days at the mill, expressed satisfaction of the milling process as well as measures taken for quality control.

The flour remains at 74% of extraction, with very little of the nutrients present in the grain. Very major and expensive change will have to be made in the machinery if the extraction rate is to be increased. Less drastic changes could be effected to fortify this flour with nutrients such as vitamin B complex and iron.   

       

Written by late Emeritus Prof. T.W. Wikramanayake, MBBS, Ph.D, Hon.DSc.       

For the Sinhalese version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ස๢๜හල ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න.    

About Us | Towards Enhancing Sri Lankans Lives through Better Nutrition …

Towards Enhancing Sri Lankans Lives through Better Nutrition …

In 1920, the De Soyza Bacteriological Institute (presently known as MRI) was established. Dr. Lucian A. Nicolas founded the Department of Nutrition in 1926 in order to calculate wages by looking at food patterns in the county.

During the dietary surveys, many deficiencies were identified throughout the Nation. To overcome these issues, ‘Thriposha’ was invented and distributed throughout the country while maintaining a regular monitoring system. Over time, ‘Thriposha’ was accepted internationally as a world-renowned supplementary food. Through out the years, the Department published Food Composition Tables of Sri Lanka using available food analysis to identify the nutrients in Sri Lankan food. Along with this, social benefit programmes (coupon systems, Food Rations and Samurdhi ), consumer Recommended Daily Allowances and estimation of the amount of food needed for the country were established.

The Department contains the field unit, laboratory and research co-ordination and information unit. The field unit consists of highly recognised staff involved in; data collection, anthropological surveys and measurements, sample collection and dietary surveys in the filed. The accredited laboratory unit possesses urinary iodine, salt iodine, food and vitamin and mineral testing facilities with highly trained staff. We also have the wealth of experienced data analysts, statisticians, and consultant community physicians that contribute to our Department.

Through out the years, we have done abundant surveys such as monitoring childhood Vitamin A status, malnutrition states and iron deficiency, both routinely and in emergency situations. We have essentially reached iodine deficiency elimination through out Sri Lanka. As well as successful surveys, the Department is involved in undergraduate and postgraduate training of medical and non-medical personnel, conferences, media seminars, and public education via official website and blog, printed and electronic media and the Nutrition Information Center.

Currently, we are in the process of employing novel approaches for bettering the nutritional status in Sri Lanka, such as to eliminate iron deficiencies through Double Fortification of Salt.

Overall; we have gained many successes with the involvement of all the medical and non-medical sectors, advocacy for policy makers and capacity building of health personnel. The Department of Nutrition is the pioneer Department of conducting nutritional related research in Sri Lanka, since 1920s and we hope to achieve more in the future for bettering the nutritional status in our Nation.

For the Sinhalese version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ස๢๜හල ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න. 

අප ගැන දැනගන්න |පෝෂණ තත්ත්වයෙන් අනූන ලාංකීය දිවිපෙවතක් කරා ...

පෝෂණ තත්ත්වයෙන් අනූන ලාංකීය දිවිපෙවතක් කරා ...

1920 අග භාගයේ දී, ද සොයිසා බැක්ටීරියානුවේද (වර්තමාන වෛද්‍ය පර්යේෂණ ආයතනය) ආයතනයේ අංශයක් ලෙස, වෛද්‍ය ලූෂන් ඒ නිකලස් මහතාගේ ප්‍රධානත්වයෙන් පෝෂණ  අංශයේ ආරම්භය සනිටුහන් විය.අපගේ ආරම්භක පරමාර්ථය වූයේ ශ්‍රී ලාංකීය පෝෂණ තත්ත්වය පිළිබඳ වාර්තා සම්පාදනය කිරීමය. කල් යත්ම අපගේ සමීක්ෂණ හා වාර්තා සැළකිල්ලට ගනිමින් රටේ ආහාර අවශ්‍යතාවය ගණනය කිරීම ,ජාතික වැටුප් තල සකස් කිරීම, ආහාර මුද්දර හා සළාක, සමෘද්ධි, ආදී සහනාධාර වැඩසටහන්ද සකස් කරන ලදී.

අපගේ පර්යේෂණ වලදී ඉතා වැදගත් සොයාගැනීම් කරන ලද අතර ඒවා නිවැරදි කිරීම සඳහා පසු කාලීනව රජයයන් විසින් විවිධ ක්‍රියාමාර්ග ගන්නා ලදී.

