IV. FOOD UTILIZATION/CONSUMPTION/NUTRITIONAL ADEQUACY Objective – To promote nutritionally adequate, safe, affordable dietary intakes and other positive lifestyle behaviours throughout the life course
1. In recognition of the challenges facing the Jamaican population with respect to increasing levels of obesity, non-communicable chronic diseases (NCDs), persistent iron deficiency anaemia and pockets of under nutrition, Government shall:
a. Promote, protect and support appropriate infant and young child feeding practices:
i. Finalize, implement, monitor and evaluate a comprehensive national policy and national plan of action on infant and young child feeding.
ii. Identify and allocate adequate resources – human, financial and organizational – to ensure the plan’s timely and successful execution.
iii. Constitute a multi-sector body with the requisite expertise to perform an advisory role on all matters concerning infant and young child feeding.
iv. Ensure that every facility providing maternity services implements relevant international best practices and follows the Ten Steps to Successful Breastfeeding set out in the joint WHO/UNICEF statement "Protecting, promoting and supporting breastfeeding: the special role of maternity services".
v. Take action to give effect to the aim and principles of all Articles of the International Code of Marketing of Breast-Milk Substitutes and subsequent relevant World Health Assembly resolutions in their entirety.
vi. Enact/Review legislation to protect the feeding rights of working women and establish the means for its implementation/enforcement.
vii. Strengthen/implement mechanisms for making foods available to vulnerable groups such as Prevention of Mother to Child Transmission Programme, Supplementary Feeding Programmes.
viii. Develop and implement a framework and/or mechanisms for promoting the responsible marketing of foods and non-alcoholic beverages to children, in order to reduce the availability to them of foods high in saturated fats, trans-fatty acids, free sugars and salt.
b. Promote consumption practices consistent with national population dietary goals in line with international standards through:
i. Establishing and implementing food-based dietary guidelines and healthier composition of food by:
- reducing sodium/salt levels
- reducing industrially produced trans-fatty acids
- decreasing saturated fats
- limiting free sugars
ii. Establishing the technical capability within the relevant ministries for operating an updated system for monitoring the cost of a nutritionally balanced food basket;
iii. Implementing a National Social Marketing Campaign to promote local foods based on their nutritional value;
iv. Implementation of programmes for incentives and dis-incentives where appropriate for nutritious and less-nutritious foods;
v. Advocating changes in the CARICOM Common External Tariff with a view to lowering tariffs on foods that will reduce the risk of chronic diseases and/or more importantly, provision of incentives for production of low sodium, low sugar and low fat- containing foods.
vi. Providing accurate and balanced information for consumers to enable them to make well-informed, healthy choices by implementing social marketing programmes (schools, workplace, communities)
c. Strengthen national nutrition surveillance systems in accordance with WHO standards, so as to monitor the nutritional status of the population and identify those at risk of nutrition-related disorders:
i. Implement a strategy of universal assessment for all children (0 to 18 years old) to identify those at risk of malnutrition (deficiency diseases, overweight, obesity and non-communicable diseases).
ii. Surveillance of dietary intake, physical activity, related disease burden to include food borne illnesses and behavioural risk factors for under/over-nutrition.
d. Promote a supportive environment that will increase physical activity in line with national and WHO recommendations
i. Develop and implement national guidelines on physical activity for health.
ii. Implement school-based programmes in line with WHOs health-promoting schools initiative.
iii. Ensure that physical environments support safe, active commuting.
iv. Create space for recreational activity, by the following:
• Ensuring that walking, cycling and other forms of physical activity are accessible to and safe for all.
• Introducing transport policies that promote active and safe methods of travelling to and from schools and workplaces, such as walking or cycling.
• Improving sports, recreation and leisure facilities.
• Increasing the number of safe spaces available for active play.
e. Provide Nutrition Standards and guidelines to strengthen programme development and implementation in all sectors by:
i. Incorporation of nutrition principles into competency development and core curricula in schools and in professional and industry training.
ii. Increasing the proficiency of persons giving nutrition information to the public.
iii. Strengthening training programmes for nutrition and dietetic professionals to meet the needs of the Jamaican population by establishing on a sustainable basis an internship programme as an integral element of the curriculum.
iv. Promoting nutrition training among food producers to assist the development and promotion of healthy, desirable food products and the development of standardized portions and labelling.
f. Implement policies and programmes to detect, prevent and manage micronutrient deficiency:
i. Promote healthy practices among women of child bearing age and in the prenatal period placing emphasis on micronutrient rich foods such as those containing iron, folate, zinc and other micronutrients of interest.
ii. Monitor and strengthen the distribution system for iron/folate supplements in antenatal clinics.
iii. Implement and/or strengthen existing food and nutrition supplementary programmes for vulnerable groups such as women of childbearing age, pregnant and lactating women, the elderly, children and adolescent girls.
iv. Conduct systematic reviews of available evidence on effective approaches to food fortification of staple products.
v. Pilot fortification of commonly used staple foods based on available evidence and best practices.
vi. Review and strengthen food fortification programmes and legislation.
