9th Asian Congress of Nutrition: Nutrition Goals for Asia--Vision 2020, New Delhi, India, 23-27 February 2003.
Under the theme of 'Nutrition Goals for Asia--Vision 2020', over 1300 eminent scientists and delegates from more than 44 countries participated in the Congress and exchanged views and experience on emerging issues and challenges in nutrition throughout Asia and the world. The Congress covered frontier areas such as genes and nutrition, micro-nutrients in health and disease, new technologies in quality food production, public health nutrition in Asia, nutrition education, nutrition programs and policy at community level, etc. The full four-day Congress consisted of three plenary lectures, five plenary sessions (with 21 lectures), 30 symposia, five free communication sessions and poster sessions. The scientific program covered emerging areas in nutrition sciences relevant to Asia. Special sessions were also devoted to discussions on practical approaches for combating the nutrition problems in Asia.
The congress was officiated by Mr Shri KC Pant, the Deputy Chairman, Planning Commission of India and Mr Smt Sheila Dikshit, the Chief Minister, Government of Delhi. The guests of honour addressed the delegates that although food supply has steadily improved in the region, appropriate national strategies to sustain food security and prevention of marco- and micro-nutrient deficiency in the vulnerable population groups are important tasks for the region. On the other hand, low birth weight is still prevailing in some Asian countries. In India for instance, one in three newborns is low birth weight and half of the infants are anaemic. In order to reduce the risk of non-communicable diseases in future generations, improvement in nutritional status of young women during reproductive age is of paramount importance.
The Nutrition Society of India conferred the 26th Gopalan Oration Award to Professor Chunming Chen, the former Director of the Chinese Academy of Preventive Medicine in recognition of her contributions to nutrition and preventive medicine in China. Professor Chen delivered the oration on 'Nutrition and Economic Development'. She took China as an example by linking nutritional status of the people and outcomes of economic progress to lobby successfully for the government to take further steps in eradicating malnutrition and in ensuring nutrition security in the country. Dr M S Swaminathan from the MS Swaminathan Research Foundation, India was the recipient of the 14th Srikantia Memorial Award. Dr Swaminathan is highly regarded as the master of agricultural renaissance and a leader in the green revolution in India. In delivering the Srikantia Memorial lecture titled 'Ensuring Ecological, Social and Economic Access to Balanced Diets and Safe Drinking Water', he stressed that the disturbance of the balance in the ecosystem is one of the major contributors to malnutrition in the developing countries. The consequence has brought about the loss of livelihoods for the poor in the countryside and has led to the influx of environmental refugees to the cities resulting in proliferation of urban slums.
In the first day's plenary session Dr Gopalan of India, Professor Keyou Ke of China, Dr E-Siong Tee of Malaysia and Dr ARO Musaiger of Bahrain provided updated reviews on 'The Changing Nutrition Scene in Asia'. Dr Gopalan opened the session by saying that the countries in South Asia over the last half century witnessed a remarkable victory in elimination of large-scale famines, declines in infant and children mortality rates, increased life expectancy and increased harvest of foods. Unfortunately, nearly 30% of the population in the region are still below the poverty line, with 80% of women anaemic and 33% of infants of low birth weight. He urged the policy makers and nutrition practitioners to shift attention from food security to nutrition security, child health rather than child survival, and from literacy to education skills. With rapid demographic and nutrition transition, chronic diseases such as diabetes, coronary heart disease and cardiovascular disease have already posed a serious threat to this dens ely populated sub-continent. Dr Gopalan also reminded participants that Asian countries should not mistake Western ways of living and food habits as the model to follow. They should seek to foster, maintain and cherish traditional good practices that are conductive to health and wellbeing. Helping those who help themselves in the community rather than providing free doles will achieve sustainable self-dependence.
Professor Keyou Ge overviewed the nutrition situations in East Asia. Developed regions like Japan and South Korea enjoy low infant mortality rates and high life expectancy. In Japan, childhood obesity increased from five to more than ten percent from 1974 to 1995, 32% of these obese boys and 41% of these obese girls have grown into obese adults. In regions undergoing transition like China, the strong economic growth will bring significant increases in per capita food availability from 1996 to 2015. China is faced with the double burden of under- and over-nutrition with rapid shifting towards over-nutrition. The prevalence of overweight in adults has increased from 6.6% to 20.7% between 1982 and 1997. Overweight in children nine to 14 years old has more than doubled between 1985 and 1995. In Taiwan, the prevalence of childhood obesity (three to 19 years) varied from 4.3 to 17.4% in 1997. In China, the incidences of cardiovascular disease and cancers will be double in the next ten years and diabetes is becoming one of the life threatening diseases in urban areas. Therefore, the first decade of the twenty-first century is critical to China for health promotion and disease intervention. As for the less developed regions like North Korea and Mongolia, there have been dramatic declines in the supplies of dietary energy, protein and fats over the last ten years--chronic shortage of foods due to natural disasters and political issues have led to poor harvests. Consequently, in North Korea, over 60% of children up to seven years are stunted, 30% of pregnant women and children under seven years old are anaemic. The global community should be alerted to the situation in this country. Timely provision of fortified foods is important to reduce the severity of chronic malnutrition in North Korea.