එකල ඉතා සුලබ වූ මන්දපෝෂණ තත්ත්වය පාලනය කිරීම පිණිස අපගේ නිෂ්පාදනයක් වූ "ත්‍රිපෝෂ" මහෝපකාරී වූ අතර එය ජාත්‍යන්තරව,මන්දපෝෂණය පාලනය කිරීම සඳහා වූ හොඳම පරිපූරක ආහාරයක් සේ පිලිගැනේ.

ලාංකීය ආහාර වල සංඝටක ප්‍රමාණ පර්යේෂණාත්මකව සොයා එම වගු සැකසීම, නිර්දේශිත ආහාර වේල් සැකසීම ආදිය අපේ අනෙකුත් ප්‍රමුඛ කාර්යයන් විය. මේ සඳහා අවශ්‍ය ආහාර වල අඩංගු විටමින, ලවණ ආදිය පවා පරීක්ෂා කල හැකි සහතිකලත් දියුණු පර්යේෂණාගාර පහසුකම් හා පුහුණු පර්යේෂකයින් අප සතු වේ.

ශ්‍රී ලාංකීය ප්‍රජාවේ පෝෂණ තත්වය, ආහාර සුරක්ෂිතතාවය හා සනීපාරක්ෂක පහසුකම් ආදිය පිලිබඳ, ලෝකයේ ඕනෑම රටකට නොදෙවෙනි ලෙස මුලු දිවයිනම ආවරණය වන පරිදි විද්‍යාත්මකව රැස් කල යාවත්කාලීන දත්ත සමුදායක් අප සතුය.මේ සඳහා අත්දැකීම් බහුල ක්ෂේත්‍ර පර්යෙෂණ කණ්ඩායම්, දත්ත සකසන්නන් ,විශ්ලේෂකයන්, සංඛ්‍යානඥයින් හා ප්‍රජා වෛද්‍ය විශේෂඥයින් ඇතුළු ජගත් පැසසුමට ලක්වූ කණ්ඩායමක් අප සතුය.

රාජ්‍ය මෙන්ම ,එක්සත් ජාතීන්ට අනුබද්ධ ආයතන මෙන්ම, රාජ්‍ය නොවන ආයතන හරහා ක්‍රියාත්මක වන වැඩසටහන් සැලසුම් කිරීමටත්, ඒ සඳහා අවශ්‍ය මූල්‍ය පහසුකම් ලබාගැනීමටත් මෙම දත්ත බහුලව පදනම් කර ගැනේ.

2009-2010 වකවානුවේ යුධ ගැටුම් වලින් අභ්‍යන්තරව අවතැන්වූ සහෝදර ජන සමූහයේ තිබූ උග්‍ර මන්දපෝෂණ තත්ත්වය ඉතා කෙටිකලක් තුල පාලනය කල ආකාරය වර්තමානයෙදී ලොව පුරා පූර්වාදර්ශයක් සේ සළකනු ලැබේ. 

ලාංකීය ළමා පරපුරේ විටමින් A, යකඩ හා අයඩින් ඌනතාවයෙන් මිදීම සඳහා අප විසින් කරන ලද පර්යේෂණ , සැළසුම් හා පසු විපරම් මහෝපකාරී විය.එහි ප්‍රතිඵලයක් ලෙස අයඩින් ඌණතාවය තුරන් කිරීමේ කඩඉම කරා අප පැමිණ සිටී.

දශක ගණනාවක් පුරා කරන ලද විවිධාකාර වූ වැඩසටහන් තිබියදී පවා ගැටළුවක්ව පවතින යකඩ ඌණතාවය තුරන් කිරීමේ නවතම ක්‍රියාමාර්ග කරා අපි එළඹෙමින් සිටිමු.

විවිධ සම්මන්ත්‍රණ, මාධ්‍ය හමු, වෙබ් හා බ්ලොග් අඩවි, විද්‍යුත් හා මුද්‍රිත මාධ්‍ය මෙන්ම විශේෂිත වූ පෝෂණ තොරතුරු මධ්‍යස්ථානය හරහා පිරිස දැනුවත් කිරීමද අප විසින් සිදු කරන කාර්යයකි.

