1. Behind the scenes the making of the Palau
Dietary Guidelines
Amanda Bennett- Nutritionist

2. Outline
• Background
• Consultation process
• Key Messages
• Dietary Modelling
• Dietary guidelines
• Feedback

3. Background
• No consistent guidelines used

4. Findings
• 90% of food imported
• Low motivation to use local foods
• Food choices based on convenience, cost and
availability
• High dependence on canned and packaged foods- +++
high in saturated fat, sodium and sugar
• Social relationships built around food sharing
• Obesogenic environments
• Confusion around:
– What a local healthy diet should include
– How much we should be eating
– 3 vs 5 food groups

5. Consultation process
• 4 formal rounds of consultation from draft to
content finalization
• Stakeholders included:
– Community groups, leaders, MOH staff, USDA and
WHO
Local stakeholders included:
MOH – clinical, public health and nursing, MOE,
UAK, Kotel A Deurreng, PCAA, OMUB, Nutrition
Working Group, Family Federation for World Peace
and Unification, Coalition for a Tobacco Free Palau
and Faith-based representation.

6. Feedback from Consultation
• Locally relevant and practical information
• Easy to read and navigate
• Comprehensive guide to address NCD lifestyle
risk factors
– Healthy eating
– Physical Activity
– Alcohol
– Tobacco use

7. Key Message development

8. Taro Leaf Development
• Prak leaf background
• Focuses on three local food
groups
• Ongraol
• Odoim
• Combining meat,
alternative, including
dairy
• Fruits and vegetables

9. Taro Leaf Messages

10. Dietary Modelling process and challenges
Getting the balance right:
• guidelines meet estimated calorie and
nutrient requirements for healthy adults
– 2000 calories per day
• Appropriate servings of protein (odoim) foods
• Focus on local foods first
• Getting the serving sizes right
– Relevant to local context

11. Food Pattern for 2000 calories
Based on USDA Food Pattern Data for 2000 calories
Food Group
USDA (calories per
food group)
Palau (calories per
food group)
Fruit 200
330
Vegetables 125
Grain/Starchy Vegetables 640 650
Protein foods 290
530
Dairy foods 245
Oils 230 230
Solid fats & Added Sugar (an
allowance- not
recommendation)
260 260
Total Calories 2000 2000

12. Food Pattern for 2000 calories
Based on USDA Food Pattern Data for 2000 calories
Food Group
USDA (calories per
food group)
Palau (calories per
food group)
Fruit 200
330
Vegetables 125
Grain/Starchy Vegetables 640 650
Protein foods 290
530
Dairy foods 245
Oils 230 230
Solid fats & Added Sugar (an
allowance- not
recommendation)
260 260
Total Calories 2000 2000
1510

13. Determining serving size
• Spent time +++++ weighing all sorts of food
• Photo documenting

14. A word on serving size
• Serving sizes are different for each
food group
• All calories are not equal
• Fat, Protein, Carbohydrates and
Alcohol all contain different amounts
of calories

15. Determining serving size
• Determined the avg weight for a variety of
commonly eaten foods
• Determined what the avg calorie amount each
serving contained for that particular food
group
• Determined approximate serving size for
different foods.

16. Bringing it all together- Palau dietary
guidelines

17. Fruits and Vegetables– aim for 5 servings every day!

18. What is a serving of vegetables?
One Serving
Vegetables
= 1/2 cup cooked
or 1 cup uncooked
A cupped
hand= 1/2 cup
cooked

19. What is a serving of fruit?
One Serving
Fruit=
1 medium fruit, 1
cup diced, 2 small
fruits
¼ soursop

20. Ongraol– energy foods: aim for 5 to 8 servings every day!

21. What is a serving of ongraol?
One Serving
Ongraol= ½ cup
cooked or ½
medium taro
A cupped
hand= 1/2 cup
cooked

22. Odoim– body building: aim for 3 to 4 servings every day!

23. What is a serving of odoim?
One Serving
Odoim=
Palm of your hand
= 1 serving fish,
chicken or meat

24. Not Odoim
Reduce amount of:
• Canned & processed meats- Corned beef,
canned pork, hamburger, sausages, turkey tail
Warning: these meats are very high in salt and
bad fat.

25. Putting it all together
Meal Food eaten Fruits &
Veg
Ongraol Odoim
Breakfast 2 slices bread with
2 tablespoon peanut butter
1 cup low fat milk
2
1
1
Snack 1 medium banana 1
Lunch 1 cup rice
1 med fish fillet
1 cup salad 1
2
1
Snack 1 medium cucumber 1
Dinner 1 medium taro
2 chicken pieces
1 cup sautéed kangkum and
mixed vegies
2
2
1
Total 5 6 4

26. Summary
• Based on three food groups
• Healthy adult achieving their calorie goal to
maintain weight (2000 calories) and nutrient
requirements
• Promotes local healthy diet and compliment
lifestyle messages to reduce NCDs and
promote good health
• Finalized Mid-December

27. Questions/Comments/Feedback