Comment by our Blog Readers

"This is indeed a big modern step to improve accessibility and benefit to the Sri Lankan community"

Farman Nizar,

Head of OTC (Wellness),

Swiss Biogenics Ltd.

"Hearty congrats on venturing into new territory! This is a first as far as I know for the MRI / MOH" 

Dr. Reggie Perera,  

MBBS, M. Med. Sc. MD, CCP, FCMA, FCCP, FSLAMA,

Hon. Senior Fellow PGIM,

Consultant in Health System Management & Community Health,

Former Secretary, Ministry of Health, Nutrition & Welfare.

"Glad to see on of our units getting IT into proper use..! I think we all can learn few things from "The Nutrition Team" lead by Dr. Renuka Jayatissa"

Dr. Anil Samaranayake,

MBBS, MSc., MD, MA, IHRM

Former Research Fellow [University of Melbourne],

Consultant Community Physician.

"Thank you for informing us about the launch of the blog "Nutrition and lifestyle" by Medical Research Institute. We will be sure to follow the blog regularly!"

Jacqueline Lye,

IOF Asia Pacific Office,

IOF - International Osteoporosis Foundation.

"It is really good, informative, helpful and beautiful. Congrats for you and your team's hard work"

Dr. Manjula Danansuriya (MBBS, MSc, MD),

Family Health Bureau.

"I went through the information. That will be a marvelous opportunity for the readers. Congratulations!"

Dr. C.M Wickramatilake,

Dept of Biochemistry, Faculty of Medicine,

University of Ruhuna, Galle.

"Congratulations, I am very proud of your work"

Kumudu Wijewardena.

"Thank you very much for you sharing with us news and updated information on Nutrition and wish you the same to continue and also for improvements. I will send more comment on this later and pl keep link with me for any update"

R.H.W.A Kumarasiri,

Director/WFP Projects,

M/Economic Development.

"I will ask my IT Savvy Children to join the blog"

Prof. Rezvi Sheriff, Director, 

PGIM, Sri Lanka.

"I congratulate you on your work in Nutrition in SL. Lets join hands and help SL in the development of these ideas! Prevention of disease is so important for a developing country as Sri Lanka"

Prof. Nihal S. DeSilva, 

Washington University/Environmental Health & Allergy/BioGene, Inc/Prevention,

St. Louis, MO, USA.

"This will be a very useful website. Pl continue with your all good work"

Dr. Padma S. Gunaratna,

Consultant Neurologist, NHSL, Sri Lanka.

"We can look at publishing some of your work in our magazine"

Roshan Madawela

CEO/Director,

The Big Issue Sri Lanka - Magazine.

"I have gone through the blog and it is very interesting. Most Sri Lankans are guided by wrong nutritional information (obtained mostly from the web or through e-mail). So this a very good way to provide them correct information"

Tissa Amarakoon,

Department of Chemistry,

University of Kelaniya. 

"Good work. Timely need for the country"

Priyanwada Amarasekara

Nutrition Information For All !- Sri Lanka Nutrition Bulletin | පෝෂණ තොරතුරු සැම අතට !

 Nutrition Department , of Medical Research Institute, Colombo in collaboration with UNICEF, launched "The Nutrition Bulletin of Sri Lanka".

By this quarterly publication we will be providing information about principle nutrition indicators, facts, new knowledge and events to all. The target audience will be medical professionals, policy makers , undergraduate and post-graduate students and anyone who is interested on nutrition status of Sri Lanka. The prime goal of this publication will be to make the scientifically gathered up-to-date nutrition data available , whenever needed.

copies of this publication could be obtained by contacting us or you can download it by clicking here.

Director MRI (Dr. Anil Samaranayaka), Presenting the Inaugural edition to Country representative UNICEF (Mr. Reza Hossaini) ; Dr.Renuka Jayathissa (Head, Nutrition Dept, MRI) , Dr. Ananda Gunasekara (DDG-MS) also seen in the picture

ඇමයිලේස් බහුල ආහාර වලින් දරුවන්ට වඩාත් ගුණාත්මක අතිරේක ආහාර.....| Amylase Rich Food (ARF) |

