全球粮食安全与营养论坛 (FSN论坛)

磋商会

在与超重和肥胖作斗争方面有无卓有成效的政策和计划?

各位同事:

 

        我们荣幸地邀请各位参加有关“在与超重和肥胖作斗争方面卓有成效的政策和计划”的在线讨论。请阅读背景资料并回答以下讨论问题。

 

讨论论坛的简要背景

        制定和实施旨在预防、监测和减少超重和肥胖的公共政策和计划无论对拉丁美洲和加勒比还是对世界其他多数区域来说都是一项挑战。

        超重和肥胖在很多国家都被看作是一个严峻的公共健康问题,需要在各级采取紧迫措施加以应对,包括适当政策和计划的制定、实施、监测和评估等。根据世界卫生组织(世卫组织)统计,2014年有19亿成年人(18岁以上)体重超重,有6亿人肥胖。此外,2013年有4200万五岁以下儿童超重或肥胖。

        为确保各项公共政策和计划的成功实施,这些政策和计划就应当建立在科学依据和/或经过验证的措施之上。但在有关应对这些问题的政策和计划的成果和影响方面却缺乏综合和全面的信息。

        针对这一不足,粮农组织和智利天主教大学(西班牙文简称PUC)与世卫组织合作正在开展一项“减少肥胖国际证据研究:个案研究经验教训”(“Estudio de evidencia internacional en la reducción de obesidad: Lecciones aprendidas de estudios de caso”)。该项研究有两个主要目的:

  • 在国际层面收集和分析应对肥胖和超重问题最有效的现有主要政策和计划。
  • 把成果提供给议会会员和(公共政策)决策者,目的是为在本区域设计和实施能有效应对超重和肥胖问题的举措提供更完备参考。

 

        该项研究目前正在进行并已考查了若干干预措施,这些干预措施划分为以下几个类别:获取(向脆弱群体提供营养食物、在学校和其他公共机构禁绝垃圾食品);教育(膳食指南、学校营养教育、促进体育活动、推广健康膳食的公众运动、营养标识、限制垃圾食品广告);供给(在“食物洼地”和“食物荒漠”等地区增加健康食物供应、为缩短销售周期提供便利、改善食品营养质量);以及经济(税收、补贴和价格变动)。为强化已经做出的努力,本论坛和各位的参与将在收集更多证据、良好实践经验和成功案例,以及反映全球、各区域和各国在这一领域的工作方面发挥关键作用。

        因此我们诚邀各位回答以下一个或多个问题并分享在与超重和肥胖作斗争的成功政策和计划方面的知识。请记住,我们尤其感兴趣的是利用这一平台获取和共享各位所在国家或其他国家政府所采取的具体举措的实例。

 

讨论问题

 

        基于你的经验和/或知识:

 

  1. 你所在国家或区域为预防超重和肥胖采取了何种政策和/或计划?请考虑:

 

  • 国家/地方政策和举措(即营养标识、食品税收/补贴、促进水果和蔬菜消费、膳食指南、促进体育活动的政策、其他政策中的营养教育);
  • 社区和学校环境下的干预措施和/或计划。

 

注: 请分享链接、科学论文和/或文件来充实你的答复。

 

  1. 你所提及的政策和/或计划中有哪些在减少超重和肥胖方面成功发挥了实效?请回答下列问题进行补充:
  • 目标人口是多少?
  • 结果评估和/或有效性确认的方式是什么?有助于获得成效的成功因素有哪些?
  • 主要挑战、制约因素和教训有哪些?

 

  1. 最后,在有效支持针对超重和肥胖的政策、战略和/或计划方面有哪些关键要素
  • 请考虑治理、资源、能力建设、协调机制、领导力或信息交流网络等方面的要素。

        请各位踊跃分享有关这一议题的经验和知识。我们期待收到各位的意见和建议并携手从战略角度克服这一全球性难题。

Francisca Silva Torrealba,智利天主教大学

Rodrigo Vásquez Panizza,粮农组织智利代表处

讨论主持人

*点击姓名阅读该成员的所有评论并与他/她直接联系
  • 阅读 73 提交内容
  • 扩展所有

Laura Andrea Miranda Solis

ConMéxico
Mexico

A quien corresponda

De manera adjunta le hacemos llegar la contribución del Consejo Mexicano de la Industria de Productos de Consumo (CONMEXICO) a la discusión sobre las políticas y programas exitosos en combate del sobrepeso y la obesidad en México.

