ABSTRACT
The marketing of formula milk as a substitute for breast milk continues to be ubiquitous and multifaceted despite passage by the World Health Assembly of the International Code of Marketing of Breast-milk Substitutes (the Code) in 1981. In this paper, we summarized reports of the Code violations from eight studies using the WHO/UNICEF NetCode protocol. Among 3,124 pregnant women and mothers with young children, in eight countries, 64% reported exposure to promotion of products covered under the Code in the previous 6 months, primarily from advertisements seen outside of health facilities (62%). Nearly 20% of mothers with an infant < 6 months reported that a health care provider had advised them to feed their child food or drink other than breast milk, and 21% of providers reported contact with a representative of a formula company in the previous 6 months to distribute promotional materials, samples, or free supplies (range 2%-53%). Of the 389 retail stores and pharmacies surveyed, promotions were observed in 63% (range 0-100%), and of 1,206 labels and inserts of products reviewed, nearly half included health and/or nutrition claims (range 0-100%). A strong, though non-significant, linear relationship between the composite violations score and quality of Code legislation was found; countries with the lowest percentage of violations had the strongest Code legislation. In Latin America, over 50% of health care providers reported no knowledge of the Code, and 50% reported no knowledge of national legislation. Our study highlights three key facts: 1) the marketing of BMS is ubiquitous and multifaceted, 2) the high variability of promotion across countries generally reflects the comprehensiveness of Code legislation, and 3) health care providers have poor knowledge of the Code and national legislation.
Subject(s)
Milk Substitutes , Infant , Child , Female , Humans , Pregnancy , Child, Preschool , Marketing , Milk, Human , Breast Feeding , MothersABSTRACT
This corrects the article DOI: 10.1038/nutd.2016.52.
ABSTRACT
BACKGROUND/OBJECTIVE: The objective of the study was to provide current estimates of the prevalence and trends of overweight and obesity (OW+OB) in Mexican children and adolescents. SUBJECTS/METHODS: Body mass index objectively measured was analyzed for 37 147 children and adolescents aged 0-19 years obtained in 2012 as part of the National Health and Nutrition Survey (ENSANUT-2012), a nationally representative sample of the Mexican population. In addition, data from previous National Nutrition Surveys obtained in 1988, 1999 and 2006 were compared with analyze trends over a 24-year period (1988-2012) for children <5 years of age and adolescents and over a 13-year period (1999-2012) for school-age children. World Health Organization Child Growth Standard was used to define OW+OB. RESULTS: In 2012, 33.5% of children <5 years of age (both sexes) were at risk of overweight or were overweight (OW); 32% and 36.9% of girls and boys 5-11 years of age were OW+OB, respectively, and 35.8% and 34.1% of female and male adolescents were OW+OB, respectively. Statistically significant trends were documented for all age groups during the study period. Overall change in the combined prevalence in preschool children was 6.3±1.0 percentage points (pp; P<0.001; 0.26 pp per year) in the last 24 years, showing the highest increase between 1988 and 1999, whereas for school-age girls (from 1999 to 2012) and adolescent females (from 1988 to 2012), OW+OB increased across all periods at a declining trend, with an overall change of 0.5 and 1.0 pp per year, respectively. Changes in the prevalence of OW+OB were highest among children and adolescents in the lowest quintile of the household living condition index. CONCLUSIONS: Prevalence of OW+OB among children and adolescents increased significantly during the last 13-24 years. The rate of increase has declined in the last 6 years in all age groups. Changes in prevalence of OW+OB presented here suggest that, in Mexico, the burden of obesity is shifting toward the groups with lower socioeconomic level.
Subject(s)
Obesity/epidemiology , Overweight/epidemiology , Adolescent , Body Mass Index , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Mexico/epidemiology , Nutrition Surveys , Prevalence , Risk Factors , Socioeconomic Factors , Young AdultABSTRACT
Fundamento: El 26% de los niños mexicanos en edad escolar tienen sobrepeso u obesidad (SP/O) lo que representa un aumento del 33% en 7 años.Objetivo: Diseñar, implementar y evaluar una estrategia para la modificación del ambiente escolar que promueva estilos de vida saludables, de actividad física y alimentación, para prevenir el SP/O en niños de escuelas públicas de la ciudad de México.Métodos: Investigación formativa para el diagnóstico del ambiente y diseño de la intervención. Evaluación con un diseño experimental en escuelas intervención y control seleccionadas aleatoriamente.Resultados: El ambiente escolar favorece el desbalance energético, promueve el consumo de alimentos y bebidas con una alta densidad energética y limita las oportunidades para realizar actividad física. Se implementaron estrategias de alimentación, actividad física y comunicación durante dos años escolares en 16 escuelas. La intervención disminuyó la oferta de alimentos densamente energéticos y aumentó la disponibilidad de frutas, verduras y agua para el consumo. Se observan pocos cambios individuales, aunque estos apuntan hacia efectos positivos de la intervención en las conductas y sus determinantes.Conclusión: La intervención modificó principalmente el ambiente escolar, pero se requiere de un esfuerzo más intensivo y permanente para modificar las conductas individuales(AU)
Background: 26% of school children in Mexico are overweight or obese (OW/OB), which means a 33% increase in 7 years.Objective: To design, implement and evaluate a strategy to modify the school environment in order to promote healthy lifestyles through physical activity and food habits to prevent OW/OB in children in public schools in Mexico city.Methods: Formative research to diagnose the environment and design the intervention. Evaluation by means of an experimental design in randomly selected intervention and control schools.Results: School environment contributes to energy imbalance, promotes consumption of energy dense foods and beverages and limits the opportunities to practice physical activity. Strategies focused on food habits, physical activity and communication were implemented during two school years in 16 schools. The intervention reduced the offer of energy dense foods, increased the availability of fruits, vegetables and water to drink. Limited changes were observed at individual level, although changes show a trend towards positive effects of the intervention on behaviours and their determinants.Conclusion: The intervention modified the school environment but a more intense and permanent effort is required to change behaviours at individual level(AU)
