caribbean copertina ok

65

Lessons learned in the project

At the end of the project, the national coordinators, consultants and FAO staff metto review the experiences and lessons learned during the project. In addition to theinformation shared in the manual, the project gained the following insights.

PoliticalA key institution and support from a senior government official is needed to pushthe process forward. FBDGs need to be viewed as part of the national policy to getpolitical support.Meetings to sensitize different actors are important. These meetings could beconducted by universities or prestigious institutions.Some topics are sensitive and affect stakeholder groups. For example, sugarconsumption is a political issue in the Caribbean.

OrganizationalThere can be obstacles to participation of the task force or multi-sectoral committeemembers. Some members may be too busy. Sometimes the high-level members donot attend all the meetings.The task force members should report to the permanentsecretary of the ministry which is leading the process. The process of producing FBDGs took around two years in the project (this istypical for most countries). The schedule should be adhered to; otherwise, the taskforce members lose interest if the process takes longer than planned. The participation by NGOs and the private sector cannot be taken for granted;many did not participate.The launch should be planned as a whole-week activity, including a week before raisingawareness through the media. National committees need to invite very senior people andagencies to the launch at least one month before and remind them the activity.The National Coordinator should carry out advocacy with the government during

Afterword

impaginato dicembre07 20-12-2007 6:39 Pagina 65

66 Developing Food-based Dietary Guidelines

the process. After all the development work is done, the Cabinet approval ofFBDGs usually took one month. However, when there were changes ingovernment, the process was affected. Political parties and stakeholder groupsshould not view the FBDGs as belonging to one group; when the process isfollowed, the FBDGs are “made by the country not by an official group”. They arebased on the population’s needs and perspectives.

ResourcesProduction of educational materials and field work are costly. Project plannersshould attempt to accurately plan the details of budgets. For example, the quantitiesof posters to distribute can be high.Training teachers, health workers, agriculture personnel, and others in how to useand explain FBDGs to their target population has to be planned. To train differentpersonnel, the regular meetings should be used. For example, teachers and nursescan be trained to use FBDGs during their routine in-service training meetings.FDBG can be incorporated into training curricula. Working with graphic designers takes time. Some designers had difficultyunderstanding the technical meaning of the graphic and the concept ofproportionality. In small countries, the choice of designers and printers may belimited. The process requires significant amounts of staff time. The ministry which leadsthe FBDGs process needs to allocate staff for this.


67

CFNI (Caribbean Food and Nutrition Institute). 2001. Obesity prevention andcontrol – the Caribbean experience, April. Kingston.

FAO. 1996. “Rome Declaration on World Food Security” World Food Summit13-17 November 1996, Rome.(www.fao.org/DOCREP/003/W3613E/W3613E00.htm).

FAO and WHO. 1992. International Conference on Nutrition World Declarationand Plan of Action for Nutrition. December. Rome.

FAO/WHO. 1992. World Declaration on Nutrition and Plan of Action, Food,Nutrition and Agriculture, 5/6: 27–49.

FAO. 1996. Rome Declaration on World Food Security. World Food Summit 13-17 November. Rome. (www.fao.org/docrep/003/w3613e/w3613e00.htm)

Friesinger,G.C.and Ryan, T.J. 1999. Coronary heart disease, stable and unstableconditions. Cardiology Clinics, 17:93-122.

Grim, CE et al. 1994 The Dominica Twin Study: Blood Pressure but not HbA1cis under genetic control in blacks in Dominica. Presented to the AHA 67th

Scientific Sessions. Circulation, 90: 1-503.

Henry, F., Morris, A. & Anderson, S. 2001. Food and nutrition. HealthConditions in the Caribbean. Pan American Health Organization (PAHO),Washington, D.C. 190–203.

Henry, F.J. 2001. Obesity-related mortality, morbidity and behaviour in theCaribbean. Cajanus, 34: 62–72.

Henry, F.J. 2004. The obesity epidemic – a major threat to Caribbeandevelopment: The case for public policies. Cajanus, 37(1): 3–21.

