Avance de la Junta Nacional de Jardines Infantiles en la incorporación de los estándares de crecimiento OMS 2006 / Transition of the chilean national nursery schools council program (JUNJI) to the use of who 2006 growth standards

This article describes the process of implementation of WHO growth standards in the Chilean National Nursery Schools Council Program (JUNJI) and how will influence the beneficiary's nutritional status estimates. Using the 2009 anthropometric data collected by the program, we compare nutritional estimates using the NCHS 1978 reference and the WHO 2006 growth standards. The use of the new WHO growth standards will determine a decrease in under nutrition (weight for height z score < -2 DS) in infants from 1.1 to 0.5 percent while in all children less than 5y of age will increase stunting (height for age z score < -2 SD; from 5.7 to 7.3 percent in children less than 2y and from 2.3 to 4.2 percent in children 2 to 5y), and overweight (weight for height > lSD from 19.6 to 29 percent in children less than 2y, and from 20.6 to 28.9 in children 2 to 5y) and obesity (weight for height>2 SD; from 8.2 to 11.4 percent in children less than 2y and from 8.3 to 13.5 percent in children 2 to 5y ). The WHO growth standards describe the growth of children that receive optimal feeding and that live in optimal conditions. The implementation of the WHO growth curves at the JUNJI program is taken place in a sequential and well-planned way that will allow not only to optimize growth monitoring at the program but also to promote short and long-term health of the beneficiaries.

En el presente artículo se describe el proceso de implementación de las nuevas curvas de crecimiento OMS a la Junta Nacional de Jardines Infantiles de Chile (JUNJI) y el efecto que tendrá esta incorporación en las estimaciones del estado nutricional de los beneficiarios. En base a la información antropométrica recolectada en el programa durante el año 2009 se realiza una comparación entre la referencia NCHS 1978 y las OMS 2006 y se muestra que con las nuevas curvas disminuirá la prevalencia de desnutrición (peso para la talla <-2 DS) en los lactantes de 1.1a 0.5 por ciento mientras que en todos los menores de 5 años aumentará la prevalencia de talla baja (< -2DS; de 5.7 a 7.3 por ciento en menores de 2 años y de 2.3 a 4.2 por ciento de 2 a 5 años), y de sobrepeso (> 1 DS peso talla, de 19.6 a 29.0 por ciento en menores de 2 años y de 20.6 a 28.9 por ciento de 2 a 5 años) y obesidad (> 2 DS peso talla, de 8.2 a 11.4 por ciento en menores de 2 años y de 8.3 a 13.5 por ciento de 2 a 5 años). Los estándares de crecimiento OMS describen la forma en que debieran crecer los niños de cualquier parte del mundo si es que fueran alimentados y vivieran en condiciones óptimas. Su implementación en la JUNJI, de manera programada y secuencial, permitirá optimizar el monitoreo del crecimiento de los beneficiarios promoviendo una mejor salud en el corto y largo plazo.

Obesidad en preescolares de la Región Metropolitana de Chile / Obesity among preschool children of Santiago, Chile

Background: In Chile, obesity is currently the main nutritional problem. Since prevention should start early in life, it is important to determine the prevalence of obesity during childhood according to age category. Aim: To determine and compare the evolution of the obesity prevalence and other anthropometric indicators in preschool children between 2002 and 2004. Material and methods: Twice a year, we analyzed the data of children aged 2 to 4 yrs, from day care centers belonging to the National Association of Day Care Centers located in Greater Santiago, from 2002 till 2004 (the number of children included on each point in time fluctuated between 3,500 and 10,000). Cross-sectional and longitudinal analyses were carried out to determine the evolution of obesity prevalence, weight for age (WA) and body mass index (BMI) Z scores (according to the Centers for Disease Control 2000 reference) on preschoolers who were 2 years old in March 2002 and that were followed 3 years, until November 2004. These parameters were compared by age and gender over time. Results: The prevalence of obesity varied between 11 and 13.6 percent in two-year old children and between 17 percent and 20 percent in three and four year olds. The cross-sectional analysis showed that WA and BMI Z scores were significantly lower at 2 years of age, while the longitudinal analysis clearly demonstrated that there was a sharp rise in obesity between 2 and 3 years of age. Conclusions: The prevalence of obesity is high in preschool children, especially among the 3 and 4 year-olds with a significant rise from 2 to 3 years of age.

Evolución de las normas de alimentación y nutrición del programa alimentario y cambios en el estado nutricional de preescolares beneficiarios de la JUNJI en las últimas 3 décadas / Evolution of the nutritiion and dietary guidelines and changes in the nutritional status of preschool children beneficiaries of the JUNJI program over the past 3 decades

Se presentan las bases institucionales del programa JUNJI y se describen los cambios en los aspectos alimentarios y nutricionales más importantes implementados desde su inicio en 1970 hasta el presente. Se presenta la evolución del estado nutricional de la población atendida, evaluando la posible relación con los cambios programáticos. La subnutrición y el déficit de talla han prácticamente desaparecido como problema de salud pública en estos 30 años, sin embargo la prevalencia de sobrepeso y obesidad ha aumentado en forma significativa en los últimos 10 años, estabilizándose a partir del 2000. Los logros alcanzados en los últimos años son el resultado de los cambios en las normativas definidas por JUNJI con respecto al aporte nutricional y patrón dietario ofrecido a los preescolares, el fomento la actividad física, la educación alimentaria dirigida a los niños y sus familias; todo esto apoya vidas más activas y alimentación más saludable. Se proponen orientaciones y recomendaciones programáticas hacia el futuro, con el fin de adecuar el programa JUNJI a los cambios epidemiológicos y nutricionales observados en el país.

The institutional development of the JUNJI programs is presented; changes in the dietary and nutritional guidelines implemented from 1970 to the present are described. The evolution of nutritional status of beneficiaries is presented and the relationship to program changes is explored. Undernutrition and stunting have practically disappeared as public health problems in the past 30 years. However the prevalence of overweight and obesity has increased significantly in the past 10 years, reaching stability after 2000. The achievements over the past years are the result of changes in the technical norms defined by JUNJI with respect to nutrition and dietary pattern guidelines offered to preschool children, the promotion of physical activity, nutrition education directed at children and families; all of which support active lives and healthier feeding patterns. We propose program orientations and recommendations for the future in order to adjust the JUNJI program to the present epidemiologic profile and nutritional problems of the country.