Saludos

Laura Andrea Miranda Solis

Salud y Bienestar

ConMéxico

Marlies Willemsen-Regelink

Steunpunt Smaaklessen & EU-Schoolfruit
Netherlands

I like to let you know that we work on two programmes in the Netherlands:

  • EU-Schoolfruit and veggieprogramme
  • Tastelessons

From both programmes there is no research done in relation to obesity.

Research is done on Tastelessons (Smaaklessen) in the past year.

http://library.wur.nl/WebQuery/clc/2149122

Some effects on  nutritional behaviour are found.

The EU-Schoolfruit and veggieprogramme in the Netherlands is not evaluated in relation to nutritional behaviour and obesity but I believe that the impact on nutrition behaviour is significant. More and more schools have rules about fruit and vegetables in the school. I see a change during the last 10 years.

Children and parents love the programme. I hope we can do research in the future.

It would also be worth full to compare EU-Schoolfruit initiatives.

Kind regards,

Marlies Willemsen-Regelink

Projectleider Smaaklessen en EU-Schoolfruit en -groente

En Costa Rica existe la Comisión Nacional sobre Promoción de la Salud creada por Decreto 38218-S que es el órgano técnico asesor en materia de prevención de Enfermedades Crónicas No Transmisibles, se cuenta con un plan de acción de la Estrategia Nacional para las ECNT al 2021, este plan se elaboró en conjunto sector público-sector privado.

Existe además el Reglamento de Kioscos Escolares que regula los alimentos que se pueden vender en los centros educativos, desde el año 2013.

Actualmente se trabaja en una Comisión Interinstitucional, la actualización del Reglamento Técnico Centroamericano de Etiquetado Nutricional con base en Codex y se está trabajando en una propuesta voluntaria de etiquetado frontal basado en GDAs.

Aun no se cuenta con indicadores de impacto de las políticas que se han implementado hasta ahora a nivel nacional para la prevención de ECNT.

En Costa Rica el éxito de la implementación de programas de prevención de enfermedades y promoción de la salud se debe al trabajo conjunto sector público-sector privado, y los logros se han alcanzado mediante procesos abiertos de diálogo y negociación.

 

As we continue with the discussions of how to fight overweight and obesity ,there is the truth by World Health Organisation that  many parts of Africa are best known for appealing for charity to combat famine and  looking at the views of the situation we are already facing an obesity epidemic.In their research they also mention that 12,7% African children will be overweight by 2020. My own analysis is that the percentage will be higher that what they are expecting. The reason being that already many young children are already affected by heart diseases,High Blood Pressure, Asthma and many other related diseases due to obesity.Secondly we are witnessing that children lake much attention by their mothers especially those who are employed as the children spend much time in the care of other people and the childcare quality may be substantially different.There is an increase of School Feeding programs in most of our countries.I also noticed that in all the decision making processes there are few or no women representatives to effect and assess the impact of any changes.Just to keep us reminded that we have changed in diet from traditional nutritious foods to high calories fast foods staples because weight is viewed as a sign of happiness.Another effect is for employed women who are obesity as there is they experience customer discrimination.

There are so many challenges faced due to overweight and obesity which already seems to divide the communities.Just to mention a few of my thoughts on what policies should be put into place.Governments should prevent companies that produce and sell  unhealthy products.It is difficult for someone obesity to get medical care as the medical costs are high and so we appeal the responsible Ministries to put into place a policy that benefits all the rich and the poor.Women should be involved in all decision making processes.We need  a policy that determines and monitor the type of food stuffs to be on the markets. Food and drinks high in fat and sugar should be taxed.If possible fast foods should be banned and looking at the increase of food sold at schools, there is need to regulate these meals

Wishes

Elizabeth

In Afghanistan the national nutrition survey carried out in 2013 shows that the overweight is increasing in women (which was target group for this survey) based on the BMI, as Afghanistan is developing and the transportation facilities and other facilities are growing. So the problem of overweight and obesity is increasing, especially in urban areas and cities. Specific strategy is not present, but awareness raising for communities are started by different channels.