References



Hill, J.O.,Wyatt,H.R.and Melanson, E.L. 2000. Genetic and environmentalcontributions to obesity. Medical Clinics of North America, 84(2): 333–46.

Molina V. et. al. April 1995. Lineamientos generales para la elaboracion de guiasalimentarias. Una propuesta de INCAP, Guatemala.

Molina, V. et. al. 2001. Documento técnico guias alimentarias para Guatemala.Comision Nacional de Guias Alimentarias, Guatemala.

PAHO (Pan American Health Organization). 2002. Health in the Americas,Volume II. Scientific and Technical Publication, 587, PAHO, Washington,DC.

Peña, M. & Molina, V. 1999. Food based dietary guidelines and healthpromotion in Latin America. PAHO and Institute of Nutrition of CentralAmerica and Panama, Washington DC.

Reddy, S.K, 1998. Cardiovascular disease in the developing countries.Heartbeat, 2: 4-6.

Riopel, D.A., et al. 1986. Coronary risk factor modification in children: exercise.A Statement for Physicians by the Committee on Atherosclerosis andHypertension in Childhood of the Council on Cardiovascular Disease in theYoung, American Heart Association. Circulation, 74: 1189A–91A.

Sinha, D.P. 1995. Changing patterns of food, nutrition and health in the Caribbean.Nutrition Research, 15: 899–938.

UN (United Nations) 2006. The Millennium Development Goals Report 2006New York http://www.un.org/millenniumgoals/goals.html#

WHO. 1996. Preparation and use of food-based dietary guidelines. Report ofJoint FAO/WHO Consultation, Geneva, 1996.

WHO. 2001. Diet, physical activity and Health. WHO, Geneva. (Doc #A55/16)http://www.who.int/dietphysicalactivity/strategy/eb11344/en/


69

Annex 1 Testing Recommendations for Feasibility

example from Dominica

Focus Group Guide: Recommendation No. 1 Read the following:

1. Reduce fat and oil intake.

1. What do you understand from the statement?2. What are the foods you prepare using fats?

PROBE solid and oils?3. Do you trim off the fat? (Meat /poultry)

a) When? (Before or after cooking) PROBE Why?4. What do you do with the fat that you trim off meat?5. What foods do you add fat to before eating?

a) Which fats?b) To which foods?

6. Do you make gravy? How do you make it?7. What are the foods that you eat fried?8. What type of fats or oil do you use for frying?9. Could you prepare these foods any other way?

a) How?10. Do you use salad dressings?

a) (If yes) what types? b) What foods do you use them on?

11. What types of packaged seasonings do you use?12. What foods do you consider as fast foods? PROBE13. How often do you and your family eat these foods?14. Which are the fast foods you eat more often and why?15. Do you understand the food labels?16. Name the six food groups.



Annex 2 Behavioural trial

Initial Interview: Recommendation

Read the following:

Reduce fat and oil intake.

Name ____________________________________________________________

Address______________________________________Phone________________

Age________Education level______________________Sex_________________

No. of persons in the house _______Adults ______Children <5_____ >5 _______

Interviewer _____________________________Date of Interview _____________

1. What are some of the things you prepare using fats and oils?

__________________________________________________________________

__________________________________________________________________

2. Do you trim off the fat? (Meat and poultry) _____________________________

__________________________________________________________________

When? (Before or after cooking)________________________________________

3. What do you do with the fats? ________________________________________

__________________________________________________________________

4. Are there any foods that you add fat to before eating? _____________________


Annex 2 71

__________________________________________________________________

Which fats? ________________________________________________________

To which foods? ____________________________________________________

5. Do you make gravy? _______________________________________________

How do you make it?_________________________________________________

6. What are the foods that you eat fried?

__________________________________________________________________

Who eats these foods?________________________________________________

7. What type of fats or oil do you use for frying? ___________________________

__________________________________________________________________

8. Could you prepare these foods any other way?___________________________

How? ____________________________________________________________

9. Do you use salad dressings?_________________________________________

(If yes) what types? __________________________________________________

What foods do you use them on?______________________________________

Who eats these foods?________________________________________________

10. What types of seasonings do you use?_________________________________

__________________________________________________________________

11. What foods do you consider as fast foods? _____________________________

__________________________________________________________________

12. How often do you and your family eat these foods? ______________________

__________________________________________________________________

13. Which are the ones you eat more often and why? _______________________



Final Interview: Recommendation (Reduce fat and oil intake)

