Food-Based Dietary Guidelines: Catalysts For Agrifood System Transformation In Uganda

A farmer in West Nile subregion shows off part of vegetable harvest. Food-based Dietary Guidelines will promote consumer education and development of sound policies for agrifood systems transformation/FAO Uganda photo

Stakeholders in the agrifood systems space in Uganda are calling for adoption of Food-Based Dietary Guidelines (FBDGs) customised to Uganda, to provide evidence to guide consumer behaviour, facilitate consumer education and foster development of sound policies for agrifood systems transformation in the country. Technical officials and sector specialists in nutrition, food security, public health, food systems and agriculture sectors made the appeal during a two-day workshop from 1-2 December 2022 in Mbale District, during which they deliberated on requirements needed to develop FBDGs tailor-made to suite Uganda. The workshop was facilitated by the Food and Agriculture Organization of the United Nations (FAO), through the European Union-funded project, “The Food and Nutrition Security Impact, Resilience, Sustainability and Transformation (FIRST).

Food-Based Dietary Guidelines (FBDGs) can catalyse food systems transformation by enhancing consumer education on healthy diets and providing direction for programmes and policies to ensure healthy diets for all.[1] By design, they provide dietary recommendations based on food groups and corresponding dietary and nutritional values based on scientific evidence, to provide guidance for making food choices that help populations to achieve optimal dietary choices for a healthy life.[2] Nonregulated food environments expose populations to unhealthy diets which increase their risks of related diseases and death. Food-Based Dietary Guidelines (FBDGs) can therefore nurture healthy eating habits and lifestyles through population education for informed food choices, as well as inform food regulations.

Participants recommended that a comprehensive national food consumption survey be conducted to generate the desired evidence to inform the different stages of development of the FBDGs for Uganda. Equally important shall be the documentation of food mapping and profiling across the entire country. To that end, it was resolved that a technical committee be appointed by relevant government authorities to commence the work and ensure that evidence-based FBDGs are adopted by 2023.

Speaking at the workshop organized by the Ministry of Health (MoH) and FAO to advance the agenda for adoption of FBDGs for sustainable agrifood systems transformation, Assistant Commissioner of Health Services in charge of the Nutrition Division at MoH- Samalie Namukose, stressed the urgency of the FBDGs “to address the worrying trends of malnutrition in the country despite an abundant supply of nutritious food in different regions”.

“The Ministry has kick-started the journey of developing FBDGs by developing draft guidelines; but more work is needed to ensure that they [guidelines] are evidence-based and fit for purpose,” she said. She informed workshop participants that plans are under way to position nutritionists in the various structures of public service, to ensure that all sectors understand the importance of the guidelines, implement them and save the population from health hazards associated with poor eating habits.

Workshop participants provided technical input into the draft FBDGs report, making the guidelines suitable for all regions in the country and ensuring they facilitate evidence generation to prevent malnutrition in all its forms and mitigate the burden of diet related non-communicable diseases.

Jean-Marie Byakweli, a Policy and Food Systems Advisor at FAO Uganda, represented Antonio Querido, FAO Uganda Representative. He explained that FBDGs are part of the recommendations from the National Food Systems Dialogues (NFSDs) held in Uganda from April to August 2021, and the first-ever UN Food Systems Summit (UNFSS) held in New York in September 2021. He noted that during the Summit and national dialogues, it was observed from the various presentations from government, that Uganda’s agrifood sector doesn’t meet all needs of Ugandans as far as food security and nutrition are concerned.

“Some pockets of the country have insufficient food while others are experiencing malnutrition challenges amidst plenty of food” he said. “Latest surveys from the Uganda Bureau of Statistics indicate that stunting in Uganda is estimated at 29 percent and anaemia is a major public health concern affecting about half of children under five years and one third of women of reproductive age, these are grim figures,” he added.

Byakweli noted that the absence of food-based dietary guidelines on the kind of food to be eaten, in what quantities, and for which region, is an impediment to achieving sustainable food consumption and health outcomes of the people of Uganda, therefore the workshop was timely.

Importance of the Food-Based Dietary Guidelines

The National Food Systems Dialogues Synthesis of 2021 noted that Uganda is experiencing a nutrition transition, especially in urban settings where people are abandoning their traditional healthy food and increasingly opting for processed and unhealthy food- most of it imported. In fact, there is an increase in marketing and consumption of processed food and beverages across the country and it is mostly driven by urbanization, increasing population and increasing disposable income alongside adoption of modern lifestyles. Coupled with innovations like door-to-door deliveries, spiced-up by modern trends in restaurants, fast-food franchises and food delivery mobile phone applications, it is easy for Ugandans to access nutritious and processed food alike. However, a lot of the foods easily available to consumers are processed with high levels of salt, free refined sugars, saturated and trans-fats which increase the risk of being overweight, obese and suffering from related health problems. Without FBDGs that can guide consumers’ choices in terms of how they can opt for healthy, safe and nutritious diets, the frequency and magnitude of food-induced non communicable diseases (NCDs) could increase countrywide in the years to come.

Currently, the World Health Organization and Uganda’s Ministry of Health estimate that 33 percent of annual adult deaths in Uganda are attributed to cardiovascular diseases, cancers, diabetes, Chronic Respiratory Diseases, mental health disorders and substance abuse. Furthermore, the Global Nutrition Report 2020 showed that Uganda has made little improvement in achieving diet-related targets. By 2016, about 24 percent of adult females and 9 percent of males aged 15-49 years were overweight.

Speaking at the workshop, Susan Oketcho- the Nutrition Focal Person at the Ministry of Education and Sports, pledged the support of the education sector towards knowledge acquisition and promotion of the dietary guidelines to improve the nutrition status of young people in schools.

Alex Bambona, the Assistant Commissioner for Food and Nutrition Security in the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) challenged participants to consider the guidelines in a perspective broader than nutrition and health, but inclusive of a food system approach that benefits the environment, climate change resilience, income security, biodiversity and genetic resource conservation, poverty eradication and sustainable development among others.

“For the guidelines to be successful, they must address the food systems issues. One of the drivers of food systems transformation is agriculture production; so MAAIF shall definitely play a big role in the utilization of FBDGs”, he said.

University Professors Achileo Kaaya from the Department of Food Technology and Nutrition of Makerere University noted that the institution has a well-equipped laboratory and appropriate capacity to carry out the necessary analysis to prepare Food Composition Tables (FCTs). The latter would support the development of FBDGs and other quality assurance mechanisms that could be supported through laboratory investigation and research.

FAO remains committed to mobilizing partners and resources to support Uganda to achieve this important milestone in its food systems transformation agenda.