HEALTH: The poor nutrition of the rich




Dr Senarath Mahamithawa, Nutrition Coordination Division, Ministry of Healthcare and Nutrition and former President of Sri Lanka Nutrition Society presents an analysis of the poor nutrition intakes of rich Lankans. This is the first of a series of articles that will elaborate on important aspects of nutrition.


Nutrition problems are traditionally attributed to poverty and related economic conditions. Many of us are inclined to think that malnutrition is confined to certain parts of the world, mainly Africa and Asia and to a section of the population namely the poor. However, careful analysis of the problem shows that the above conclusions are far from the truth.

It should not be forgotten that malnutrition has raised its head among the not so poor as well. The word malnutrition is commonly and loosely used to indicate “not getting adequate food´. However, proper or optimum nutrition has many facets. Ingestion of adequate amount of quality food certainly forms the basis. Ingested food has to be digested and absorbed properly and has to be used up by the body in the proper manner. It is after these take place that one can be assured of proper nutrition. The other important fact that should not be forgotten is that both inadequate and excessive supply of nutrition leads to adverse consequences and should be avoided. This holds true not only for adults but also for children.

Micro-nutrients, macro impact

In general many affluent individuals are not affected with deficiency of calories. This means they consume more than the minimum requirement of energy giving food by taking carbohydrates, sugar and proteins. Nor do they show signs of protein inadequacy. But proper nutrition does not end there. A significant proportion of affluent people are affected with micro-nutrient deficiencies, nutrition imbalances and over-nutrition. It is not only buying power that matters for good nutrition but also the proper knowledge and commitment to practice regularly. In fact good nutrition practices should be built in to the life of each individual so that good practices follow without making an effort.

Nutrients that are needed in minute quantities are called micro-nutrients. But their importance is by no means minute. Iron deficiency is a common deficiency disease which affects people of all socio economic classes. In the Sri Lankan scenario a significant proportion of women, particularly pregnant women, suffer from iron deficiency anemia. A special emphasis should be given in the case of pregnant mothers as it can have adverse consequences both during confinement and to the baby that is born. Complications such as excessive bleeding during child birth are more common in mothers who are suffering from iron deficiency anemia. Iron deficiency negatively influences the growth of the baby while inside the womb.


Vitamin A deficiency is another micronutrient deficiency affecting even the affluent populations particularly, the children under five years of age. Vitamin A again is essential for a host of bodily functions including proper vision, skin health as well as resistance to infections. Here again, more than the affordability of certain food items, it is making correct food choices that prevents individual from these deficiency diseases. In a similar manner, any individual is at the risk of not getting the other micronutrients in adequate quantity if he or she does not consume a diversified diet comprising of the staple, vegetables, fruits, fish and meat. At this point it should be mentioned that it is not essential to consume fish and meat if alternate sources of protein and other nutrients are used in adequate quantities.

High society health

Affluent sections of the society are at a higher risk of being fed with unhealthy diet much more often than their poorer counterparts. They use processed food more often and are in the habit of “eating out”. High society people are more often than not the victims of being guinea pigs at invited dinners where cookery experts show their prowess at the expense of unsuspecting invitees. It is the responsibility of each individual to scan through the “spread” before they indulge in it. The policy of eating without restrictions at functions and “occasions” does not hold ground as they encounter these occasions more than occasionally. All these situations ultimately make us take high amounts of carbohydrates, sugar, fat and salt. Even in home cooking convenience plays a major role in selecting food items and the recipe that is used. Many busy housewives are in the habit of using oil as the cooking medium and less vegetables are used in their cooking. These are thought to be the underlying factors seen in the higher socio economic class of Sri Lanka.

Adding to what was mentioned above, lifestyle of a busy executive or a successful businessman is quiet different from that of an ordinary peasant. The latter walks to the workplace or at least to the bus stand, his work involves some physical activity and does his household chaos manually where as the former uses the modern technological innovations to help him out and leads a sedentary lifestyle. The end result is that the people of higher social class tend to put on weight leading to an overweight or obese stature while the “ordinary” person strikes a balance. Consequences of obesity are very wide and can affect the health of an individual drastically. While an obese person finds it difficult to move about freely and attend to his daily work he is at the risk of developing one or more diseases such as high blood pressure, ischemic heart diseases, diabetes and even some cancers. It has to be borne in mind that action has to be taken well before one is afflicted with these ailments or better still before he or she falls in to the category of overweight.

Stress affects a significant proportion of individuals of the high end society and this also leads to nutritional derangements. Some tend to avoid taking regular meals and undergo wasting while others indulge in food while trying to fight stress and end up with overweight. Regular exercise programs together with forms of relaxation, depending on preferences of the individual, helps to control stress as well as to reduce overweight. A practical but healthy meal plan together with appropriate lifestyle changes will go a long way in maintaining good health.

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