Postsecondary Public Health Nutrition Programs On Syria

Malnutrition has become one of the leading contributor to the global burden of non communicable diseases. Malnutrition does not only refers to undernutrition associated with deficiency states, but also refers as overnutrition, excesses or imbalances in intake of energy, protein and/or other important nutrient and is associated with overweight or obesity. (1)In Middle East and North Africa have a high prevalence of overweight/obese population and has reported that by 2020 over 60% of non-communicable disease burden results from obesity as a consequence of changes in dietary habits, physical activity patterns and westernization which occurred in the Arab countries during the past three decades.(2)

Changes in the dietary habits in Arab countries are mainly characterized by an increase of calorific intake and the replacement of the traditional diet with high intake of fast food and processed food and a low intake of milk, fruits, and vegetables.Data from regional STEPS surveys measured the change in dietary intake behavior and showed that 79–96% of adults in Egypt, Jordan, Iraq, Kuwait, Saudi Arabia, Qatar, and Syria reported over intake of diet rich in fat and salt, and inadequate intake of fruit and vegetable and to be less than the recommended five servings per day.(3) This dietary behavior does not only restricted to the adult population, but also shows a health concern in children and adolescence as data from the National Health and Nutrition Examination Survey (NHANES), the Pediatric Nutrition Surveillance System (PedNSS), and the National Center for Health Statistics (NSCH) reported high overweight and obesity rates in young children (ages studied ranged from 1 to 5 years), school-aged children (aged 6–11 years), and adolescents (age range 10–19 years).

This will eventually generate a significant proportion of pediatric obesity to continue into adulthood obesity with broad range of adverse health effects such as hypertension, type 2 diabetes, and insulin resistance in early ages.(3) In Syria, overweight/obesity prevalence is high specially in urban and rural areas than suburban areas and the highest regional prevalence of overweight in the Syrian Arab Republic was in Halab 31.5% and Al-Raka 47.8% and particularly in women and this is likely rooted in the social norms and gender roles of traditional Arab societies, whereby women are mainly looked at as childbearers/child-rearers. Confined to their homes, either because of societal traditions or their pressing household duties, women may have little chance for recreational or sport activities (4) Obesity is a known risk factor for Cardiovascular disease (CVD) increasing its risk by 50%. In the Syrian public relation, the CVD mortality accounting for almost 45% of all deaths of adults between 45 to 74 years of age. In comparison to other neighboring countries, the mortality rates count about 25% of all deaths.(4)

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A paradox is likely rooted in Arab societies when a high socioeconomic status is associated with decreased probability of CVD risk factor, however in Syria population this was not applicable. It was noticed that people with low education had the worst CVD risk profile mostly because of obesity and hypertension. Fruits and vegetables can be widely affordable in Syria, however their beneficial effects on the quality of health status , particularly on cardiovascular health is not widespread in the society (4). A study focuses on analysis of dietary habits and food consumption among adolescents’ students and revealed that dietary behavior is influenced by cultural norms, socioeconomic factors, lifestyle and nutrition education. The average consumption of fruit and vegetable was lower than the actual recommendation and this was associated with the low knowledge of its health benefits or other healthy eating behaviors. The study revealed that sources of nutrition education of students revealed that 33.1% of nutrition information was from family members,6.4% from schools,5.1% from social media.(5)

In 2011,A massive revolution have displaced a civilian war in Syria and has devastated the country’s population which had a detrimental impact on the lives of over 11 million Syrians and millions of citizens in host countries. The massive displacement of Syrians has not only as a result of the enormous political war but also due to the impact of the crises on the national economy, destruction of security, damage to infrastructure and collapses of services and social consequences including education (6). As the conflict continues, Syria now considered s one of the most food-insecure regions in the Arab world. The World Food Programme addressed that 2·5 million Syrians are suffering from hunger reported from inaccessibility of food due to financial crisis in the country or due to the unmet food needs, nonfood assistance or health in refugees shelter(7). These people who are suffering from humanitarian crisis are associated with higher risk for a major public health malnutrition and its comorbidities due to the lack access to healthy food and health services.(8)

To tackle the complex nature and multi-faceted aspect of malnutrition that is burdening the region several actions are needed to reorient services related nutrition behavior. One of them is implementation and development of culturally sensitive nutrition programs and policies that reaches families and the community at large since few studies revealed that families might have an important role in nutrition sources.(9) Nutrition programs seek to promote healthy dietary behavior, improving eating habits by delivering health nutrition educations and this can be achieved through a solid practice and framework of public health nutrition to effectively address, through both prevention and treatment. Nutritionists/Dietitians considered one of the most important roles in public health nutrition for better assessment nutrition related health problems and better for developing and implementing evidence-based nutrition programs at reducing the burden of malnutrition. A curios query to answer about the number capacity of nutrition education programs in Syria and the role of these programs on the Syrian society. Thus, the aim of this paper to examine and review nutrition-affiliated programs that is offered in colleges and universities in Syria.