Name_____________________________________________________________

Address______________________________________Phone________________

District____________________________________________________________

Interviewer _________________________ Date of interview ________________

1. Do you remember what we spoke about last time? (ASK THEM TO EXPLAIN)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

2. Were you able to follow the recommendation? Yes______ No______

Somewhat________ (YES) Why? ____________________________________

__________________________________________________________________

(NO or somewhat) Why? _____________________________________________

__________________________________________________________________

3. Did you have any problem following the recommendation? Yes_____ No_____

(YES) What exactly?_________________________________________________

__________________________________________________________________

__________________________________________________________________

4. For how many days did you follow this recommendation?__________________

__________________________________________________________________

5. Did you make any changes? YES _____ NO ______ (YES) What?

__________________________________________________________________

__________________________________________________________________


Annex 2 73

6. Do you plan to continue with the recommendation in the future? YES________

NO______ If YES, why?______________________________________________

If NO, why not?_____________________________________________________

7. What would you suggest to other people so that they would reduce their fat

intake? _________________________________________________________

__________________________________________________________________



Annex 3 Choosing the pictorial diagram

Saint Vincent and the Grenadines

Instructions:

Each diagram should have a number on the bottom. Try to post all diagramson the wall. Ask the participants to look at them very carefully and askindividually the following questions:

1. Which of these diagrams makes you think more of our country?

2. Why?

3. If we were to show you how to divide the different types of foods you should eatevery day, which of these diagrams would you like to see them on?

4. Do you have any suggestions?


75Annex 3

Grenada

Instructions:

1. We are encouraging healthy lifestyle habits for our people and we want toillustrate it in picture form. On which of these diagrams would you like to seethose tips illustrated? (Select first and second choices)

2. Why?

Follow the sample below:

Choice Diagram #

1st

2nd

1st 2nd Reasons VillageChoice ChoiceBanana Nutmeg Banana – its food Harford

Isle of spice Village



An

nex

4D

raft

Co

mm

un

icat

ion

Str

ateg

y -

Sain

t V

ince

nt

and

th

e G

ren

adin

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ain

go

al

Ob

ject

ives

Ind

icato

rsD

raft

M

ess

ag

ePri

ori

ty l

evel

(An

cho

r A

ctiv

ity)

(Mil

est

on

e

Act

ivit

y)

Au

die

nce

s:

Pri

mary

Seco

nd

ary

Typ

e o

f A

ctiv

ity

an

d/o

r o

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ut

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an

nels

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cyPart

ner

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cies

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e F

ram

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get

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sk F

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of

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tes

of

mee

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gs

and

qu

arte

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. of

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ric.

and

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lth

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ts,

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and

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vate

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tor

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an

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al

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rela

ted

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ary:

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eral

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blic

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nd

ary:

Tech

nic

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on

nel

,

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cto

rs, N

urs

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s et

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ics,

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mac

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etc

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ral

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rce

CFN

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rses

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oci

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ical

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oci

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by

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nth

in

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uar

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gan

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du

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nal

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to

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rt

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ary:

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eral

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blic

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on

pro

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dio

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nd

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nt

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eria

ls

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istr

y

of

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lth

,

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f

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f Ed

uca

tio

n

and

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ltu

re

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du

ctio

n a

nd

air

ing

of

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gle

s –

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io a

nd

TV

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rod

uce

pro

mo

tio

nal

item

s to

sup

po

rt

cam

pai

gn

an

d

secu

re t

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sup

po

rt o

f

loca

l rad

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nd

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tati

on

s fo

r

bro

adca

st o

f

sam

e

Jin

gle

s

pre

par

ed o

n

each

of

the

gu

idel

ines

Mile

sto

ne

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ary:

