Archives

by Dr. Renuka Silva

Nutrition is a remarkable science because it is multi disciplinary. Although it is increasingly being recognised that nutrition and health are closely related, the field of nutrition has not been given its due recognition in higher education in Sri Lanka until recently.

Some courses in nutrition are included at the undergraduate level in the BSc Agriculture curriculum offered by 6 Faculties of Agriculture, as a subject area under Food Science and Technology. There are no systematic curricula at university level to medical students per se. Medical Faculties offer some nutrition related courses in their MBBS degree programmes in the basic disciplines: physiology, physiopathlology, biochemistry and community medicine.

Wayamba University

A significant change in nutrition education at the undergraduate level took place six years ago, when the Wayamba Campus of the Rajarata University was established in 1996. The Faculty of Applied Sciences started to offer a three-year (General) degree programme in `Nutrition and Community Resources Management'. In 1999 the Wayamba Campus was upgraded to a fully-fledged Wayamba University of Sri Lanka (WUSL) and the Department of Applied Nutrition was established under the Faculty of Livestock, Fisheries and Nutrition.

The three-year general degree programme offered at Wayamba University has been upgraded to a four-year special degree.

Nutrition curricula

The undergraduate programme in nutrition at WUSL is a comprehensive course with both theory and practical components in nutrition.

The objective of the degree programme comprise the following: (a) to provide graduates with knowledge on the relation between food, nutrition and health; (b) to equip them with skills to determine and evaluate food and nutrition situations/problems; (c) to promote nutrition intervention to groups and individuals from both a preventive and curative perspective by assisting in planning, implementing, monitoring and evaluation of intervention programmes; (d) to incorporate nutrition in a community and public health perspective, and (e) ability to assist in undertaking research activities.

Recently, the curricula of the WUSL nutrition degree programme was reviewed by many national and international experts in nutrition field and updates with latest knowledge in nutrition. The curricula was reviewed and evaluated at the 'Workshop on Curricula Review of Nutrition Course Offering in Asia' held in January 2002, jointly organised by the Regional Training Programme - Food & Nutrition Planning (RTP-FNP) Network, University of Philippines, Los Banos and PGIA.

First two years in the degree programme, students will have the opportunity to follow courses in wide range of subject areas in Food and Nutrition. These courses will provide a broader knowledge in the areas of nutrition, food, science and technology, livestock and fisheries.

The nutrition courses covers following topics (a) aspects of food and nutrition - biochemistry, nutrition and physiology, food technology, nutrition and hygiene, nutrition and toxicology, microbiology, quality control and food/nutrient analysis, catering and meal preparation, food consumption and nutrient bioavailability; (b) nutritional sciences - human nutrition, nutritional needs in stages of life cycle (infancy, adolescence, adulthood, elderly, pregnancy, lactation etc), nutritional assessment of populations, nutrition research methods and protocols, sports and exercise nutrition, nutrition epidemiology; (c) diet and disease - dietary risk factors, obesity, diabetes, heart diseases, cancers, osteoporosis and obesity (d) clinical nutrition - (dietetics) deficiencies, enteral/parenteral nutrition, therapeutic diets for patients with renal diseases, diabetes, gastrointestinal diseases, cancer, heart disease etc.; (e) public health and nutrition - behaviour, education, communication, nutrition programmes, prevention of nutritional problems at community level.

Knowledge in nutrition is essential for those involve in food industry to understand toxicological, microbiological and biochemical mechanisms, by which foods spoil and become unsafe. With the economic development and improvement in technology, nutritious and safe foods have a greater demand in the market. The courses in food science and technology will provide modern knowledge and practice.

Community nutrition (also called public health nutrition) captures a wide range of sciences, from basic sciences to technology and social sciences, with nutrition as its core science. Community nutritionists are experts in determining nutritional problems and needs of people, and in planning, implementing and evaluating programmes for better nutrition of the people in the community.

Sports and exercise nutrition is one of the demanding and modern subject offered in the degree programme. This course provides understanding of how can diet be used in improving sports performance (may be in cricket or athletics) and obtaining health benefits by doing exercises scientifically.

Clinical nutrition (or dietetics) is the other branch of nutrition which has been neglected in medical and allied curricula. Undernutrition, or impaired nutrition status, has been frequently reported from surveys estimating their prevalence among patients in hospitals, not only in Sri Lanka but also in many developed countries. In order to provide various skills to be used in the field of nutrition, a number of laboratory and field practical modules have been incorporated to the nutrition curricula in addition to the classroom teaching for more realistic understanding of the subjects. Recently the department initiated a practical dietetic course in order to expose the undergraduates to the hospital care environment.

