Jaacks Lindsay M, Kavle Justine, Perry Abigail, Nyaku Albertha
1Department of Global Health and Population,Harvard T.H. Chan School of Public Health,Harvard University,665 Huntington Avenue,Building 1,Room 1221,Boston,MA 02115,USA.
2Maternal and Child Survival Program,Washington,DC,USA.
Public Health Nutr. 2017 May;20(7):1286-1296. doi: 10.1017/S1368980016003323. Epub 2017 Jan 9.
The goals of the present targeted review on maternal and child overweight and obesity were to: (i) understand the current situation in low- and middle-income countries (LMIC) with regard to recent trends and context-specific risk factors; and (ii) building off this, identify entry points for leveraging existing undernutrition programmes to address overweight and obesity in LMIC. Trends reveal that overweight and obesity are a growing problem among women and children in LMIC; as in Ghana, Kenya, Niger, Sierra Leone, Tanzania and Zimbabwe, where the prevalence among urban women is approaching 50 %. Four promising entry points were identified: (i) the integration of overweight and obesity into national nutrition plans; (ii) food systems (integration of food and beverage marketing regulations into existing polices on the marketing of breast-milk substitutes and adoption of policies to promote healthy diets); (iii) education systems (integration of nutrition into school curricula with provision of high-quality foods through school feeding programmes); and (iv) health systems (counselling and social and behaviour change communication to improve maternal diet, appropriate gestational weight gain, and optimal infant and young child feeding practices). We conclude by presenting a step-by-step guide for programme officers and policy makers in LMIC with actionable objectives to address overweight and obesity.
(i)了解低收入和中等收入国家(LMIC)在近期趋势和特定背景风险因素方面的现状;(ii)在此基础上,确定利用现有营养不足项目来解决LMIC超重与肥胖问题的切入点。趋势表明,超重与肥胖在LMIC的妇女和儿童中是一个日益严重的问题;如在加纳、肯尼亚、尼日尔、塞拉利昂、坦桑尼亚和津巴布韦,城市妇女中的患病率接近50%。确定了四个有前景的切入点:(i)将超重与肥胖纳入国家营养计划;(ii)食品系统(将食品和饮料营销法规纳入现有的母乳代用品营销政策,并采取促进健康饮食的政策);(iii)教育系统(将营养纳入学校课程,并通过学校供餐计划提供高质量食品);以及(iv)卫生系统(提供咨询以及进行社会和行为改变宣传,以改善孕产妇饮食、适当的孕期体重增加以及最佳的婴幼儿喂养方式)。我们通过为LMIC的项目官员和政策制定者提供一份逐步指南来结束本文,该指南具有解决超重与肥胖问题的可操作目标。