Institute of Nutrition and Food Technology (INTA) University of Chile

Transcription

1 Institute of Nutrition and Food Technology (INTA) University of Chile Demographic Indicators Chile* % <15 population % 65 population Mortality Crude Rate Infant Mortality Rate Birth Rate % Annual Growth Birth Life Expectancy Men Women * Source: Census 197 and Census 22 Socioeconomic changes* Chile Urban population Drinking Water * Sewage* Illiteracy GDP per capita ($US) * Urban population CHILE COMMUNICABLE MALIGNANT TUMOURS CARDIOVASCULAR PERINATAL INJURIES OTHERS *Source: Census 197 and Census Cardiovascular Diseases Malignant Tumours Injuries Respiratory Digestive Parasitary and Infectious Perinatal Causes Availability of Fat Per Capita. Chile Gr/pc/day % calories from fat ill defined and others % day calories from fat Vegetal fat gr/day Animal fat gr/day Source: FAO. Food balance sheets

2 Daily consumption of fruits >15 years Chile. By sex 4,1 52, ,5 37, By level of Education 49,7 57,1 62,2 18% SEDENTARY BEHAVIOUR 9% No Physical Activity Physical Activity 1-2 times per week Physical activity more than 3 times per week men women Never attended Primary Secondary Technical Universitary 73% Source: Quality of life survey INE/MINSAL 2 Source: Quality of life survey INE/MINSAL 2 Evolution of nutritional status* in children over 6 years old attending school by sex Men deficit Women deficit Men obesity Women obesity Deficit: BMI < 5 Percentile for Reference NCHS/CDC 2 Obesity: BMI > 95 Percentile for Reference NCHS/CDC 2 *Source: JUNAEB, Prevalence of obesity and underweight in pregnant women. MINSAL Reference. Chile Underweight Obese Source: MINSAL Obesity Men Women Total Morbid Obesity Obesity Overweight ERRADICATION OF UNDER NUTRITION IN THE 8 s FOOD AND NUTRITION POLICY: Primary prevention: National Supplementary Feeding Programs Secondary Prevention: Targeted programs to mothers and children at risk Tertiary Prevention: Rehabilitation of severe malnourished children at recovery centers (CONIN) Source: National Health Survey 23

3 : FOOD AND NUTRITION POLICY DISAPPEAR FROM THE AGENDA : ACADEMIC FORUM FOR FOOD AND NUTRITION AND FOOD AND NUTRITION NATIONAL COMMISSION (CONAN) 4 WORKING GROUPS: Food Programs Food Sanitary Regulations Food Security for the poor Health Promotion and Prevention of Chronic Diseases MAIN ACCOMPLISHMENTS National Supplementary Feeding Program (PNAC): Milk fortified with iron and zinc (1998) Wheat flour fortified with folic acid (1999) School Food Programs: New regulations including healthy food Food Safety Regulations: New regulations enacted in 1997 Food Security for the poor: New targeted program for the poorest families (CHILE SOLIDARIO) MAIN ACCOMPLISHMENTS Health Promotion and Prevention of Chronic Diseases: 1995 Burden of Disease (DALYs) study 1997 Changes in health priorities 1998 National Health Promotion Commission (VIDA CHILE) Health Promotion Ministerio del Interior - Subdere Ministerio Secretaría General de la Presidencia Ministerio Secretaría General de Gobierno Ministerio de Planificación y Cooperación Ministerio de Educación Ministerio del Trabajo y Previsión Social Ministerio de Salud Ministerio de Vivienda, Urbanismo y Bienes Nacionales Ministerio de Agricultura Ministerio Servicio Nacional de la Mujer - SERNAM Carabineros de Chile Consejo Nacional para el Control de Estupefacientes - CONACE Comisión Nacional del Medio Ambiente - CONAMA Comité Nacional para el Adulto Mayor Consejo Científico Tabaco o Salud Fondo de Solidaridad e Inversión Social - FOSIS Instituto Nacional de la Juventud - INJ Instituto Nacional del Deporte Fundación INTEGRA Junta Nacional de Auxilio Escolar y Becas - JUNAEB Junta Nacional de Jardines Infantiles - JUNJI Organización Panamericana de la Salud - OPS/OMS Servicio Nacional del Consumidor - SERNAC Universidad de Chile - INTA Intersectorial goals by 21 TOPICS Food and Nutrition Physical Activity Tobacco Psycho- social Environment PLACES INDICATOR 2 % Kindergartens, Schools and Universities Work places Counties 21 % Pre-school obesity P/T>2 DE st grade obesity P/T >2 DE Obesity in pregnancy Sedentarism >15 years Smoking in 8 grade 27 2 Smoking in women 45 4 Population in organizations 13 2

4 ORGANIZATIONAL CHART VIDA CHILE VIDA CHILE NATIONAL COUNCIL NATIONAL PLAN FOR HEALTH PROMOTION NATIONAL PLAN OF HEALTH PROMOTION. BENEFICIARIES ACCORDING TO AGE GROUPS REGIONAL COUNCILS 13 REGIONAL PLANS COUNTY COMMITTEES 32 COUNTY LOCAL PLANS 94% OF COUNTIES IN THE COUNTRY UNCENTRALIZED AND INTERSECTORIAL MANAGEMENT Beneficiaries Years Source: MINSAL School children Teenagers Adults Elderly HUMAN RESOURCES TRAINING IN HEATH PROMOTION 1998: 3 short courses for top local health authorities in 5 Regions 1999: 4 pilot courses to train county staff and community leaders 2-22: 6 week on-site training in more than 1 counties 23-24: postgraduate on-line course in Health Promotion for 654 professionals

5 Distribution of materials on food and nutrition education for primary schools. Chile printed copies and 1. CD-Roms for MINEDUC LESSONS LEARNED insufficient policies for the magnitude of the problem need of new methodologies to change population behaviour lack of human resources to cope with the epidemiological and nutritional changes lack of regulations to protect the population for more safety and healthy food CONCLUSIONS Chile has had extremely rapid changes from undernutrition to obesity Policy and programs were not adjusted timely to these changes A new adequate policy has been implemented successfully since 1998, but this policy has been insufficient for the magnitude of the problem To be successful, the new policy needs a strong political support with two purposes: new regulations and adequate funding RECOMMENDATIONS Include Double Burden of Disease (obesity/undernutrition undernutrition) ) in the SCN agenda for developing and transitional countries. UN and bilateral agencies should support governments in the implementation of policies to address the double burden of disease Human resources training for the new agenda (obesity) diabetes- cardiovascular disease in developing countries