全球粮食安全与营养论坛 (FSN论坛)

It's heartening to hear of so many good strategies for reducing obesity.  What we also need is evidence. Today I received a communication circulated on the SNEEZE network which cites evidence of falling child obesity rates in some parts of the US. I am copying the communication below.  

The question is then - how did this occur?  Does it depend more on public debate, well-developed institutions and community nutrition education (very strongly established in the US) or on industry regulation?  Does it require the resources of a wealthy country?    Jane Sherman  

E-mail on SNEEZE network:

This morning RWJF released new stories and data from a growing number of states, cities, and counties that have measured declines in their childhood obesity rates. Many of these places have made broad, far-reaching changes to help support healthy eating and regular physical activity. For example:

·         Kaiser Permanente, the Safe Routes to School Partnership and the National PTA are running a “Fire Up Your Feet” campaign in Southern California to encourage kids to walk or bike to school.

·         All YMCA’s in South Carolina have adopted Healthy Eating and Physical Activity (HEPA) standards in their afterschool programs to help kids have healthy snacks and drinks and at least 30 minutes of physical activity. 

·         CentraCare Health, a nonprofit healthcare system in St. Cloud, Minn., is working with the local government and community organizations to help school districts update their wellness policies and implement nutrition labeling in grocery stores and schools.......



List of new or updated locations and their stories:

 

Just added to the RWJF Signs of Progress collection!

·         Cherokee County, South Carolina: The obesity and overweight rate fell from 43 percent in 2012 to 34.3 percent in 2015 among first grade students, a 20.2 percent relative decline. Among third graders, the obesity and overweight rate fell from 51.5 percent in 2012 to 40.7 percent in 2015, a 21 percent relative decline.

·         Colorado: The obesity and overweight rate fell from 22.9 percent in 2012 to 21.2 percent in 2015 among 2- to 4-year olds enrolled in the state’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a 7.4 percent relative decline.  

·         Southern California: The obesity rate fell from 19.1 percent in 2008 to 17.5 percent in 2013 among Kaiser Permanente members ages 2 to 19, an 8.4 percent relative decline.

·         St. Cloud, Minnesota: The obesity and overweight rate fell from 17 percent in 2008 to 13 percent in 2015 among 12-year-olds, a 24 percent relative decline.

 

Updated with an additional year of data!

·         New Mexico: The obesity and overweight rate fell from 30.3 percent in 2010 to 25.6 percent in 2015 among Kindergarten students in public schools, a 15.5 percent relative decline. Among the public school students in third grade, the obesity and overweight rate fell from 38.7 percent in 2010 to 34.4 percent in 2015, an 11.1 percent relative decline.

·         Philadelphia: The obesity rate fell from 21.7 percent in 2006-07 to 20.3 percent in 2012-13 among Philadelphia public school students in grades K-12, a 6.5 percent relative decline.

·         Seminole County, Florida: The obesity and overweight rate fell from 34.3 percent in 2006-07 to 29.6 percent in 2013-14 among students in grades 1, 3, and 6, a 13.7 percent relative decline.

 

Urban farming is expanding in many cities and towns to produce part of the foods, particularly fresh vegetables and fruits, that we consume. My friend Dr. S.P. Periaswamy and I, along a few other friends, are promoting home gardening including roof-top gardening and micro-greens (Word.docx attached) in Coimbatore, India. On third Sunday each month at 15:30-17:00 hours, We provide training on planting media, soil-manure-fertilizer-filler mix, seed and seedling management, nutrient use, watering and moisture management, ecological pest management, and harvest procedures and use of the fresh produce. We provide this training free of cost to participants with a view to promote home gardening and provision of pesticide-free fresh vegatables and fruits to family members, particularly children. About 25 to 30 people, of whom 60-70% are women, participate in this training. Among the participants there are organic production enthusiasts, rational producers with organic and fertilizer nutrient sources, and others who use fertilizers and other input to produce for local markets. This forum also promotes exchange of ideas and experiences from among the participants. We have conducted 7 sessions until 19th June 2016. We are happy that the response is good even after 7 sessions. 

One question that is not addressed in this forum is the nexus between soil health, production practices, crops/animal health, and human health (that includes overweight/obesity). Unless soil health is maintained, producing healthy and nutritious food from crops and animals is impossible. Promotion of conservation agricultural practices (minimum tillage, soil mulch/cover crops, and diversification of farming) is the first step in regenerating degraded landscapes and soils and in maintaining soil health in other areas for producing healthy and nutritious foods for the local, national and international markets. Another aspect is the integrated pest management (IPM) to minimize or avoid pesticide residues in foods that we consume. Production of pesticide-free foods must be our goal if we were to protect human health. A third aspect is the proper management of postharvest processing, storage and distribution/retailing. These activities must be managed to reduce wastages, prevent contamination from food-borne patogens and insect pests, and use of air-tight packaging that minimizes deterioration food quality over time.

One chapter must be allocated to discuss this linkage among soil health, production practices, crops/animal health, and human health.  

First of all I want to thanks you for all the comments, suggestions and ideas; those are very valuable and useful for our study.

Most of the comments are more related with health, nutrition, education and economic policy; which are fundamental in the fight against obesity. Also some contributors have made some comments relative to the role of the farmers in the context of having a supply of healthy food. I think that in order to address this epidemic we need to have a policy that covers an inclusive and efficient food system, from supply to demand. So, as a moderator I would like to know if someone knows successful programs or policies where the farmers were included as part of short marketing circuits. Additionally another related intervention with supply of healthy food is the case of urban community or school farms or gardens; anyone knows successful experiences in this area? 

Thanks again for all the contributions.