They will be trained on planning and administering different therapeutic diets scientifically during their training sessions conducted in hospitals. A formal dietetic training and internship has been identified as a future need, with cooperation of the Ministry of Health. In the final year, each student undertakes a research project under the supervision of a member of academic staff and has to present the findings and submit a printed report at the end. That will develop their analytical thinking and writing skills.

The nutrition laboratory contains a range of equipment and suitably instrumental for analytical work. The clinical unit of the department is equipped to measure anthoropometrics, body composition and to conduct clinical investigations. Special computer applications in nutrition are available for student use. Further assistance has been sought from various sources to improve the laboratory facilities.

Careers

The courses in nutrition are career oriented and this means that graduates are in great demand. Graduates with a degree in nutrition would be able to enter a wide a range of careers within the food industry and health services. Graduates of nutrition may gain employment in research institutes, with major food companies concerned with food production and processing; as nutrition coordinators in nutrition programmes conducted by non-governmental organisations (NGOs) and governmental organisations or as trainee-dieticians/nutritionists in hospitals.

Future needs

Sri Lanka has far too few professionals who are expert in or knowledgeable about nutrition. Moreover nutrition training is often a neglected topic for persons other than nutritionists. A wide range of professional could benefit from more and better training in nutrition: health professionals such as doctors, nurses, midwives, health assistants or auxiliaries; agriculture staff (extension workers, research scientists and high level ministry officials; teachers and others in the formal and non-formal education system; social and community development workers; workers in institutional feeding (hostels, armed forces); staff in NGOs involved in development, health, agriculture, community development; professionals in the food industry and related industries are some examples.

Diet therapy is important for almost all physiological diseases and disorders. Nutritional advice from doctors and other health workers is held in high regard by the general public. A pilot survey carried out by us to investigate the appropriateness of the dietary advice obtained by diabetic and heart (cardiovascular) patients in government hospitals, has revealed that most of them are not getting adequate sound and safe dietary advice in the clinics or in the hospitals. A qualified dietitian should do that. As far as the author knows, only two dietitiansposts are available in the whole hospital system at present! This may be due to lack of understanding of the importance of such a profession by the relevant authorities and/or unavailability of the trained personnel in the field of nutrition to be recruited.

The government should take necessary steps to create cadres in hospitals as dietitians and nutritionists.

Nutrition content of the curricula of training institutes of many kinds in various fields such as health, education, agriculture and community development should be reviewed in order to design an appropriate training at suitable levels. Most institutes other than Wayamba University are found to have inadequate coverage of nutrition. A group of experienced persons should be formed to make the recommendations regarding strategies for improving nutrition training, changes in the curricula and the means to make the changes. The first need would be to train the trainers.

Nutrition policy

It is regrettable to emphasise that there is no documented nutrition policy in Sri Lanka. Few years ago, a Presidential Task Force was formed to formulate an action plan for nutrition but the implementation of it has not been done successfully mainly due to lack of commitment and coordination between relevant authorities.

The government should take immediate action to formulate nutrition policy for the country. The academics, experts from various disciplines should join in this process. Nationally, nutrition education should be carried out by several ministries (health, agriculture, education, etc.) and also by various NGOs. All these bodies should agree on common objectives for a nutrition education programme, and each ministry must decide how it implements it. The present situation in this regard is completely unsatisfactory. Research in food and nutrition, which is anther essential component if a country wants to address its nutritional problems is also carried out at a lower profile, again due to lack if qualified nutrition researchers and resources.

Sri Lanka has number of nutrition related problems which affect the productivity and the quality of life of the individual as well as the society. Only few qualified nutritionists with excellent level of accreditation are in the country. Due to lack of knowledgeable manpower an improvement in nutritional status would not be achieved. The Wayamba University of Sri Lanka is the focal point of formal training in food and nutrition, whilst some other institutes offer postgraduate level training. It is a challenge for the government to formulate a national nutrition policy and to use the manpower produced by the higher education institutes effectively and productively to improve the present double-burden (i.e. overnutrition/lack of balance and lack of nutrition) of nutritional problems. The responsible officials in relevant bodies should understand the multidisciplinary nature of the science of nutrition.

(The writer is a Senior Lecturer in Human Nutrition, Registered Nutritionist & Head, Department of Applied Nutrition, Faculty of Livestock, Fisheries & Nutrition of the Wayamba University of Sri Lanka.)

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager