Preventing Childhood Obesity - Evidence Policy and Practice.pdf

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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. References 1 Martorell R , Kettel Khan L , Hughes ML , Grummer Strawn ML : Obesity in Latin American women and children . J Nutr 1998 ; 128 ( 9 ): 1464 – 1473 . 2 Martorell R , Kettel Khan L , Hughes ML , Grummer - Strawn LM : Overweight and obesity in pre - school children from developing countries . Int J Obes 2000 ; 24 : 959 – 967 . 3 Kain J , Vio F , Albala C : Obesity trends and determinant factors in Latin America . Cad Saúde Pública 2003 ; 19 (Suppl. 1 ):S77 –S86 . 4 Amigo H : Obesity in Latin American children: situation, diagnostic criteria and challenges . Cad Saúde Pública 2003 ; 19 (Suppl. 1 ):S163 –S170 . 5 Prentice AM : The emerging epidemic of obesity in developing countries . Int J Epidemiol 2006 ; 35 : 93 – 99 . 6 Luo J , Hu FB : Time trends of childhood obesity in China from 1989 to 1997 . Int J Obes 2002 ; 26 ( 4 ): 553 – 558 . 153
Chapter 18 7 Jafar TH , Qadri Z , Islam M , Hatcher J , Bhutta ZA , Chaturvedi N : Rise of obesity with persistent rates of undernutrition among urban school-aged Indo-Asian children . Arc Dis Child 2008 ; 93 : 373 – 378 . 8 Kumanyika S , Jeffery RW , Morabia A , Ritenbaugh C , Atipatis VJ : Obesity prevention: the case for action . Int J Obes 2002 ; 26 : 425 – 436 . 9 Bonvecchio A , Safdie M , Monterrubio E , Gust T , Villalpando S , Rivera J : Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006: results of the National Health and Nutrition Survey . 2006 . 10 Victora CG , Adair L , Fall C et al, for the Maternal and Child Undernutrition Study Group : Maternal and child undernutrition: consequences for adult health and human capital . Lancet 2008 ; 371 : 340 – 357 . 11 Long A , Reed R , Lehman G : The cost of lifestyle health risks: obesity . J Occup Environ Med 2006 ; 48 : 244 – 251 . 12 Bhutta ZA , Ahmed T , Black ER et al, for the Maternal and Child Undernutrition Study Group : Maternal and child undernutrition: what works? Interventions for maternal and child undernutrition and survival . Lancet 2008 ; 371 : 417 – 440 . 13 Rivera JA , Sotrés-Alvarez D , Habicht JP , Shamah T , Villalpando S : Impact of the Mexican program for education, health and nutrition (Progresa) on rates of growth and anemia in infants and young children. A randomized effectiveness study . JAMA 2004 ; 291 : 2563 – 2570 . 14 Bautista - Casta ñ o I , Doreste J , Serra - Majem L : Effectiveness of interventions in the prevention of childhood obesity . Eur J Epidemil 2004 ; 19 : 617 – 622 . 15 Summerbell CD , Waters E , Edmunds LD , Kelly S , Brown T , Campbell KJ : Interventions for preventing obesity in children . Cochrane Database Syst Rev 2005 ; ( 3 ): Art. No. CD001871. doi: 10.1002/14651858.CD001871.pub2 16 Kain J , Uauy R , Albala FV , Vio F , Cerda R , Leyton B : Schoolbased obesity prevention in Chilean primary school children: methodology and evaluation of a controlled study . Int J Obes 2004 ; 28 : 483 – 493 . 17 Mo - suwan L , Pongprapai S , Junjana C , Puetpaiboon A : Effects of a controlled trial of a school - based exercise program on the obesity indexes of preschool children . Am J Clin Nutr 1998 ; 68 : 1006 – 1011 . 18 Safdie M , Bonvecchio A , Theodore F et al: Promoting physical activity and a healthful diet in the Mexican school system for the prevention of obesity in children . Final Report to ILSI and PAHO. 2008 . 19 Jenninngs - Aburto NJ , Nava F , Bonvecchio A , Safdie M , Casanova I , Gust T , Rivera J : Physical activity during the school day in public primary schools in Mexico City . Salud Pública Méx 2009 ; 51 (2 ):141 –147 . In press. 20 Cole T , Bellizzi M : Establishing a standard definition for child overweight and obesity worldwide: international survey . BMJ 2000 ; 320 : 1 – 6 . 21 Doak C : Large - scale interventions and programmes addressing nutrition related chronic diseases and obesity: examples from 14 countries . Public Health Nutr 2002 ; 5 ( 1A ): 275 – 277 . 22 Zhai F , Fu D , Du S , Ge K , Chen C , Popkin BM : What is China doing in policy - making to push back the negative aspects of the nutrition transition? Public Health Nutr 2002 ; 5 : 269 – 273 . 23 Matsudo V , Matsudo S , Andrade D et al: Promotion of physical activity in a developing country: the Agita Sa õ Paulo experience . Public Health Nutr 2002 ; 5 : 253 – 261 . 24 Albala C , Vio F , Kain J , Uauy R : Nutrition transition in Chile: determinants and consequences . Public Health Nutr 2002 ; 5 : 123 – 128 . 25 Rivera JA , Muñoz-Hernández O , Rosas-Peralta M , Aguilar - Salinas CA , Popkin BM , Willett WC : Consumo de bebidas para una vida saludable: recomendaciones para la poblaci ó n mexicana . Salud Publica Mex 2008 ; 50 : 173 – 195 . 26 Mason JB , Habicht J-P , Tabatabai H , Valverde V : Nutritional Surveillance . Geneva : WHO , 1984 : 1 – 194 . 27 McGinnis JM , Harrell JA , Meyers LD : Nutrition monitoring: interface of science and policy . J Nutr 1990 ; 120 (Suppl. 11 ): 1437 – 1439 . 154
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Preventing Childhood Obesity Eviden
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Preventing Childhood Obesity Eviden
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Contents Foreword, vii Contributors
