No abstract

Latin America is undergoing a rapid demographic and nutritional transition. A recent WHO/PAHO survey on obesity in the region revealed an increasing trend in obesity as countries emerge from poverty, especially in urban areas. In contrast, in middle income countries, obesity tends to decline as income increases; this is especially so in women. Dietary changes and increasing inactivity are considered the crucial contributory factors that explain this rise. The end result is a progressive rise in overweight and obesity, especially in low income groups who improve their income and buy high fat/high carbohydrate energy-dense foods. Intake of these foods increases to the detriment of grains, fruits and vegetables. Most aboriginal populations of the Americas have changed their diet and physical activity patterns to fit an industrialized country model. They now derive most of their diet from Western foods and live sedentary and physically inactive lives. Under these circumstances they develop high rates of obesity, insulin resistance and type 2 diabetes. Supplementary feeding programs are common in the region; the number of beneficiaries significantly exceeds the malnourished. Weight-for-age definition of undernutrition without assessment of length will overestimate the dimension of malnutrition and neglect the identification of stunted overweight children. Providing food to low income stunted populations may be beneficial for some, although it may be detrimental for others, inducing obesity especially in urban areas. Defining the right combination of foods/nutrients, education and lifestyle interventions that are required to optimize nutrition and health is a present imperative.

OBJECTIVE:To assess the impact of a 6 months nutrition education and physical activity intervention on primary school children through changes in adiposity and physical fitness. DESIGN: Longitudinal school-based controlled evaluation study. SUBJECTS: Children from 1st to 8th grade, 2141 in intervention and 945 in control schools. INTERVENTION: Nutrition education for children and parents, 'healthier' kiosks, 90 min of additional physical activity (PA) weekly, behavioral PA program and active recess. MEASUREMENTS: Adiposity indices (BMI, BMI Z-score, triceps skinfold thickness (TSF), waist circumference and physical fitness (20 m shuttle run test and lower back flexibility). RESULTS: Positive effect on adiposity indices (except TSF) was observed in boys (Po0.001 for BMI Z), while both physical fitness parameters increased significantly in both boys (Po0.001 for each test) and girls (Po0.0001 for each test). A differential effect in BMI Z was observed according to baseline nutritional status. CONCLUSIONS: This intervention showed a robust effect on physical fitness in both genders and decreased adiposity only in boys.

Objectives: The purpose of this study was to analyse the determinants and consequences of the nutrition transition in Chile and describe the related health promotion policies. Design and setting: This is a descriptive, population-based study including data on demographic, diet, nutrition and biomedical related variables. Data came from the Food and Agriculture Organization (FAO), the National Institute of Statistics (INE), the Ministries of Planning, Health and Education surveillance systems, and national surveys. Results: As malnutrition decreased during the 1980s, obesity increased rapidly in all age groups. In adults, currently about 25% of women are obese (body mass index .30 kg m 22); particularly those from low socio-economic levels. Among preschoolers, obesity is now 10% while in 6-year-old children it is 17.5% (weight/height greater than two standard deviations (.2SD) of the World Health Organization reference). Nutritional risk factors are prevalent, diet is changing to a 'Western diet' with an increasing fat consumption, and sedentarianism is constant in all groups. High blood pressure (.140/90) is greater than 10% in adults. Diabetes is increasing in urban areas, including in the indigenous population, and more than 40% of adults have a cholesterol level of more than 200 mg ml 21. Conclusions: Promotion of healthy lifestyles is the main strategy to cope with this situation, particularly changing behaviour in food habits, physical activity and psychosocial factors. Changes in lifestyles will not only allow the prolonged life expectancy to be of better quality, but also will favour a decrease in the morbidity and mortality from chronic diseases, mainly cardiovascular diseases.

Objective: To assess the nutritional status, food consumption and physical activity (PA) habits of Chilean school children, as a baseline for developing an educational intervention. Design: Cross-sectional study. Subjects: A total of 1701 children from 3rd to 7th grade in nine schools located in three geographical regions. Methods: We determined body mass index, food consumption (quantified FFQ which we categorised into five groups), PA in terms of TV viewing and frequency of after school PA. The data were analysed according to age, nutritional status and gender. A logistic regression analysis was performed using obesity as outcome. Results: Obesity was higher among boys; younger children presented higher prevalence in both genders. Daily intake of dairy products varied between 240 and 308 g, fruits/vegetables, between 197 and 271 g, energy-dense foods between 343 and 460 g. In all, 22.3 and 47% of the children watched over 3 h of TV during the week and weekend, respectively. Older children watched significantly more TV during the week, while on weekends all children increased this time significantly. Boys were more active than girls after school. The logistic regression analysis showed a significant association between obesity and low intake of dairy products. Conclusions: Prevalence of obesity among Chilean children is high. Although TV time, intake of energy dense foods and fruits/ vegetables appeared as risk factors for obesity, only dairy consumption was significantly associated with obesity. Sponsorship: FAO