Keep posting please!

The fight against obesity is a long run goal, but we need to start now!

Best

Rodrigo

In Swaziland there is a programme that are aimed at physical fitness. The country currently has no policy or any legislative framework to prevent obesity. The programme that is currently running is referred to as Shukuma Swaziland in the local language which means be active and exercise Sweaziland. This programme is running throughout the whole country and is supported by the government of the country. In this programme people are encouraged and given practical exercises that are aimed at keeping the populace fit. Followin this programme people have established gym clubs at local level.

The programme encouraging the nation to exercise is targeted at people of all ages. The success factors include the numbers that attend the awareness raising day and the number of clubs being formed after this day.

Challenges include lack of facilities to continue the exercises after the facilitators are gone. The government gives the areas some start up kits but these are not adequate. Since the programme is new, there still is a challenge that has not yet been seen that of what happens when these kits get old or need repair and maintenance.

Schools have a programme for pupils to participate in schools athletic competitions in the first months of the year and ball games are played during the second stanza of the academic year.

There has not been any research to check the impact of these programmes especially the one that has just been introduced. Evaluation of the impacts thereof are still to be undertaken.

Awareness raising needs to be intensified with programmes over the national radio and television. Capacity for trainers within the locality should be built to ensure sustainability of the programmes and close monitoring and evaluation to measure success. 

First of all, in urban areas of high-income countries sustainable mobility should be promoted through the building of dedicated bike lanes in all major cities, to encourage people moving by bike rather than by car. Indeed, many people (especially in countries where bicycle is not yet part of the culture) do not ride bicycles  due to the risks associated to its use in the city traffic.

The cities should be entirely re-designed, building  not only bike lanes, but also dedicated parking for bikes; even the public transportation should be redesigned in order to be integrated with the use of bicycles (in Tucson Arizona, US, for instance, public buses have on the front a special apparatus to carry bicycles); underground stations should allow for easy pass to bikes, etc. Campaigns on media like TV should encourage the use of bikes to achieve both targets of weight loss and reduction of emissions, besides being a much cheaper way to move around.

Secondly, given the strong effects of obesity on health, mainly through cardiovascular diseases, campaigns for healthy diets should be promoted, as well as nutritional education at all level of schooling.



Thirdly, the introduction of stricter controls on the substances and additives introduced in the processed food we eat is of the utmost importance.



Finally, agricultural policies favouring the production and sales of “km 0”, unprocessed food products should be strengthened, in order to avoid small farmers exiting the market, leaving the entire food market in the hands of big industries. Policies should aim to create more market opportunities for local farmers selling their products in the nearest urban areas.

New Life Style diseases include obesity,diabetes, cardiovascular diseases and a plethora of mental disorders like depression. Overweight due to over consumption of fats and carbohydrates is resultant of sedative life style.The Chennai(India) based World Noni Research Foundation has formulated and is propagating TEN COMMANDMENTS to manage new life style diseases.1) Meditate and exercise 2) Eat moderate 3) Go vegetarian 4) Manage water intake 5) Eat 3 hours before sleep 6) Check your words 7) Vibrate Love 8) Live Gratitude 9) Care Mother Earth and 10) Manage your stress are a few tips. At the instance of India United Nations has declared 21 June as International Day for Yoga.Yoga takes care both body and mind. At food front crops like Amaranth and Quinoa are recommended for healthy body. Amaranth is a grain cum leaf vegetables with balanced nutrient content. A review on Amaranth is available in the series FUTURE CROPS published by Astra International Pvt Ltd New Delhi (www.astralint.com). Another series EVOLUTION OF HORTICULTURAL CROPS Vol.I also carries a nutritional review on Amaranth. Consumption of leaf vegetables like spinach,lettuce,celery, cabbages, beat leaf and drum stick leaf is recommended for obese people. Sedentary life style can be broken by occassional exercises and brisk morning walks.

The most important is the consumer education. It is the consumers who decide wat to buy and eat. If they are ignorant of food and nutrition issues, nothing will succeed. (1) Adult education and awareness creation on food choices and their impact on their heath is the first step to healthy eating habits. (2) It is equally important that kids in schools receive proper education on food, nutrition, exercise/physical activity, and health. We need a healthy body to house a healthy mind. They should learn about cooking and how to prepare healthy foods for themselves and for their families. (3) Food processing industries must be given all the incentives to produce healthy foods and consumers must be prepared to pay higher prices for healthy foods. With both spouses going to work to maintain the family, it is important to provide easy-to-prepare food choices that are nutritious and healthy to the entire family. With these three initiatives, we can improve our diets and popularize healthy eating habits among the population.

Understanding how people become obese or overweight in the first place is an important step toward breaking the cycle. Most cases of people’s obesity are caused by eating too much and exercising too little. People need enough food to support healthy and development. But when they take in more calories than they burn throughout the day, the result is weight gain.

Many factors contribute to this growing imbalance between calories in and calories out:

• Busy families are cooking less and eating out more.
• Easy access to cheap, high-calorie fast food and junk food.
• Food portions are bigger than they used to be, both in restaurants and at home.

Although we don’t have a “successful policy” per se, we are working on an initiative that could significantly improve the quality of future policy and programs. 

The proposed Alliance for Food & Health (AFH) is a new global multi-stakeholder initiative designed to find new and synergistic ways to address our global food/nutrition NCD challenges through thought leadership.  AFH is distinctive in its diversity, commitment to balance between interests, and focus on creating actionable ideas.  The goal is to create a better way forward on critical public health issues that will lead to more effective commitments and a positive impact on public health. 

Interest in the group includes highly diverse actors in international organizations, industry, academia, governments, and the scientific community.