Capacidad de investigación en obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos: estado de la investigación, problemas, oportunidades y líneas de trabajo para el futuro.

La obesidad infantil es un problema grave en Latinoamérica y entre la población latina de EE. UU. Para ser eficaces, las políticas de salud pública tienen que estar guiadas por evidencias contextuales pertinentes, lo cual exige una capacidad de investigación sostenida a través del tiempo. Los objetivos de este estudio son determinar la productividad de la investigación enfocada en las poblaciones latinas en Latinoamérica y Estados Unidos, y examinar los dominios de la capacidad de investigación (infraestructuras, programas de formación, mentoría, financiamiento y redes de contactos). Realizamos una revisión exploratoria de artículos indexados relacionados con la obesidad infantil publicados entre junio de 2015 y diciembre de 2019. Recabamos información sobre las percepciones de los investigadores latinoamericanos respecto a la capacidad de investigación en obesidad infantil a través de una encuesta en línea. Identificamos 612 artículos relacionados con la obesidad infantil (505 de Latinoamérica, 124 de EE. UU. y 17 de colaboraciones entre EE. UU. y Latinoamérica). Brasil, México, Chile, Colombia y Estados Unidos son los países con más publicaciones. Encontramos aproximadamente el mismo número de artículos sobre obesidad, nutrición y actividad física; sin embargo, observamos que la capacidad de investigación sobre actividad física está rezagada en otros dominios (formación en investigación, financiamiento y oportunidades para establecer contactos). Otras áreas de investigación complementarias, como el comportamiento sedentario, la ciencia de sistemas y los estudios de políticas, son poco frecuentes en Latinoamérica, pero más habituales en Estados Unidos, mientras que la investigación sobre el sueño es incipiente en ambas regiones. Para cumplir la promesa de crear un programa eficaz de colaboración transfronteriza para la prevención de la obesidad infantil será necesario invertir en todos los dominios de la capacidad de investigación y en todos los temas pertinentes.

Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions.

Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.

Designing and Implementing a Quality Physical Education Policy: Successes, Setbacks, and Lessons Learned From the Quality Physical Education Policy Project in Mexico.

BACKGROUND: Quality physical education (QPE) is part of a whole-of-school approach for school-based physical activity promotion. The United Nations Educational, Scientific and Cultural Organization QPE Policy Project supported 4 countries to develop QPE policies. The authors summarize the process, progress, successes, setbacks, and lessons learned during the implementation of the project in Mexico. METHODS: The project was developed from August 2016 to April 2018 following the methodology proposed by the United Nations Educational, Scientific and Cultural Organization. Adaptations to the methodology were made to meet local needs. RESULTS AND DISCUSSION: The project successfully implemented the United Nations Educational, Scientific and Cultural Organization methodology and prepared a national strategy for the provision of QPE in Mexico. The national strategy progressed despite the change in presidential administration. Successes included the use of a QPE policy evaluation framework, the inclusion of stakeholders representing extreme PE views and from all regions in the country, and the presence of international agencies in the national team. Setbacks included difficulties in engaging key organizations and a weak communication campaign. Lessons learned are discussed. CONCLUSIONS: The QPE project in Mexico served as a pilot project to test the feasibility of implementing a QPE policy revision process. The experience and lessons learned in Mexico can be drawn on to inform the work of other stakeholders interested in advocating for a national QPE policy.

Physical activity, sedentary time and cardiometabolic health indicators among Mexican children.

We examined the independent associations of moderate to vigorous physical activity (MVPA) and sedentary time (ST) with cardiometabolic indicators in Mexican children (4-6 years of age). We conducted a cross-sectional study (n = 400) using the measures of MVPA and ST (7-day accelerometry) and the following indicators: % body fat, waist circumference, body mass index (BMI) z-score, glycated haemoglobin, blood glucose, triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, leptin, adiponectin and resting blood pressure. We examined the independent associations of MVPA and ST with cardiometabolic indicators through confounder-adjusted and mutually adjusted (including both MVPA and ST) linear regression models. Confounder-adjusted models showed that MVPA was associated with higher BMI z-scores and lower adiponectin levels in girls and lower body fat among boys. ST was associated with higher body fat, in the full sample, and lower LDL cholesterol among boys. After mutually adjusting for MVPA and ST, MVPA (10-minute increase) remained significantly associated with BMI z-score in girls (ß = 0.187, 95% CI: 0.019, 0.356) and ST (60-minute increase) remained significantly associated with higher body fat (ß = 1.11%, 95% CI: 0.019, 2.203) among boys and higher glycated haemoglobin (ß = 0.047% points, 95% CI: 0.000, 0.094) in the full sample. In preschool-aged children, the objective measures of ST and MVPA were associated with small differences in cardiometabolic health indicators. ST was unfavourably associated with some cardiometabolic indicators even after adjusting for MVPA, and thus appeared to have a more significant role than MVPA, especially in boys. Future longitudinal studies should confirm these results.