Dear Sir / Madam
Please find attached the comments that in behalf of International Pediatric association I made on the document with 23 para logically grouped under the three sections.
I received the zero draft very recently. In order to keep the given deadline I’m sending it now. Should I give an additional explanation, please do not hesitate in contacting me.
Catedrático E Pediatría/E Professor and Head
Chair of Technical Adviser Group on Nutrition. International Pediatric Association
International Pediatric Association Foundation, Board of Directors
Vice President European Pediatric Association
Academician of the Real Academia de Medicina
- Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?
- Definitions. Malnutrition is still interpreted as undernutrition, perhaps it would be worth applying the terms of Undernutrition (underweight ?) Overweight and Obesity where appropriate.
- Among the multiple threats perhaps the lack of a basic nutritional education program should be included to be applied by health providers. This could help the items covered in para 2 and 3.
- Political declaration (para 4-20)
7 para. Prevention of pediatric obesity in children > 2years (i.e. beyond breast feeding period) should be considered, because of the persistence in adulthood with all its comorbidities.
9-19 para. Related to political actions, para 18 is very important and should be emphasized not only in low and middle income countries but also in higher ones with specific actions (obesity prevention, Iodide etc)
21 para. ‘Better metrics’ This is a small point in this general approach, but one of the present problems is the different ways of quantifying the nutritional status particularly in pediatric ages due to variable growth periods and the reluctance for changing methods. I would suggest the use of a plastified card for each health provider with the data of T. Cole ( TJ Cole et al. BMJ 2000; 320:1) that allows to identify underweight, overweight and obesity from 2-18 y in both genders with the simple BMI (kg/m2) for the whole world population.
- Technical guide for commitment (21-23 para)
This approach (21-23) is very adequate to the present global nutritional situation. Para 21/ vii is to be emphasized (and budgeted) as monitoring will improve the undertaken action.
In this section of Committing to action, basic nutritional education for health providers will contribute to a proper use of available food in different areas. This can be a link between the general plan and the individual application.