සාමාන්‍යයෙන් ළදරුවනට අතිරේක ආහාර ලබා දීම ආරම්භ කරන විට පළමුව බත් කැද දීමට පුරුදුව ඇත. මෙම කැද බොහෝවිට පිළියෙළ කරුණු ලබන්නේ බත් හෝ වෙනත් ධාන්‍ය වර්ගයක් යොදාගෙනය. නමුත් මෙම ආහාරයේ ශක්ති ජනක අගය අඩු වන අතර දියරමය ස්වභාවය ද වැඩි වේ.එනිසා මෙය ළදරුවාගේ දිනක ශක්ති අවශ්‍යතාව සපුරලිඉමට අපොහොසත් වේ. මෙයට හොදම විසදුම වන්නේ ඇමයිලේස් බහුල ආහාරයක් මෙයට එකතු කිරීමයි.එමගින් ආහාරයේ මුළු පරිමාව අඩු වන අතර එහි ශක්ති ප්‍රමානය ද වැඩි වේ.එනිසා එය ළදරුවාට පහසුවෙන් ආහාරයට ගත හකිවේ. මෙම ඇමයිලේස් බහුල ආහාර ඔබට නිවසේදීම පිළියෙළ කර ගත හැකි වේ.ඒ සදහා පහත ක්‍රමය යොදාගත හැක.

1. මුං , කවුපි , උඳු යන ඕනෑම ධාන්‍ය වර්ගයක් තෝරා ගන්න.

2. එය මුල් අදින තුරු වතුරේ පොඟවා ගන්න;පැය 48 ක් පමණ තැබීම ප්‍රමාණවත් වේ.

3. පසුව එය හිරු එළියේ හෝ උදුනක අඩු උෂ්ණත්වයක් යටතේ වියලා ගන්න.

4.වියලුනු පසුව එය කුඩු කර ගන්න

5.එම කුඩු පියන හොදින් වැසිය හැකි බෝතලයක බහා තබන්න.

6. ළදරුවාට ආහාර පිළියෙළ කරන විට මෙම කුඩු තේ හැදි 1 ක් ඊට එකතු කරන්න

මෙය ඔබට නිවසේදී සාදා ගත හැකි සුළු මුදලක් වැයවන ආහාරයේ ගන ස්වභාවය වැඩි කර එහි ශක්ති ප්‍රමාණය ද වැඩි කරන පෝෂණ අතිරේකයකි. ඔබත් ළදරුවකු සිටින මවක නම් මෙය අත්හදා බලන්න.


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

Iodine deficiency disorder (IDD) status in Sri Lanka | ලංකාවේ අයඩින් ඌනතාවයේ නවතම තත්වය ගැන දැනගන්න...

From 1940’s onwards goiter had been identified as a common problem in Sri Lanka. There was a goiter belt across Western, Sabaragamuva, Central, Southern and Uva provinces. During this period Goiter prevalence was 40% and different actions had been taken to reduce the goiter occurrence. In spite of these actions, in 1986 goiter prevalence was at a higher level of 18%.In response to these findings and keeping in line with the goals set by the World Summit for Children in 1990, the Sri Lankan government initiated and implemented the Universal Salt Iodization programme in 1995. According to the Food Act, a minimum of 50ppm of iodine at factory level and 25ppm at the household level was essential.

After that in year 2000, 2005 and 2010, regular assessment of IDD status and quality of iodized salt were done by   Department of Nutrition, Medical Research Institute. According to the WHO/ICCIDD the Criteria for monitoring progress towards sustainable elimination of IDD, Sri Lanka had achieved all the criteria by 2005.

Assessment done in 2010 included measurement of urinary iodine levels in school children and pregnant women as well as water iodine levels and iodine levels in household salt.  

According to this assessment, overall goiter prevalence was 4.4% and it was higher among females than males in almost all provinces except in Central Province. The highest prevalence was seen in Northwestern, Central and southern provinces while lowest in Northern province.

 
Goiter prevalence in provinces             

Urinary iodine level is an indicator of amount of iodine taken in to the body. In a normal person this value would be 100-200µg/L and during pregnancy it is about 250µg/L. More than 300µg/L is considered as toxic levels. In 2010, among school children 37.7% had urinary iodine levels between 100µg/L - 200µg/L. The median urinary iodine level in pregnant women was 133µg/L.

 

Water iodine levels in 2010 in the different provinces are shown below.

Households with recommended salt iodine level should be more than 90%. In Sri Lanka it was 91% in 2005 but there was a decline in 2010 to 68.2%. None of the provinces have achieved the recommended household salt iodine levels.

 In summary by 2010 Sri Lanka has fulfilled three criteria out of four in the WHO/ICCID criteria for monitoring progress for sustainable elimination of IDD as shown below. Sri Lanka is yet to achieve the usage of adequately iodized salt at household level.

