Countries in the APAC region are at different stages of economical, social and healthcare developments. Healthcare practitioners and hospitals have a leading role to play to drive nutritional awareness and to achieve healthcare outcomes. Collaboration between multiple stakeholders will be significant to drive this cause
The Asia-Pacific (APAC) region is home to some of the world’s fastest growing economies and, ironically, more than half of the undernourished children on the planet too. In the wake of the pandemic, government priorities are very much centred on containing the outbreaks and economic support measures, while healthcare systems continue to operate under immense stress. It is not unexpected then that the current health crisis has side-lined less ‘urgent’, longer term agendas such as advancing public nutrition awareness and education and multi-sector collaboration to strengthen the overall health system.
The countries in APAC are all at varied stages of development economically, socially and on healthcare preparedness too. A few countries are driving the agenda of achieving universal healthcare within the next decade. However, the task of achieving superior healthcare is not achievable without active involvement and contribution of key stake-holders. Within healthcare, nutrition is one agenda which has been less understood and emphasised upon. Herbalife Nutrition conducted a survey in early 2020 with 5,500 consumers and 250 Healthcare Professionals (HCPs) from 11 countries to gauge the prevalence and variety of nutrition myths that exist amidst consumers in APAC. The insights from this survey were startling. Multiple myths around nutrition existed amidst consumers and the gap in accurate nutrition knowledge was wide. In addition, consumers pointed to HCPs as the most credible sources of nutrition information. The survey was also administered to HCPs and about 80 per cent of them believed that nutrition companies should take a larger role in spreading accurate, credible and timely nutrition information.
To achieve the desired state of nutrition awareness and knowledge in APAC, collaboration is the key. Multiple sectors and economies are witnessing and experimenting with innovative collaborations and partnerships in the healthcare and technology space. A few of these possible collaborations to bring about an effective, significant and agile change now include not one or two but, multiple stakeholders playing a part in the food and nutrition supply chain. The quality and nutritional content of food right from the cultivation stage impacts the eventual state of nutrition in a country. Food manufacturers, suppliers, nutrition companies, advocates, and, most importantly, HCPs who according to the Herbalife Nutrition Myth survey top the credibility chart, make the most critical peg in the scheme of collaboration.
A very interesting study conducted in 2015 revealed why collaboration is beneficial in healthcare systems. In this study, the various aspects and impacts of collaboration and teamwork were compared with a similar scenario in sports, which always demand team spirit and working together. Over the last few years, we have witnessed the impact of high collaborat ion that is visible in the healthcare sector. In times of the pandemic, it was only collaboration that helped build the much-needed efficiency and resilience in the healthcare systems.
According to The Lancet 2019 Global Burden of Disease Study of 195 countries, dietary factors are the single leading cause of death, exacting an even greater health burden than smoking. Excessive consumption of cheaper and unhealthy processed foods which offer little beyond salts, sugars and carbohydrates is on the rise. A few countries like Indonesia, Vietnam and Philippines are fighting the triple burden of malnutrition which essentially implies the coexistence of over-nutrition, undernutrition and micronutrient deficiencies. Over-nutrition, undernutrition, and micronutrient deficiencies equally increase the risk of various health problems. In such a scenario, it’s imperative to make people across the region understand the importance of nutrition, awareness of foods and eating habits that can improve the situation.
Apart from the lack of awareness about the science of nutrition, several food and nutrition-related myths are also prevalent in the region. For instance, one in three people in APAC believes the false idea that our body requires less protein as we grow older; nearly two out of three people believe the myth that carbohydrates make one gain weight; a majority of people believe the myth that a very low-fat diet is the best way to lose weight, and one in three people holds on to the myth that eating saturated fat raises ‘good’ cholesterol. The wide existence of these myths is a testimony of the prevalence of inaccurate and harmful nutrition habits amidst consumers in the region.
Public health and nutrition are a matter of the state and no other organisation can drive an effective solution without the involvement and support of the government. A public private partnership has been proving of immense value in the healthcare space in countries like Vietnam, Indonesia and Thailand and more such initiatives are needed in the region. Nutrition Foundations and education societies develop a deep understanding of public health, demographics, issues and challenges at the grass root level and the hurdles that may come in the way. Nutrition companies who are experts in the field of nutrition can look at long term collaborations such as these and support these foundations and societies with accurate nutrition knowledge and other resources needed. The problem of child obesity, for instance, is immense in Malaysia.
Technology and innovation have built inroads in all aspects of our lives including the nutrition and well-being space. Right from testing authenticity of ingredients to communicating food quality and creating communities – technology is providing immense support. Nutrition companies, nutrition experts and HCPs can all benefit from these technology support and partnerships in enhancing what they are offering the consumers.