දේශීය හා විදේශීය ප්‍රථම හා පශ්චාත් උපාධි ආයතන, හෙද හා මහජන සෞඛ්‍ය පුහුණු පාසල් හා විවිධ වෲත්තික ආයතන හා සමීප සබඳතා පවත්වා ගනිමින් එම සිසුන් හා වෲත්තිකයන් පුහුණු කිරීම සඳහා න්‍යායත්මක හා ප්‍රායෝගික යන දෙ අංශයෙන්ම සම්පත් දායකයන් ලෙසද අපි කටයුතු කරමු.

සෞඛ්‍ය ක්ෂෙත්‍රයේ සියළු අංශ හා අනෙකුත් ක්ෂේත්‍රද එක්ව පෝෂණීය ලාංකීය ජනතාවක් බිහිකිරීමෙහිලා මෙතෙක් අප ආ ගමනේ ලබාගත් ජයග්‍රහණ අතිමහත්ය. අපගේ ශක්තීන් පෙරදැරිව වඩාත් පැහැබර අනාගතය කරා ගමන් කරමින් අප අරමුණු ලඟා කර ගැනීම  අපගේ ඒකායන අරමුණයි.

For the English version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ඉංග්‍රීසි ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න. 

Health Benefits of the Soya Bean |රස ගුණ පිරි සෝයා බෝංචි

Source: Tradenote.net

Soya has been an all time favorite food across the globe for decades.

Composition of soya: 

• Protein (g): 51.5%
• Carbohydrate (g): 33.9%
• Total Lipid (g): 1.2%
• Total dietary fibre (g): 17
•  High in soluble fibre.

Soya bean is not consumed in the raw state and processing helps to destroy the anti-nutritive substances, e.g. trypsin inhibitors and improve the nutritive value.

(Trypsin: a catalyst in the hydrolysis of peptides into amino acids. This is a vital step as peptides are too big to  pass through the lining of the small intestines). 

Soya has low glycaemic index & moderately low glycaemic load with insulin sparing effect which helps in control of type 2 diabetes. In addition soya has cholesterol lowering effect and antiangiogenic effect of isoflavones may prevent diabetic retinopathy & diabetic nephropathy. 

Isoflavones in soya is structurally similar to mammalian oestradiol (hence called  phytoestrogens) and major compounds are: daidzein and genistein which occur in foods as glycosides. It is not oestrogenically active unless deconjugated. Therefore few studies have shown the protective effect of soy bean isoflavones for breast cancer and lower risk for endometrial cancer. 

(Isoflavones: organic compound. Has antioxidant properties)

Studies have shown that soy protein improves lipids levels. Especially it reduces the LDL, Triglycerides and increases the HDL levels, which will reduce the risk of getting heart attacks.

Written by

-Dr. Renuka Jayatissa

Nutrition Management of Diseases(for health care workers) | නේවාසික රෝගීන් සඳහා පෝෂණය

courtesy-imprintmag.org

Medical teachers usually refrain from teaching dietetics to medical students. As a result, doctors seldom prescribe full dietetic instructions. For example, instructions are commonly given to a patient to ‘avoid sour and spiced foods’ without specifying the forbidden items. Where facilities are available, dietetic prescriptions are prepared by a dietician. Unfortunately, dietetics facilities are not available everywhere, and hence the need for medical doctors to be able to prescribe a diet. Patients prefer to get advices from the doctor treating his or her sickness. Because doctors are not trained to give adequate dietary advice, the public turn to unqualified, unregulated bodies. Too much attention is being paid by people with eating ‘correct food’; this has killed the pleasure of eating. It focuses on the nutritional management of individual patients or groups of patients with established disease and aims to treat (and prevent) suffering from malnutrition.

This article will be highlighted the importance of nutrition management in sick adults and the easy way of screening them. 

What is malnutrition?

 

The term malnutrition indicates a bad nutritional status. Nutritional status is the physiological state of an individual, which results from the relationship between nutrient intake and requirements, and the body’s ability to digest, absorb and use these nutrients. Malnutrition arises from deficiencies or excesses of specific nutrients, or from un-diversified diets (wrong kinds or proportions of foods). A distinction must be made between malnutrition and under nutrition.

What is under nutrition? 

It is the outcome of insufficient food. It is caused primarily by an inadequate intake of dietary or food energy. It is defined as a dietary energy intake below the minimum requirement level to maintain the balance between actual energy intake and acceptable levels of energy expenditure. Co-existence of micronutrient deficiencies is also included.