Gen

eral

Pu

blic

Seco

nd

ary:

Med

ia H

ou

se

Man

ager

s an

d

Pers

on

nel

Nin

e (9

)

jing

les

pre

par

ed

All

Rad

io a

nd

Tele

visi

on

Stat

ion

s

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istr

y

of

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lth

,

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y o

f

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ricu

ltu

re

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, NB

C

All

oth

er R

adio

an

d

TV S

tati

on

s

Co

rpo

rate

Sec

tor

Jan

.–M

ar.


Annex 4 77Pro

du

ctio

n a

nd

Est

ab

lish

men

t o

f Tw

o B

illb

oard

s

To p

rep

are,

esta

blis

h a

nd

mai

nta

in

bill

bo

ard

s

at s

trat

egic

loca

tio

ns

dep

icti

ng

th

e

FBD

G

Bo

ard

s

wit

h m

ain

gra

ph

ic a

nd

gu

idel

ines

Mile

sto

ne

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ary:

Gen

eral

Pop

ula

tio

n

Two

(2

)

bill

bo

ard

s

pre

par

ed a

nd

esta

blis

hed

at s

trat

egic

loca

tio

ns

Mu

ltis

ecto

ral

Task

Fo

rce

Cen

tral

Pla

nn

ing

Ch

amb

er o

f In

du

stry

and

Co

mm

erce

– C

orp

ora

te S

ecto

r

(EC

GC

)

Ap

r.–Ju

ne

July

– A

ug

.

Pu

bli

c-Sp

eakin

g

Co

mp

eti

tio

n

(Sch

oo

ls)

To u

se t

he

com

pet

itio

n

to f

urt

her

hig

hlig

ht

the

gu

idel

ines

Mile

sto

ne

Prim

ary:

Spec

ifi c

Au

die

nce

Seco

nd

ary:

Part

icip

ants

Teac

her

s

Live

tele

visi

on

and

rad

io

bro

adca

st o

f

the

even

t

Rad

io a

nd

tele

visi

on

Mu

ltis

ecto

ral

Task

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rce

Cab

le a

nd

Wir

eles

s/

Jayc

ees

Oct

.–N

ov.

Yo

un

g L

ead

ers

Pro

gra

mm

eTo

use

th

e

ann

ual

eve

nt

to h

igh

ligh

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the

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e o

f

the

nee

d f

or

the

gu

idel

ines

and

a h

ealt

hy

po

pu

lati

on

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mo

tio

nal

mat

eria

ls o

f

you

ng

lead

ers

pro

gra

mm

e

wit

h t

he

mes

sag

es

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ne

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ary:

Gen

eral

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nd

ary:

Sch

oo

ls

Part

icip

ants

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her

s

Var

iou

s

pro

mo

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nal

item

s as

det

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ined

by

the

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ng

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s

chan

nel

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det

erm

ined

by

the

You

ng

Lead

ers

Mu

ltis

ecto

ral

Task

Fo

rce

RB

TT

Seco

nd

ary

Sch

oo

ls

Jan

.–M

ar.

Ap

r. –

Jun

e Se

pt

– D

ec.

Lab

ell

ing

of

Pack

ag

es,

bag

s etc

. in

Su

perm

ark

ets

To la

bel

pac

kag

es,

bag

s et

c. t

hat

are

use

fo

r

pla

cin

g lo

cal

foo

d it

ems

– ve

get

able

s,

mea

t, f

ruit

s

etc.