Herbalife Nutrition for instance, has been passionately working on how organisations should start investing in research and innovation and create new industry standards for botanical species ingredient authentication right from sourcing the ingredients, DNA testing of the botanicals, to ensuring that they are authentic ingredients, to maintaining high-level packaging standards. The Quality Assurance team has also made significant investments through research alliances in testing ingredients and have partnered with the University of Guelph, a comprehensive public research university in Canada, leader in food science investigation, and global hub for DNA barcoding research. Technologies also exist for educating consumers about food labelling which we know has been instrumental in bringing down the harmful effects of uncontrolled and ignorant binging. According to researchers from the American Journal of Preventive Medicine, specific food labelling has helped reduce consumers’ intake of calories by 6.6. per cent, total fat by 10.6 per cent and other unhealthy food options by 13 per cent.
Diet and nutritional status impact on health outcomes. The global rise of dietrelated non-communicable diseases plus the double burden of obesity and malnutrition means that it is imperative more than ever that all HCPs can provide at least basic evidence-based nutrition advice. For that reason, if medical education were to be based solely on the needs of patient and population health, nutrition would surely be meaningfully addressed. But, basis a study by Jennifer Crowley and colleagues in The Lancet Planetary Health and in defiance of the obvious need for physicians to possess, at minimum, solid foundational skills in clinical nutrition, medical education in nutrition across the globe is decidedly lacking.
Amidst this conundrum of research and discussions, many often pose these questions1: what is the role of the physician in a disease that is caused mainly by poor diet and lifestyle habits? Do we have a right to push patients to make major lifestyle changes? Do we have obligations toward those who are at risk but have not sought our help?
Take the example of smoking. Back in the 1980s, smoking was a very common practice amongst doctors themselves. However, today we hardly see any doctor who lights a cigarette and the number of cases of smoking induced lung cancer too have spiralled down. How did this change occur2? First, physicians and the public became aware that the smoker was not the only one at risk. There were second-hand dangers to that smoke. Second, doctors realized they were more effective at counselling patients to quit smoking if they no longer had tobacco stains on their own fingers. Third, hospitals began to ban smoking, businesses and government offices followed suit. In other words, doctors went from being bystanders—or even enablers—to leading the fight against smoking. By making the conscious decision to address a deadly epidemic, the medical community has saved countless lives. The current generation is facing an even bigger fight; that against unhealthy food, malnutrition and NCDs - all inter-related.
Communication has a very critical role to play in driving this agenda and Southeast Asia is using diverse approaches like - Information Dissemination; Education Communication and Participatory Communication. While these approaches appear to be separate, sometimes different ones are used within the same national context to address different nutritional problems. This is also the pillar where the government, public sector, private sector, nutrition companies such as ours and HCPs can play a better role. Government initiatives are using different nutrition communication approaches, depending upon the resources and expertise available to them. Some have adopted new and innovative methods while others are using more outdated ones such as a purely information dissemination approach. Moreover, countries with lower technological and personnel capacities are using older models of nutrition education, while other developing nations are applying newer, more integrated communication approaches. The result is uneven achievement within and among nations in changing the nutritional situations of vulnerable target groups.
Many patients who are admitted to the hospital and are already in a state of malnourishment. Therefore, hospital staff like nurses, nutrition consultants and treating physicians; and hospital management, needs to work towards optimising nutrition care in hospitals to improve the prevention, detection and treatment of malnutrition. There are many ways nurses can teach their patients about proper nutrition as it relates to their health. Presentations at community health centres are crucial to community health. A nurse with the right knowledge can prepare a PowerPoint presentation to show for a group of seniors during a health fair. They can also give the attendees literature to take home for further study and guidance. Nurses who work in hospitals and clinics are likely more concerned with nutrition as it relates to recovery from illness, surgery or other treatments. They can talk to patients at the bedside and explain the special meals they have at the hospital that aid recovery, as many patients will be on special diets during their stay. These nurses can also gather informative and accurate literature to give patients when they are discharged.
It’s now a matter of bringing all the piece-meal efforts towards the common cause of nutrition together and derive more significant outcomes. A place where collaboration stands a winning chance. Regular dialogues, informative content and support to the HCPs to impart nutrition knowledge to the consumers are a few parts where nutrition companies such as ours can play a significant role. Communities need to transform from within and this transformation must be driven by the HCPs and dietary experts due to the trust that they evoke from the common public.
References:
1 https://journalofethics.ama-assn.org/article/physiciansrole-nutrition-related-disorders-bystander-leader/2013-04
2 https://journalofethics.ama-assn.org/article/physiciansrole-nutrition-related-disorders-bystander-leader/2013-04
