Countries of the Americas took a giant step forward in the fight against the rising epidemic of obesity when they unanimously signed the new 5-year plan of action for the prevention of obesity in children and adolescents. This was signed during the 53rd Directing Council of the Pan American Health Organization (PAHO), which was also the 66th Session of the Regional Committee of WHO for the Americas. Alongside other measures, the plan calls for fiscal policies and regulation of food marketing and labelling, improvement of school nutrition and physical activity environments, and promotion of breastfeeding and healthy eating. Its goal is to halt the rise of the obesity epidemic so that obesity prevalence in each country does not increase further.
The prevalence of overweight and obesity is highest in the Americas compared with other WHO regions. 62% of adults aged older than 20 years in the region are overweight or obese. In three countries—Chile, Mexico, and the USA—obesity and overweight now affect about seven out of ten adults. 20–25% of children aged younger than 19 years in Latin America are overweight or obese.
Rates are increasing sharply and rapidly, even in the youngest age groups. According to PAHO calculations based on data from demographic and health surveys from 1992 to 2012, in children aged 5 years and younger, obesity and overweight rates more than tripled in the Dominican Republic between 1991 and 2013 (from 2•2 to 7•3%), and doubled in El Salvador between 1993 and 2008 (from 1•5 to 3%). In seven eastern Caribbean countries, rates of overweight and obesity in children aged 4 years and younger doubled in just 10 years, from 7•4% in 2000 to 14•8% in 2010.4 In adolescents (aged 12–19 years) of both sexes, obesity rates increased by 20%, from 17•4% in 2003 to 20•5% in 2012 in the USA.5 In adolescent girls (aged 15–20 years), overweight and obesity rates have risen steadily over the past two decades—eg, in Bolivia, from 21•1% to 42•7%; in Guatemala, from 19•6% to 29•4%; and in Peru, from 22•0% to 28•5%.
Countries in the Americas recognise that to fight this epidemic, more is needed than mere public education about the importance of healthy habits. Aggressive measures are needed and are now being taken. These measures include fiscal and regulatory measures, such as taxes on sugar-sweetened beverages and energy-dense nutrient-poor products that aim to reduce consumption (in Mexico); new policies to improve the school food environment, particularly foods sold in schools (in Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Peru, the USA, and Uruguay); regulations on food marketing to children (in Brazil, Chile, and Peru); mandatory front-of-package, easy-to-understand labelling of processed food products (in Ecuador); and comprehensive frameworks for promotion of healthy weight on the basis of multisectoral partnerships (in Canada and the USA).
For child and adolescent obesity to be addressed, sustained multisectoral actions are also needed from the public and nongovernmental sectors and, when appropriate, the private sector. Two key areas addressed by the PAHO plan of action are provision of urban spaces for physical activity and measures to increase the availability of and access to nutritious foods. Promotion of public spaces and improvement of public transport systems help increase physical activity. Interventions to improve production, storage, and distribution systems for natural, whole foods are also important; family farming initiatives are a good example.
To support countries in implementation of the plan of action,1 PAHO is providing evidence-based information for development of policies and regulations, regional nutrition guidelines for preschool and school feeding programmes, and guidelines for food and drink sold in schools. Additionally, PAHO is supporting adoption of indicators of obesity, will develop and maintain a database of nationally representative figures on overweight and obesity prevalence, and will monitor activities related to implementation of policies, laws, and programmes in the Americas. Through unanimous approval of the PAHO plan of action, governments in the Americas have set an example of leadership to protect children and adolescents from one of the most serious health threats facing present and future generations.
Carissa F. Etienne, Director of the Pan American Health Organization.
Source: The Lancet