Recently a food dietary guideline was introduced in English and local languages, for health staff and other staff, in order to increase knowledge of the communities .

In all Health facillities, growth monitoring for children under 2, screening for children under 5 and measuring of MUAC is doing in order to find malnutrition.

Also health educations and consultations are providing to the communites on healthy life style, infant and young child feeding and other nutrition topics.

Still we need advocacy and awareness raising regarding over nutrition to prevent obesity and related diseases.

Rodrigo’s summary was excellent but omitted two key items:

(a) consistent and clear food labeling (see my prior message on this topic)

(b) institutional support and coping mechanisms for at-risk populations

Example: There are 3,143 county jurisdictions in USA. And one single county, Holmes County in Mississippi, is now famous because it is both the US county with the highest obesity rate (47%), AND the US county documented as the “most food insecure” by USDA. Nearly 40 percent of children there have poor access to food. The common denominator is poverty and a lack of social services.   

http://www.usnews.com/news/slideshows/study-the-worst-us-counties-for-your-health

Keith L. Kline 

Senior Research Staff, Environmental Sciences

Climate Change Science Institute http://climatechangescience.ornl.gov/

Center for BioEnergy Sustainability http://www.ornl.gov/sci/ees/cbes/

Oak  Ridge National Laboratory    

1 Bethel Valley Road, Bldg 4500 N, MS 6301

P.O. Box 2008

Oak Ridge, TN 37831-6301

USA

There is no specific policy for the preventing obesity in Afghanistan but in local communities some of food remidies are used for preventing and control obesity.

These food should be avoided for controling obesity or during obesity:

1.Red meat and processes meat.

2.White bread and Whit rice.

3.Potatos, White Pista and sweets.

Strategies for preventin Obesity:

1.Eat five or six serving of fruit or vegetables daily.

2.Exercise regulary especially up and down using of stairs.

 

 

 

 

Hi everyone!

 

I really wanted to thank you all for the excellent contributions that we have received. People from more than 36 countries, 5 continents, and from very different areas of work have provided input to the discussion:  from governments, the private sector, universities, independent consultants, NGOs, etc. The result is a great set of proven policies, practices and ideas to fight obesity and overweight, which generally speaking includes: changing the way to measure obesity and overweight, understanding the causes of obesity, changing eating habits, increasing nutritional education at all levels, increasing information and its reachability, increasing the sale and supply of fresh products, increasing physical activity and break sedentary life styles, improving school programs against child obesity with the participation of parents and teachers, imposing taxes on processed food, promoting conservation agricultural practices, and controlling the content of processed food. In addition, many contributors highlighted the importance of coordinating actions among stakeholders like the government, consumers, producers, and the industry. So in order to reduce obesity one should work together and the issue should be approached from different angles.

I want to remind you that the input from the Forum will help us to have a better output regarding the "Study of international evidence of obesity reduction: lessons learned from case studies". As soon as we have completed the study, we will share it with everyone.

Finally, after reading all the comments and practices from all around the world, I believe that the reduction of obesity is possible, even if it is a hard-to-reach and long-term goal.

Thank you again for all the contributions and efforts.



Best



Rodrigo Vásquez Panizza

Manuel Moya

International Pediatric Association. TAG on Nutrition
西班牙

Dear FSN Forum,

I thank you for the extended deadline. Really it is very appropriate to approach obesity prevention in LMIC, because it is a fast growing problem particularly in growing urban areas and  before overweight grows up to the HIC rates something must be done. Once obesity has been established in children (and adults) treatment is disappointing in spite of using all the facilities given by specialized units that even include bariatric surgery. In the annexed document some new actions addressed to interrupt the  obesity circle of maternal , offspring, mature girls are approached.

Please find in it our program for prevention of pediatric overweight and obesity in low- and middle-income countries.

This is an easy to run and low cost program and that can indicate the basic food changes according to the country (and child population) possibilities.

With my kindest regards

 

Manuel Moya

Catedrático E/ E Professor & Head

Editor in Chief of the Newsletter. International Pediatric Asociation (IPA)

Chair of the IPA Technical Advisory Group on Nutrition

Board of Directors of IPA Foundation

Academician of the Real Academia de Medicina

Pediatric Dept. University Miguel Hernández

Ctra Valencia s/n, 03550 S.Juan. Alicante. Spain