2. Institutions and schools provide an entry point for interventions to prevent and control some of the identified nutrition conditions and influence food tastes and preferences. In this regard, the policy shall seek to address the following areas:
a. Early Childhood Institutions, Primary and Secondary schools through
i. Preparation and implementation of a national comprehensive school nutrition policy.
ii. Support for the development of curricula at different levels of the education system - teacher training, early childhood institutions, primary and secondary schools - that include nutrition and health education for making lifestyle choices.
iii. Development of national guidelines for the preparation and sale to children of school meals that promote health and wellness.
iv. Adopting a policy that the local content of the meals provided under national school feeding programmes should be increased in keeping with the import replacement strategy.
v. Reviewing the school gardening programmes to identify strategic areas for intervention, including the provision of technical support, promotional and other relevant materials.
vi. Developing national social marketing campaigns to encourage nutritious food choices in schools and communities.
vii. Recruitment of qualified nutrition officers to monitor implementation of school nutrition policy.
b. Health Care Facilities through:
i. Development and implementation of National Standards of Care for nutritional management of chronic conditions.
ii. Provision of adequate resources to strengthen primary care renewal and hospital dietetics departments (human, financial, physical) to facilitate the highest quality of care, reduce length of stay and decrease health care costs.
iii. Adopting a policy that the meals provided in hospitals should include local food content in keeping with the import replacement strategy.
iv. Strengthening of the supplementary feeding programmes in primary health care.
v. Provision of adequate resources for nutrition education in the training of health personnel and other key stakeholders, such as agricultural extension officers.
c. Residential Facilities through
i. Development of nutritional standards of care for the elderly, mentally challenged and persons living in institutions e.g. child care institutions and prisons.
ii. Adopting a policy that the meals provided in such facilities should include local food content in keeping with the import replacement strategy.
3. Strengthen existing legislation and regulations and enact new laws, where necessary, to foster the implementation/enforcement of food safety standards in keeping with international standards.
a. Coordinate national guidelines for maintaining food safety and traceability programmes along the food chain.
b. Review the Food and Drug Act to incorporate standards for food and nutrition labelling.
c. Develop consumer protection legislation to include accurate labelling of food for nutrition content and redress measures.
d. Ensure prevention and management of infectious diseases through standardized food safety programmes including inspection of restaurants and food shops and certification of food handlers.
4. Promote, through the mass media, good nutrition practices, wise purchasing, storage and utilization of food products:
i. Implement a promotional campaign that emphasizes the health and nutritional benefits of selected national/regional foods.
ii. Creative approaches will be used to promote the consumption of nutritious national/regional foods, for example, using Outstanding National and Caribbean Personalities.
5. Increase awareness among policy makers and planners of the extent and severity of nutritional problems and of their causes, of the economic benefit of interventions and of how activities under their control can affect the nutritional status of different socio-economic groups.
6. Encourage and support the inclusion of the community in the identification of their own nutritional problems and the implementation, monitoring and evaluation of programmes.
7. Facilitate linkages with civil society, private sector and consumer advocacy groups to increase their participation in the process of food and nutrition security planning and implementation.
8. Government shall make adequate investments in potable water, sanitation and waste disposal especially for vulnerable populations:
a. Strengthen regular water and sanitation monitoring of communities and institutions;
b. Provide facilities to communities for waste disposal.
9. Collaborate with relevant organizations to coordinate a nutrition response in emergency situations.
a. Nutrition in shelters (before, during and after disaster);
b. Appropriate food items, storage, transportation, preparation, distribution and rationing.
10. Develop and implement, in consultation with relevant national and regional tertiary institutions, a National Research Agenda for Nutrition, to provide evidence-based support for policies and programmes, in support of food and nutrition security, to mitigate the impact of nutrition-related disorders:
a. New and existing national health surveys including nutrition and physical activity components;
b. Surveillance studies inter alia on the trans fat content and other nutrients of interest in the national food supply as well as the concentration of contaminants in food products and the extent of iron deficiency anaemia in the country;
c. Research on more effective approaches to food fortification of staple products
d. Five-yearly food consumption and special surveys, as necessary;
e. Research on the ecological suitability and nutrient content of GMOs and LMOs; and
f. Studies to investigate the levels of genetically modified organisms (GMOs) and living modified organisms (LMOs) in the food supply and their impact on the health of the population.