Malnutrition in the hospitalised patient

More common among following categories: Patients admitted to medical wards, Preoperative patient, Postoperative patient, Cancer patient and Chronically ill.

Starvation and subsequent malnutrition may occur as complicating factor during the course of the patient’s illness. Death will occur from Protein Energy Malnutrition within 60-70 days of total starvation and functional metabolic deficits occur after 10-15 days of semi-starvation in previously healthy adults and shorter periods in those already compromised by disease. Consequences of starvation are weight loss, alterations in organ function, malaise, lethargy and changes in cognitive function.

Why is under nutrition important in management of sick?

Under nutrition has both physical and phycosocial effects which will directly or indirectly affect the prognosis of the disease.

Physical effects of under nutrition are impaired immune responses (predisposes to infection), reduce muscle strength and fatigue (inactivity, inability to work effectively, poor self care, abnormal muscle function), reduce respiratory muscle strength which will give poor cough pressure, predisposing to and delaying recovery from chest infection, inactivity, especially in bed-bound patient, predisposes to pressure sores and thromboembolism, Impaired thermoregulation, hypothermia, especially in elderly, impaired wound healing, failure of fistulae to close, un-united fractures, increased risk of wound infection resulting prolonged recovery from illness, increased length of hospital stay, delayed return to work, fetal and infant programming which predisposes to common chronic diseases: cardivascular, stroke, diabetes in adult life and Growth failure give rise stunting, delayed sexual development, reduce muscle mass and strength.

Psychosocial effects of under nutrition are Impaired psychosocial functions like Apathy, Depression, Self-neglect, Hypochondriasis, Loss of libido, Deterioration of social interactions, Affect personality, Mother-to-child bonding.

All these factors contribute to severity, duration, hospital stay and complications of the disease.

How do we assess Nutritional Status of sick adults?

Nutritional status can be assessed through body (anthropometric) measurements, weight and height, mid upper arm circumference (MUAC) in adults and body weight changes; clinical examination and biochemical testing, used to diagnose deficiencies of micronutrients (e.g. iodine, vitamin A and iron). Body Mass Index (BMI) will be calculated with weight and height of adults (BMI=Weight (kg)/Height² (cm).

Below table provide the information on interpreting indicators and cut off points of BMI for adults.

LEVEL OF SEVERITY	CUT-OFF POINTS
Severe energy deficiency	≤ 16 or oedema
Moderate energy deficiency	Between 16 and 17
Marginal energy deficiency	Between 17 and 18.4
Normal	≥ 18.5

Screening Tool:

Malnutrition Universal screening tool (MUST) can be used to screen patients on admission. Weight and height can be taken on admission and the MUST can be applied to categorize the patients while taking the history and performing clinical examination. The chart below provides the scoring system. We can use one of the scoring system. If the weight and height measurement is feasible BMI score can be taken, If weight and height has not been taken on admission weight loss score can be adopted and in acute cases acute disease effect score can be adopted.

 

Overall risk of malnutrition and management guidelines

 

Use of parental or enteral nutritional support

•         Maximum period of 7 days of a severely limited nutrient intake

•         Weight loss of 10-15% recalled pre-illness weight

Guidence for Nutrition support group in modification of diet

•         Interview the patient to determine his nutritional needs, dietary habits and food preference.

•         Prescribe the diet in relation to dietary goals

Dietary goals

•         Total Carbohydrate – 55% - 75% of the calories

•         Protein – 10-15% of the calories

•         Total Fat – 15-30%

–        Saturated fats                          < 10% of calories

–        Poly unsaturated FA              6-10%

–        n-6 PUFA                                 5-8%

–        N-3 PUFA                                1-2%

–        Trans fatty acid                        <1%

–        Monounsaturated FAs by difference

•         Vegetables & fruits                         >=400g / day

•         Cholesterol                                          < 300mg / day

•         Salt                                                       < 5g / day

•         Non- starch polysaccharides           25g/day

•         Free sugar                                          <10% of calories

•         Total dietary fibre from food

Management plan

•          Maintain the normal BMI of 18.5 – 24.9 kg/m2 and optimum BMI will be 21-23 kg/m2

Written By
-Dr. Renuka Jayatissa