MUNICIPALITY OF ATHENS Tsiftis George, Paediatrician Municipality of Athens Nursery Centers MEDITERANIAN DIET - BALANCED NUTRITION FROM THEORY TO IMPLEMENTATION

During 2008, our main activity was the prevention both of diseases and pathogenic attitudes. Overconsumption of calories ends to obesity. Obesity is connected with arterial blood hypertension, hypercholesterolaemia, coronary disease and metabolic syndrome.

Obesity presupposes correct nutrition, development of healthy nutrition attitudes. Mediterranean nutrition constitutes the best model for a healthy diet. The development of healthy attitudes requires patience, persistence, consistency and repetition both on behalf of parents and teachers.

Prevention is the best cure. Health maintenance and improvement is most significant. Methodology and technique is required for the child to develop healthy habits. Health promotion is: One step ahead of prevention. Now a social issue rather than a personal one.

Mrs Vicky Benetou, indicated: There is convincing scientific evidence that Diet And Nutrition are important factors in the Maintenance and Promotion of good health (Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation, Geneva, 2002). Throughout the entire life course. Begins in fetal life and continues into the old age (cumulative lifetime exposure) Leads to short- and long-term consequences for health Nutrition is a major modifiable environmental determinant affecting all population groups Great importance for public health workers

Optimum nutrition determines health, growth and development. First 2-3 years of life are the most crucial (critical window) for normal physical, mental, social and emotional development. (Feeding and Nutrition of Infants and Young Children. Guidelines for the WHO European Region, with Emphasis on the Former Soviet Countries. WHO Regional Publications, European Series No ) Eating habits, lifestyle and behavior patterns are developed during this period and may persist throughout adulthood. Thus, childhood nutrition has long-term implications for preventing disease in adulthood as: Cardiovascular diseases Obesity Diabetes mellitus type II Osteoporosis Cancer

The improvement of childrens health depends on research; the provision of services require a culture that constantly examines and criticises A. Aynsly–Green, Arch. Dis. Child. 1998

Main Preventive Medicine Programmes A model diet based on the Mediterranean diet and traditional Greek cuisine. Detection of iron deficiency: The use of new, sensitive indices led to the conclusion that 18.4% of the children were sideropenic Vitamin D level detection: All children tested normal Dental examination: 36.5 % of children with caries, leading to the creation of a children-oriented oral hygiene education programme

Annual visual acuity test for children >4 years: 2-3% suffers from refractor errors without being aware of it Recording of childrens somatometric data, contribution to the creation of percentile tables for Greek children. Obesity propensity detection programme Overweight and obese children identification: 13.6% overweight, 5% obese Migratory wave mapping. Recording of needs/ habits Use of a special test for the identification of children possible to manifest learning disabilities at school. The School Awareness programme proved that 28% of children required assistance

1. Providing medical advice on specific problems is both useful and valuable, but it only lasts as long as the problem does. 2. On the contrary, teaching people the art of protecting and promoting health results in the duration required. 3. For children, a single practical example is worth a thousand pieces of theoretical advice, we started, in cooperation with the professor Mrs. Trichopoulou, preparing various diets based on the Mediterranean nutrition pyramid.

1st step: Preparation of 25 diets (breakfast + lunch) based on Mediterranean nutrition and Greek traditional cuisine. 2nd step: Daily caloric needs have been calculated; however half of them have been prescribed. 3rd step: food have been weighted unrefined and skinned and then, cooked. Thus, eventual loss could be estimated and appropriate quantity (of each food) could be calculated. 4th step: Thanks to P/C and special tables, we are able to calculate a) Calories (half of daily needs), b) appropriate proportion of proteins, fats and carbohydrates, c) qualitative mix-up of fats (saturated, monounsaturated, polyunsaturated) and carbohydrates (polysaccharides) and d) needs in trace elements and natural fibers. 5th step: Finally, quantity of portion per food and per child has been calculated. Thus, according to the number of children to be hosted, we calculated supplies and we cooked specific quantities and recipes. These are the steps we followed

These are some of the diets we have already prepared.

Hard work, information and training of all involved parties (cookers, professors and parents) is required, thats why Seminars are constantly organized.

Our meetings allow us to be optimistic about the future, underline the states interest and sensitise all parties involved

Dr.William Harvey (a physiologist describing blood circulation system) is carrying out experiments. King Charles the 1st is watching along with the little princess. Canvas painted by Robert Hannah. Royal College of Physicians, London. The evolution of medicine through art, Dr. Th. Dolatza, Grafida, Athens 1999

The Municipality of Athens, as well as Prince Charles and Dr. Harvey, have been really supportive to our projects, and therefore we may be more optimistic about the future!

Thank you