Southeast Asia, like East Asia has undergone rapid socioeconomic development in the last 30 years. Demographic changes and nutrition transition have led to a decline in under-nutrition in some rapidly developing countries. However, due to different rates of development in the region, the extent of under- and over-nutrition problems vary considerably between countries. About 33% and 29% of children in Southeast Asia are stunted and underweight respectively. In the region 60% of school age children are anaemic--the highest prevalence in the world. There are 172 million people (12% population) in Southeast Asia suffering from iodine deficiency goitre. Frank and sub-clinical vitamin A deficiencies still prevail in the region. Bangkok, Kuala Lumpur, Manila and Singapore are the cities in the region with highest prevalence of obesity (> 23%, with BMI > 25). Diet-related chronic diseases are expected to rise. It is a challenge for governments to tackle concomitantly the problems of under- and over-nutrition in the region.
Over the last 40 years, the Arabian states of West Asia have undergone dramatic changes in lifestyles and dietary patterns. A shift to Western diets has escalated average intakes of energy and fat by 30% and 40% respectively. Not surprisingly, obesity, diabetes, cardiovascular disease and cancers are on the rise. However, iron deficiency anaemia, vitamin D and calcium deficiencies still exist in the region. Although there are national policies to address the public health problems, very few countries put them into practice. The belief that the government alone is solely responsible for the nation's health business is widespread in the region leading to weak support from non-governmental sectors to promote health education and disease program campaigns in these communities.
Dr AP Simopoulos from Washington DC provided an excellent update on diet and genes. Nutritional status is largely influenced by the interaction between diet (environment) and genetic control of metabolism via the production of proteins as receptors, enzymes and growth factors, etc. Most chronic diet-related diseases such as cancers, hypertension and osteoporosis are genetically pre-determined. Genes must interact with the environment to manifest the disease. On the other hand, genetic variations affect the response to the diet and vice versa--n-3 fatty acids are a good example. Successful dietary interventions should be based on the understanding of the frequency of gene expression. By identifying groups susceptible to chronic diseases, early intervention with a 'designer diet' can be initiated.
Mark Wahlqvist, from Melbourne, in delivering a plenary lecture on nutrition and ageing pointed out that for successful ageing, healthy cognition and physical and social activity should be regarded as some of the contributing factors. High scoring of food variety also contributes to longevity with habitual intakes of plant foods in particular legumes (beans, soy and chick peas) being the strongest predictor cross-culturally. Furthermore, regular endurance and resistance physical activity can defer the onset of metabolic diseases and immune dysfunction in the aged.
The Symposium, 'Obesity in Asia', covered Japan having demonstrated a scenario similar to some post-industrialised countries where there is a marked increase in 'young and thin' women in the metropolitan areas (BMI < 18.5). This may be attributable to the increasingly distorted social norm that slimness equates to prettiness and health for females. On the other hand, more Japanese men than women are getting overweight, the sharp rise in overweight men has been found in small towns. Dr Mabel Deurenberg-Yap from Singapore reported some delightful and successful nation-wide healthy lifestyle and school health promotion campaigns in reducing obesity in this island state with a few million inhabitants. A strong commitment from the government, including the Prime Minister, active partnership with non-governmental sectors together with the size of the country are among some of the key factors for success in these large-scale public health campaigns.
In the poster review session on the final day, the contents and scientific quality of posters displayed during the Congress were summarised by a panel of experts. Personally, I highly appreciated the professional attitude of the panellists. I could recall one of the them sitting down and jotting notes when she was evaluating posters including mine in the exhibition hall. On another occasion, I enjoyed an educational discussion with a panellist on my second poster. After all this effort by the panel it would have been encouraging if awards were made for the best posters. Such a scheme would be useful to encourage and reward young scientists in Asia to undertake quality research.
The congress also provided a platform for friendship, sharing and partnership. The forthcoming 10th Asian Congress of Nutrition will be held in Taiwan in 2007.
Warren TK Lee
Department of Orthopaedics and Traumatology
The Chinese University of Hong Kong
Faculty of Medicine
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|Publication:||Nutrition & Dietetics: The Journal of the Dietitians Association of Australia|
|Date:||Jun 1, 2003|
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