Photo by Marco Simola, courtesy of Photoshare
Malnutrition in all its forms, particularly childhood obesity, is growing at an alarming rate among children in Latin America. Researchers, policymakers and implementers must urgently work together to identify evidence-based strategies to turn the tide, according to participants in a recent workshop organized by Fogarty's Center for Global Health Studies.
Designed to connect stakeholders from the Americas, the meeting was co-sponsored by NIH's National Heart, Lung and Blood Institute (NHLBI), Office of Behavioral and Social Sciences Research (OBSSR), National Institute of Child Health and Human Development (NICHD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the CDC, Pan American Health Organization (PAHO) and Office of Global Affairs at the U.S. Department of Health and Human Services (HHS). The 50 conference participants represented more than a dozen countries and came from academia, civil society, international organizations and government - including lawmakers from Chile and Peru.
The combination of unhealthy diets, physical inactivity, and lack of access to healthy food and environments conducive to physical activity pose a serious health burden in many Central and South American countries. According to workshop co-chair Dr. Juan Rivera Dommarco of Mexico's Institute of Medicine, about a quarter of adolescents in the region are overweight or obese, "and the problem is growing." To reverse this trend, he said, researchers must produce evidence on how to prevent children from gaining too much weight in the first place and convince policymakers to support appropriate interventions.
Obesity research conducted elsewhere is not always applicable to Latin America's different populations, cultures and environments, according to co-chair Dr. Benjamin Caballero of Johns Hopkins School of Public Health, who obtained his medical degree in Argentina. "Obesity is a much more complex problem in developing countries," he said, noting that programs to alleviate poverty can under certain conditions spur chronic diseases such as obesity and diabetes when they boost caloric intake, rather than promote healthy eating and physical activity.
Workshop attendees highlighted many aspects of childhood obesity that they said need further multidisciplinary research and evaluation, from biology to policy, and discussed important factors influencing weight gain. These span the life course, from mothers' pregnancy weight and weight gain, initiation and duration of breast-feeding, to children's sleep patterns, consumption of processed food, the family's socioeconomic position, television viewing habits and physical activity levels. With data in hand, policymakers can take action through a variety of methods, for instance by improving the quality of school lunches, constructing more playgrounds, placing high taxes on sodas and encouraging breast-feeding.
"Obesity is developing rapidly around the world and we can best counteract it with a multisectoral, multidisciplinary approach," said Fogarty Director Dr. Roger I. Glass. "We need to meet the challenge with appropriate research evidence, skill sets and policymaker support that lead to effective interventions."
Conference participants are developing a series of articles that will identify the future research agenda, define policy and implementation issues, and describe capacity building needs required to move the field of obesity prevention forward in Latin America. The articles will be published in a journal supplement next year.