Nutrition transition in Chile revisited: mid-term evaluation of obesity goals for the period 2000-2010
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Objective: To analyse the nutritional status component of the nutrition transition in Chile in relation to the evolution of obesity rates in all age groups until 2005, comparing these with the goals established by the Ministry of Health for the period 2000–2010. Design and setting: A descriptive study which includes data on the nutritional status of the Chilean population categorised by age. The data originate from: (1) institutions which administer nutritional programmes – the National Board for Day-Care Centres (JUNJI) and the National Board for School Assistance and Scholarships (JUNAEB); (2) the Ministry of Health and the National Institute of Statistics; and (3) epidemiological studies which include adolescents and the elderly. Results: The prevalence of obesity in pre-school children attending JUNJI was 10.6% in 2005; by age group, it was 6% in 2-year-olds, 11% in 3-year-olds and 14% in 4-year-olds. Among schoolchildren in first grade, obesity prevalence was 18.5%. In pregnant women, obesity has increased from 12% in 1987 to 33% in 2004. For adults, the 2003 National Health Survey showed that the prevalence of obesity (body mass index (BMI)$30 kgm22) was 22% and of morbid obesity (BMI$40 kgm22), 1.3%. Obesity varied according to gender and educational level, being higher among women (25% vs. 19% in men) and adults from low socio-economic levels. In the elderly there was a high prevalence of obesity in the 60–64 years age group for both men (35.6%) and women (44.1%), decreasing to 18% and 26%, respectively, in those aged 75 years and older. Conclusions: The goals for the decade (2000–2010) consider a reduction of obesity rates from 10% to 7% in pre-school children attending JUNJI, and from 16% to 12% in schoolchildren attending first grade. For pregnant women, the goal is to reduce the prevalence from 32% to 28%. Despite the implementation of initiatives in nutrition and physical activity, these have been insufficient to shift the rising trend in obesity. The explanation could be that after a rapid rise in obesity in children and pregnant women between 1987 and 2000, a stabilisation period or a ‘plateau’ is observed. In that situation, very effective interventions are required to reduce obesity, because it is extremely difficult to reverse the trend. Some positive experiences are being implemented in Chile, but government priorities are not focused in health promotion. A comprehensive State Policy in health promotion, that includes the public and private sectors related with obesity, is needed to reverse this trend.