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Foreword Obesity became a major hea
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Contributors Rob Carter PhD Head, H
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Contributors Shiriki Kumanyika PhD,
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Preface If we had all the evidence,
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CHAPTER 1 The c hildhood o besity e
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Childhood obesity epidemic Table 1.
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Childhood obesity epidemic explain
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Childhood obesity epidemic Table 1.
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Childhood obesity epidemic hepatiti
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Childhood obesity epidemic 15 Shiel
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CHAPTER 2 Lessons from the c ontrol
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Lessons from the control of other e
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Childhood obesity prevention overvi
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CHAPTER 4 No c ountry for f at c hi
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No country for fat children? Ethica
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A human rights approach to childhoo
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Part 2 community and government age
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Chapter 6 Questions Evidence needed
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Chapter 6 ioral determinants rather
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Chapter 6 These issues are particul
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Chapter 6 15 Carrel AL , Bernhardt
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Chapter 7 at the state level to app
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Chapter 7 prevention efforts, parti
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Chapter 7 interventions. This appro
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CHAPTER 8 Evidence of the i nfl uen
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Chapter 8 choices in adolescence, 1
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Chapter 8 itself is unlikely to res
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Chapter 8 20 Cullen K , Baranowski
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Chapter 9 meal frequency, decreased
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Chapter 9 were behavioral (parent -
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Chapter 9 changes regarding partici
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Chapter 9 36 Campbell KJ , Hesketh
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Chapter 10 condition obesity in chi
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Chapter 10 the release of energy an
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Chapter 10 whereas Flynn et al 25 a
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Chapter 10 11 Baranowski T : Advanc
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CHAPTER 11 Obesity p revention in s
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Chapter 11 translation (see Chapter
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Chapter 11 overweight and obesity r
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CHAPTER 12 The p revention of c hil
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Chapter 12 Selective prevention pro
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Chapter 12 Table 12.1 Recommendatio
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Chapter 12 Table 12.1 Continued Gui
Page 121 and 122: Chapter 12 short - and long - term
Page 123 and 124: Chapter 12 33 Woo KS , Chook P , Yu
Page 125 and 126: Chapter 13 There is a relatively sm
Page 127 and 128: Chapter 13 Modifying the b uilt e n
Page 129 and 130: Chapter 13 capacity to support chil
Page 131 and 132: Chapter 13 45 Staunton C , Hubsmith
Page 133 and 134: Chapter 14 Changes in the food envi
Page 135 and 136: Chapter 14 Promising interventions
Page 137 and 138: Chapter 14 10 USDA - ERS : Food CPI
Page 139 and 140: CHAPTER 15 Food and b everage m ark
Page 141 and 142: Chapter 15 Box 15.1 The findings of
Page 143 and 144: Chapter 15 Food, however, is not to
Page 145 and 146: Chapter 15 competitive analysis eac
Page 147 and 148: Chapter 15 behaviour: exploring the
Page 149 and 150: Chapter 16 pawn or sell possessions
Page 151 and 152: Chapter 16 obesity and that this ma
Page 153 and 154: Chapter 16 impact of this deprivati
Page 155 and 156: Chapter 16 10 Marin - Leon L , Sega
Page 157 and 158: CHAPTER 17 Socio - c ultural i ssue
Page 159 and 160: Chapter 17 The s ocio - c ultural e
Page 161 and 162: Chapter 17 with limited access and/
Page 163 and 164: Chapter 17 What else can be done to
Page 165 and 166: Chapter 17 55 Grier S , Kumanyika S
Page 167 and 168: Chapter 18 Ironically, these countr
Page 169 and 170: Chapter 18 key environmental factor
Page 171: Chapter 18 countries precludes the
Page 176 and 177: CHAPTER 19 Evaluation of c ommunity
Page 178 and 179: Evaluation of community-based obesi
