Pushti, Improving Nutrition in Bangladeshi Population: From Research to Practice Biomedical Research Group, BIRDEM, Bangladesh

The number of people with diabetes mellitus (DM) in the developing countries is increasing at an alarming rate and Bangladesh is no exception. Current prevalence of the disease in the adult population in the country is estimated to be- 5.2% with a total number estimated as 3 million. DM poses considerable medical as well as socioeconomic burden all over the world and this is specially true for resource constrained countries like Bangladesh. Accordingly, early management and more particularly, prevention should be the cornerstone for diabetes-health care movement in such countries.

'Nutrition' plays a central role in the prevention and management of DM and other disorder associated with metabolic syndrome. The health care providers in developing countries, however, do not seriously acknowledge this fact in most cases and this leads to the unfortunate consequence of looking "health" as a purely "medical" issue. Blames are easily given to the policy makers and health care agencies, but the professionals and scientists cannot avoid their failure. Although limited in scope, efforts have often been taken in Bangladesh in improving nutrition of population within the major goal of health care reform, but most of these programs utterly failed in attaining their objectives.

One of the major reasons for such failure is that such programs were divorced with the chemical-biological, socioeconomic and cultural realities of the population that they addressed. Without primary data generated on the food items consumed, on the biological effects they produce on the specific population and on the knowledge, attitude and practices of the community concerned, any attempt for a nutritional reform program is bound to fail in producing optimum result.

Realizing the above facts, the Biomedical Research Group (BMRG) of BIRDEM (the central institute of the Diabetic Association of Bangladesh) started, back in 1997, a comprehensive program on nutritional evaluation of local food materials with particular focus on chemical analysis and on glycemic index (GI) which has direct implication for prevention and management of DM and metabolic syndrome in general. The program also contained projects in studying issues related to BMI and KAP in various groups of diabetic subjects. The project has been conducted mainly in collaboration with Research Dept. of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark (group led by A/Prof Dr Shakuntala Thilsted and Dr Inge Tetens) and has been supported by the ENRECA program of DANIDA. The International Program of Chemical Sciences (IPICS), Sweden, also provided some support. A considerable volume of data have already been produced in these areas and now BMRG feels that it is in a position to ventilate this information to the patients and general public as well as to the policy makers. BMRG strongly feels that development of appropriate promotional tools and strategies based on the present context sensitive data (as well as on additional data to be generated), from chemistry and biology to sociology will be highly useful in improving the nutrition and thus health of the Bangladeshi population, and these tools, can help as guidelines in other developing countries particularly with similar cultural and socioeconomic realities.