– f

or

a

per

iod

of

two

(2)

year

s

FBD

G e

ith

er

ind

ivid

ual

ly

or

in a

com

bin

atio

n

Mile

sto

ne

Prim

ary:

Ho

use

wiv

es

Gen

eral

Pu

blic

Seco

nd

ary:

Sup

erm

arke

t,

Foo

d S

tore

s

and

Res

tau

ran

t

Ow

ner

s

Var

iou

s

pac

kag

es,

bag

s,

con

tain

ers

wit

h

gu

idel

ines

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erm

arke

t,

Res

tau

ran

t

and

Fo

od

sto

res

pro

du

cts

Mu

ltis

ecto

ral

Task

Fo

rce

Ch

amb

er o

f In

du

stry

and

Co

mm

erce

– Su

per

mar

ket,

Res

tau

ran

t an

d F

oo

d

Pro

cess

ing

fac

ility

Man

ager

s,

No

v..

Dec

.

Ad

op

tio

n o

f a

Gu

ideli

ne b

y a

M

em

ber

of

the

Co

rpo

rate

Sect

or

To u

se a

pro

du

ct o

f a

mem

ber

(s)

of

the

corp

ora

te

sect

or

to

pro

mo

te

gu

idel

ine

FBD

GM

ilest

on

ePr

imar

y:

Gen

eral

Pu

blic

Seco

nd

ary:

Co

rpo

rate

Sect

or

For

exam

ple

,

bo

ttle

d w

ater

and

th

e n

eed

for

dri

nki

ng

mo

re w

ater

Pro

du

cts

to b

e

det

erm

ined

Mu

ltis

ecto

ral

Task

Fo

rce

– C

ham

ber

of

Ind

ust

ry a

nd

Co

mm

erce

Mo

un

tain

To

p W

ater

Bo

ttlin

g a

nd

Co

con

ut

Wat

er B

ott

ling

,

ECG

C, V

acu

um

Pack

ing

Pro

du

cts

Cas

sava

Pro

du

cts

Jan

. D

ec.



Pro

du

ctio

n o

f a

Cale

nd

ar

To p

rom

ote

a g

uid

elin

e

wit

h t

ips

each

mo

nth

FBD

GM

ilest

on

ePr

imar

y:

Gen

eral

Pu

blic

Seco

nd

ary:

Man

agem

ent

of

Ban

k o

r V

inle

c

Cal

end

ar

dep

icti

ng

gu

idel

ines

each

mo

nth

Cal

end

arM

ult

isec

tora

l

Task

Fo

rce

Vin

lec,

Ban

kA

pr.–

Jun

e Ju

l.–Se

pt

Dec

.

Flyers

in

N

ew

spap

ers

To p

rod

uce

glo

ssy,

colo

urf

ul,

on

e-

leaf

fl y

ers

wit

h

gra

ph

ics

and

mes

sag

es t

o

ach

ieve

hig

h

imp

act

in t

he

po

pu

lati

on

Nin

e (9

) FB

DG

and

gra

ph

ic

wit

h f

oo

d

gro

up

s

Mile

sto

ne

Prim

ary:

Gen

eral

Pu

blic

10,0

00 fl

ier

sN

ewsp

aper

sM

ult

isec

tora

l

Task

Fo

rce

New

spap

ers

New

s, S

earc

hlig

ht

or

Vin

cen

tian

Last

wee

k

Dec

. an

d

Web

Pag

e w

ith

B

asi

c G

uid

eli

nes

To p

rod

uce

,

esta

blis

h

a w

eb

pre

sen

ce w

ith

gu

idel

ines

an

d

bo

okl

et

Gra

ph

ic a

nd

FBD

G

Mile

sto

ne

Prim

ary:

Gen

eral

Pu

blic

Seco

nd

ary

Web

Sit

e

Man

ager

s

Web

Site

wit

h

Gu

idel

ines

Go

vern

men

t

Web

site

,

wit

h li

nks

to

the

rele

van

t

Min

istr

ies,

Intr

anet

Min

istr

y

of

Hea

lth

,

Edu

cati

on

an

d

Ag

ricu

ltu

re

Web

Un

it, M

inis

try

of

Tele

com

mu

nic

atio

ns,

Scie

nce

an

d

Tech

no

log

y an

d

Ind

ust

ry

Oct

. –N

ov.

