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Chapter 9: Malnutrition's new frontier: The challenge of obesity [Nourishing Millions]


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OVERWEIGHT AND OBESITY prevalence has increased substantially over the past decades, affecting 2.1 billion people worldwide and causing 3.4 million deaths globally.1 Currently, 42 million children are overweight or obese—the result of a staggering 47.1 percent rise in prevalence between 1980 and 2013.2 No longer exclusive to affluent societies, obesity has reached alarmingly high levels in many low- and middle-income countries (LMICs).3 In fact, the number of individuals who are overweight or obese (1.9 billion) has now surpassed the 794 million people who do not get enough calories.4 Nearly half of all overweight children under 5 years of age now live in Asia, and a further 25 percent are found in Africa.

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Chapter 9: Malnutrition's new frontier: The challenge of obesity [Nourishing Millions]

  1. 1. Malnutrition’s New Frontier: The Challenge of Obesity Judith Hodge, Roos Verstraeten, and Angélica Ochoa
  2. 2. Prevention of Obesity and Related Noncommunicable Diseases • 1.9 billion people are currently overweight or obese, now surpassing the 794 million people who do not get enough calories. • 42 million children are overweight or obese, a 47.1% increase from 1980 to 2013. Nearly 50% of all overweight children <5 yrs live in Asia and another 25% live in Africa. • Obesity has reached alarmingly high levels in many low- and middle- income countries, carrying significant health risks for noncommunicable diseases (NCDs), but an investment of $1-3 per person per year in these countries could dramatically reduce illness and deaths from NCDs. • Multi-intervention packages including fiscal and regulatory measures, health information, and communication strategies have been found to deliver large and cost-effective health gains.
  3. 3. Case Study: Mexico’s Soda Tax (1 of 2) Mexico’s 2006 National Survey of Health and Nutrition revealed obesity in children ages 5-11 years increased 40% from 1999-2006. Following a well-planned and coordinated strategy by scientists, lobbyists, and consumer advocates, the sugar-sweetened beverage tax was passed in 2013, increasing the average price of one liter of soda by about 10%. Impact • Soda sales decreased 12% from December 2013 to December 2014. The reduction was greater in households of low socioeconomic status, who bought 17% fewer sugary drinks. • Purchases of untaxed beverages (e.g. bottled water) rose by 4%.
  4. 4. Case Study: Mexico’s Soda Tax (2 of 2) Factors contributing to success • Experienced alliance of consumer advocates developed high-impact media campaign and engaged lobbyists • Timing: political transition and government focus on raising revenue, combined with efforts to use revenue to provide water fountains and potable water, created opportunity to build support for soda tax Reuters/E. Garrido
  5. 5. Case Study: ACTIVITAL In Ecuador, 26% of adolescents aged 12-19 yrs are overweight or obese. The school-based ACTIVITAL (Health Promotion Intervention in Ecuadorian Adolescents to Promote Healthy Dietary and Physical Activity Patterns) program combined components directed at changing individual behavior and the environment to improve dietary diversity and physical activity of adolescents. Impact • Added sugar, processed food intake during snacks, waist circumference, and blood pressure all decreased among participants • Trends toward lower fruit and vegetable intake, less physical activity, and more sedentary behavior were also weakened among participants Factors contributing to success • Health program was integrated into broader educational curriculum • Health education activities were combined with environmental changes
  6. 6. Lessons Learned • Tackling obesity will require a “systems approach” and the involvement of multiple actors including government, scientists, civil society, the media, and communities. • Engaging organizations with experience in media advocacy and using scientific evidence to defend policy measures can be extremely effective in building support for regulatory measures to address overweight and obesity. • Health promotion programs can result in successful outcomes by combining health education activities with environmental changes to enable healthy behaviors.