Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Developing countries perspective on interventions to prevent overweight and obesity in children
The double-burden challenge
One of the most complex and inevitable challenges
faced by countries developing strategies to face the
growing rates of childhood obesity where undernutrition
prevails is working around existing nutrition programs.
One of the universal goals of most nutritional
assistance and supplementary feeding programs in
developing countries has been to promote normal
growth and development in children. Through the
provision of energy - rich foods such as whole milk and
fortified cereals at the household and school level
these programs ensure that children meet their daily
caloric needs. However, among populations experiencing
nutrition transition, and where some beneficiaries
already meet the recommended daily energy
allowance, universal feeding programs are likely to
promote obesity.
As obesity prevention strategies are developed in
developing countries, the role of supplementary nutrition
programs must not be overlooked. While they are
likely to continue to be necessary for segments of the
population, their structure must respond to the
changing nutritional reality of transitioning countries.
Failing to do so will inevitably result in the execution
of programs that have conflicting objectives simultaneously.
Therefore, particularly in rapidly developing
countries and urban areas, existing pro - poor nutrition
programs should begin to identify strategies by which
children continue to receive an adequate nutrition
while at the same time avoiding the risk of their
becoming overweight. Specifically, in geographical
areas where under - and overnutrition are observed,
potential strategies include the revision of the types
and quality of foods offered as part of school breakfasts
and lunch program menus (i.e. providing reduced
fat milk and including more fruit and vegetables), a
revision of national feeding practices guidelines and
recommendations, and the modification of targeting
mechanisms of program benefit distribution.
Conclusion
The prevalence of unhealthy weight in children is
increasing in developing countries at a high rate. The
potentially devastating long - term consequences of
this epidemic on children ’ s quality of life call for
immediate actions and policies aimed at the prevention
and control of these conditions. Although there
is consensus that the caloric energy imbalance that has
resulted from the simultaneous increase in consumption
and decrease in levels of activity is a determining
factor in the problem, the relative importance of more
distal factors is still contested. Hence, the need to
promote physical activity and healthy diets in a variety
of different settings, particular those that children are
influenced by or take part in, such as the home, school
and community, is widely accepted.
At a global level, increasing children ’ s physical
activity levels and reducing energy intake will require
environmental changes so that the option to make
healthy choices is available. Only in environments
where healthy choices are an option will communication
strategies to inform and motivate reach their full
potential. Producing effective interventions, particularly
in developing countries, poses countless logistical
challenges that require careful examination. Yet, in
many cases the nature of the problem does not afford
countries the luxury of conducting preliminary
research. Programs and interventions need to be
developed and implemented without further delay
and based on the best available evidence. The key to
their success lies in the implementation of thoughtful
monitoring, evaluation plans and malleable structures.
Only then will we be able to generate evidence -
based literature to learn from — evidence that bravely
documents failures, is unassuming about successes
and allows all of us to draw lessons from a wide range
of experiences.
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