Pre

para

tio

n o

f A

dvert

isin

g B

oard

sTo

pro

mo

te

FBD

G a

t m

ajo

r

pla

yin

g fi

eld

s

and

har

d

cou

rts

Gra

ph

ic w

ith

foo

d g

rou

ps

and

FB

DG

s

Mile

sto

ne

Prim

ary

Spo

rtsp

erso

ns

Gen

eral

Pu

blic

Seco

nd

ary

Spo

rts

Ass

oci

atio

ns

and

Org

anis

atio

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leas

t 3

adve

rtis

ing

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isin

g

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ltis

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ral

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rce

Nat

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al S

po

rts

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t sp

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ing

org

anis

atio

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. D

ec.

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sen

tati

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s to

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om

mu

nit

y G

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ps

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rom

ote

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and

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ary

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ult

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tio

n

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nd

ary

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ic a

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mm

un

ity

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anis

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ns,

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ip a

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mem

ber

s

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con

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uen

cy

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elo

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ent,

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y o

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on

, Ad

ult

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sad

e

Jan

. M

ar.

An

nex

4 (

con

tin

ued

)


Annex 4 79In

corp

ora

tio

n

into

th

e H

om

e

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no

mic

s C

urr

icu

lum

an

d

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ed

ing

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mm

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nsu

re

that

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e

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ines

are

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rate

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into

th

e h

om

e

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mic

s,

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al s

tud

ies

and

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ily

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cati

on

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e sc

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ol

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ing

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and

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DG

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sto

ne

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ary

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oo

l

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n

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nd

ary

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y o

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pt

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n f

or

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du

ctio

n

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nsu

re

that

op

tim

um

qu

anti

ties

of

veg

etab

les

are

avai

lab

le t

hat

are

of

go

od

qu

alit

y an

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an a

ffo

rdab

le

pri

ce f

or

the

gen

eral

po

pu

lati

on

FBD

G

–Eat

mo

re

veg

etab

les

and

fru

its,

enco

ura

ge

farm

ers

to

pro

du

ce m

ore

veg

etab

les

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sto

ne

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ary

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ers

Seco

nd

ary

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istr

y o

f

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ricu

ltu

re

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nsi

on

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ff

and

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licy

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ers

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etab

le

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du

ctio

n

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nsi

on

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ice

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ers

mee

tin

gs

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io a

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visi

on

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gra

ms

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istr

y o

f

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ricu

ltu

re

Min

istr

y o

f H

ealt

h

Sup

erm

arke

ts e

tc;

Sep

t

Mo

nit

ori

ng

an

d

Evalu

ati

on

of

the

Imp

lem

en

tati

on

of

the S

trate

gy a

nd

its

Im

pact

To c

on

du

ct

fou

r (4

)

sam

ple

surv

eys

ever

y

six

mo

nth

s

to a

sses

s th

e

imp

act

of

the

cam

pai

gn

Mu

ltis

ecto

ral

Task

Fo

rce

Jan

. –Ja

n.

Jul.

–Ju

l.


Developing Food-based

DietaryGuidelines

A manual from the English-speaking

Caribbean

Food-based dietary guidelines (FBDGs) provide practical advice

about ways to improve diets and health in a manner that is easy

for the public to understand. This manual explains a 10-step

process for developing FBDGs that can be used in most countries.

By following this process, nutritionists and others can create

FBDGs that are well-adapted to national needs and based on

nutrition science and communication expertise. A

multidisciplinary approach enables governments to assess the

country’s nutrition problems and to set realistic priorities for

improving diets. Technical recommendations are transformed into

simple messages the average person can follow. Nutritionists

learn to develop strategies for communicating dietary

information to the public. This manual is based on the

experiences of four Caribbean countries in developing national

FBDGs to promote healthy diets and to prevent obesity, diabetes

and cardiovascular diseases.

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