“My Rice Plate” an evidence-based model to lose excess body weight by Dr. Ranil Jayawardena

Source: Newsletter of the College of General Dental Practitioners of Sri Lanka

Dietary changes of Sri Lankans have drastically changed in the past two decades with the evolving urbanization, economic transition and technology growth. A study conducted presented that a considerable percentage of the adult population failed to follow the recommended dietary guidelines. Nearly 70% had exceeded the recommended starch intake, the daily intake of fruit (0.43 servings per day) and vegetable portions (1.73 servings per day) had dropped well below national recommendations, with only 3.5% of adults consuming the recommended five portions of fruits and vegetables per day. Sri Lankans obtain nearly 72% of their calorie requirement by carbohydrates (mainly refined), while only 10% of calories are derived from proteins which is not surprising for a country where our staple food is rice. Prevalence of Obesity is drastically increasing worldwide, and Sri Lanka has not been left behind. Currently, over a quarter of Sri Lankan adults are suffering from obesity with a higher prevalence of obesity seen among women and middle -aged adults.

Obesity is caused mainly by the imbalance of energy intake and expenditure. With obesity the associated major rising health burden on a country is the prevalence of Non-communicable diseases (NCDs), which is the leading cause of morbidity and mortality worldwide. The obesity associated NCDs have reached epidemic proportions in Sri Lankan adults for example; prevalence of metabolic syndrome is 25%, hypertension is over 20%, and dysglycemia is 21%. Such comorbid factors have had a huge impact on health care expenditures. Of total deaths, 75% of deaths were accounted by NCDs. Of these deaths, 40% were Cardiovascular disease (CVD) related deaths alone. Epidemic of Obesity and associated NCDs are results of unfavourable changes in lifestyle including unhealthy dietary habits and physical inactivity which further impacts the energy balance affecting the body weight.
A typical rice plate of a Sri Lankan consists of 400g of boiled rice in average and the contribution of vegetables and proteins are considerably very low. Therefore, the total plate would provide around 600kcal and thus if eaten thrice a day the daily energy requirement of a sedentary adult is exceeded. As mentioned, excess energy intake is a major determinant with weight gain, obesity and associated chronic NCDs. To tackle this “My Rice Plate” was designed according to the ‘Plate Model’ recommended by local and international nutrition guidelines.

‘Plate model’ is a practical method to overcome the prevailing dietary patterns by reducing the average portion size of the staple food in main meals and ensures the sufficient intake of vegetables and protein rich foods synchronously.
“My Rice Plate” is a portion perfection plate designed for Sri Lanka complying with the internationally used ‘Plate Model’ concept.
“My Rice Plate” model is key in addressing three common issues; Controlling portion size, Nutrition balance and eating awareness. DR. Ranil Jayawardena’s team has conducted a clinical trial on this plate
concept. Key findings of the study revealed that the intervention group that followed the plate model had a significant effect on weight and BMI reduction after 12 weeks than the control group.
There is a huge emphasis on dietary guidelines as its importance of a balance and varied diet. Meals that include no servings or few servings of protein and vegetables lack both balance and variety. A substantial proportion of the Sri Lankan population does not consume a varied and balanced diet which results in unhealthy eating habits. ‘My Rice Plate’ is ideal as it is simple and is an efficient method to follow a balanced diet, certainly it is an alternative to the traditional way of exchange-based teaching and meal planning.