Page 186 and 187: CHAPTER 20 Economic e valuation of
Page 188 and 189: Economic evaluation of obesity inte
Page 194 and 195: CHAPTER 21 Monitoring of c hildhood
Page 196 and 197: Monitoring of childhood obesity Non
Page 198 and 199: Monitoring of childhood obesity Noo
Page 200 and 201: Monitoring of childhood obesity Tab
Page 202 and 203: Monitoring of childhood obesity 11
Page 204 and 205: Knowledge translation and exchange
Page 212 and 213: The role of advocacy Why d o w e n
Page 214 and 215: The role of advocacy mate long - te
Page 216 and 217: The role of advocacy position put o
Page 218: The role of advocacy 6 Yach D , Haw
Page 221 and 222: Part 4 infrastructure, funding or r
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Chapter 24 by examining why policy
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Chapter 24 has privileged the manuf
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Chapter 24 case study is an analysi
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Chapter 24 by being highly visible
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CHAPTER 25 Developing the political
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Chapter 25 Involuntary: all society
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Chapter 25 Shiriki Kumanyika and co
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Chapter 25 The next steps Given the
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CHAPTER 26 Community i nterventions
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Chapter 26 Table 26.1 The health pr
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Chapter 26 consider and build on th
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Chapter 26 programs and messages be
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Chapter 26 Victoria, Australia. The
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Chapter 26 participants for appropr
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CHAPTER 27 Community c apacity b ui
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Chapter 27 level and macro - change
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Chapter 27 & Chomp ” where the co
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Chapter 27 Box 27.4 Excerpt from Go
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Chapter 27 Table 27.1 Capacity buil
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Chapter 27 38 Borys Jean - Michel :
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Chapter 28 Box 28.1 The EPODE progr
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Chapter 28 Figure 28.1 For parents:
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Chapter 28 Figure 28.2 Promoting ph
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Chapter 28 marketing, there is ofte
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Chapter 28 social problems. The art
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Chapter 29 length gain observed in
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Chapter 29 tissue deposition relate
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Chapter 29 A study in the USA found
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Chapter 29 7 Cole TJ , Bellizzi MC
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Chapter 29 environmental approaches
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Chapter 30 it all on their own, sin
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Chapter 30 Forty - three countries
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Chapter 30 Box 30.2 Elements of the
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Chapter 31 childhood obesity rates
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Chapter 31 became inactive or was t
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Chapter 31 healthy diets and portio
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CHAPTER 32 Working with m inority g
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Chapter 32 and reflect the circumst
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Chapter 32 inclusion and exclusion
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Chapter 32 3 Mercer SL , Vinney JD
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Chapter 33 % of total DALYs lost 2
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Chapter 33 Finally, within a given
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Chapter 33 urbanized and have aband
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Chapter 33 Box 33.1 Recommendations
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CHAPTER 34 Preventing c hildhood o
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Chapter 34 with a plateau in cigare
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Chapter 34 segments of the populati
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Index academic performance 11, 264
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Index evidence-based and evidence-i
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Index community-based 33, 58, 151,
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Index parental support 67 PE 25, 81
Page 325:
Index Minnesota Heart Heath Project
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