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

Current Nutritional Status of Chilren in Sri Lanka-II |ශ්‍රී ලංකාවේ ළමා පෝෂණ තත්ත්වය පිලිබඳ විපරමක් -II

please refer the 1st part of this article first


Micronutrient (vitamin and mineral) Deficiencies


Sri Lanka has three major micronutrient deficiencies that have been identified as public health problems, namely, iron, Vitamin A and iodine. The prevalence of anaemia among children under five years, primary schoolchildren, adolescents, adult females and pregnant women are 29.9%, 20.9%, 22.3%, 31.6% and 30.3% respectively. Iodine deficiency has successfully control with the implementation of universal iodination of salt. It was revealed that 29% of children under five years were suffering from Vitamin A deficiency in 2006.


What causes malnutrition?


The common perception stands that the cause for malnutrition is poverty, but in reality it is multifactorial. The immediate causes of malnutrition are inadequate food intake and illnesses; Underlying causes include inadequacies in access to food, inaccessibility to health services, poor sanitary environment, and inadequate caring practices for children, poor eating behaviors and inadequate personal hygiene etc. Complementary feeding is intricately interwoven with various myths, beliefs and practices; many babies receive diluted, unhygienic foods at the incorrect age and in inadequate quantities; inadequate knowledge of complementary food among parents have become a serious issue.


Why does malnutrition matter?


The risks of malnutrition are extremely high during the stages of fetal development and during the first two years of life, it will affect physical growth and mental development and resulting irreversible damages. Experts have shown that eliminating malnutrition would remove one third of the global burden of disease. World Bank has indicated that a 1% increase in height has been associated with a 4% increase in total wages and eliminating anaemia would contribute to an estimated 5-17% increase in lifetime earning. Same time low birth weight has been shown to reduce intelligent quotation (IQ) scores by 5 points.


What are the loopholes in exiting interventions?


Vitamin and mineral supplementation: Free Supplementations of calcium, iron, folate and vitamin ‘C’ which are provided to all pregnant mothers who attend clinics and Vitamin A supplementation for children at 9 months, 18 months and 3 years by the Ministry of Health. Loopholes are poor compliance with vitamins due to lack of appropriate knowledge.


Food supplementation:


The Thriposha food supplementation programme has been in operation since 1976 at the cost of around Rs. 600 million annually. A daily ration of 50 gm is distributed to pregnant mothers throughout pregnancy and lactating mothers for a period of 6 months, and under fives who show growth faltering. Production is inadequate to provide all the needy groups. It suffers from distribution problems, especially in remote areas; the food is shared with families; difficult to maintain regular supplies, daily ration is not enough to cover the minimum requirements;


Nutrition education:


It is mainly implemented at clinics and during home visits by the Public Health personnel. There is hardly any time for nutrition education at many of the largely over-crowded clinics; many mothers travel long distances to the clinic and are impatient to get back to their homes.


Food based dietary guidelines:


Food based dietary guidelines have been developed by the Ministry of Health for Sri Lankans based on customary dietary patterns, taking into account the relevant social, cultural, environmental and agricultural factors affecting food availability, food habits and eating patterns. But the applicability is very low.


Food security interventions:


Since achieving Independence in 1948, Sri Lanka’s Food Security Strategy was determined by three sets of policies


• Achieving self-sufficiency in basic food items such as rice, milk, fish etc.
• A public distribution system through Multi-Purpose Cooperative Societies; and public institutions such as Corporative Wholesale Establishment (CWE), Paddy Marketing Board (PMB) and Food Commissioner’s Dept.
• Welfare Programmes, which included either a food subsidy or food stamps or an income transfer component.


Though the above measures are important to improving food security, the determination of the nutritional status of an individual occurs primarily within a household (family) and is dependent on resource accessibility and availability, intra-household resource distribution and information availability.


Food subsidies and income supplementation programmes: With a view to ensure food security at household level, Sri Lanka has implemented various food subsidy and income supplementation schemes.


• the universal coverage of the food subsidy;
• commodity specific subsidy;
• Food Stamp Scheme;
• the Janasaviya, programme which had micro credit, health and nutrition improvement, infra-structure development, income supplement and entrepreneur development components and lately introduced
• The ongoing Samurdhi programme.
• School breakfast or mid day meal programmes
• Current Mahinda Chinthana programme
Some of these programmes were poor targeting and interrupted flow of distribution, where a substantial proportion of resources were distributed among the non-poor.




Written by-


Dr.Renuka Jayatissa (MBBS,MSc,MD)
Nutrition Specialist and Head, Department of Nutrition, MRI

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.