A quasi-cohort trend analysis of adult obesity in Colombia.

In Colombia, the prevalence of obesity has been increasing in recent years due to changes in dietary and nutritional patterns. While previous studies have focussed on describing obesity and its associated factors, they have mainly used a cross-sectional methodology. Accordingly, this study aims to conduct a descriptive quasi-cohort analysis to capture age-specific cohort trends in body mass index (BMI) according to sex and ethnicity (indigenous, Afro-Colombian, and the remaining population). The study utilised data from the National Survey of the Nutritional Situation in Colombia (ENSIN) conducted in 2005, 2010, and 2015 that included 214,136 individuals aged 20-64 years after screening. Data on ethnicity were only available from the 2010 and 2015 surveys. Overall, the prevalence of obesity increased by 6.1 percentage points (from 15.2% to 21.3%) between 2005 and 2015 (men from 10.4% to 15.7%; women from 18.2% to 25.7%). Among Afro-Colombians, obesity rose 6.6 percentage points (from 19.4% to 26.0%), again more so in women than in men (2015: 35.2% versus 17.8%). Among indigenous people, the proportion increased by 5.3 percentage points (from 13.5% to 18.8%), with women reporting highest rates (2015: 23.7% against 12.6% in men). Age- and cohort-specific results also indicate that recent adult cohorts are experiencing sharp increases in BMI, for example, while 25-29-year-old males born in 1975-1979 had a BMI of 24.2 kg/m2, among 40-44-year-olds of the same cohort, this equalled 26.8 kg/m2. In the case of women, these age differences in BMI among the same cohort are even greater (24.4 and 28.0 kg/m2). In summary, the results of this study indicate that Colombia is still in the early stages of the obesity transition, urging the need to monitor obesity trends in Colombia from both an age and cohort perspective. To achieve this, longitudinal surveys or repeated cross-sectional surveys like the ENSIN could be utilised.

Reduction of chronic malnutrition for infants in Bogotá, Colombia.

BACKGROUND: According to the 2015 National Survey of the Nutritional Situation in Colombia the prevalence of stunting in children under 5 years of age was 10.8%. In terms of region, Bogotá, presented the highest prevalence rate (13%), a figure that exceeded national records. With the collaboration of local and national government, and nongovernmental it was decided to develop a pilot study involving a public health intervention with residents of Bogotá under 1 year of age with nutritional classification by anthropometry compatible with stunting risk or stunting. METHODS: Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status through a 10 months public health nutrition intervention in children under one-year-old residing in 3 prioritized territories of Bogotá. RESULTS: The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate length for their age. CONCLUSION: That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the length-for-age indicator after the intervention.

Sembrando Salud: escuelas de campo para el mejoramiento de la seguridad alimentaria en Soracá, Boyacá, Colombia, en 2017 / Sembrando Salud: Farmer Schools for the Improvement of the Food Security in Soracá, Boyacá Colombia, in 2017

Resumen: Antecedentes: las escuelas de campo para agricultores constituyen una metodología en la que los participantes comparten conocimientos previos para brindar soluciones a problemas agrarios. Objetivo: fortalecer la disponibilidad, acceso y consumo de alimentos saludables, mediante la estrategia Sembrando Salud en dos veredas rurales y el centro poblado del municipio de Soracá, Boyacá, Colombia, en el año 2017. Materiales y métodos: se realizó un estudio mixto que incluyó observación participante para evidenciar el fenómeno del acceso a alimentos y encuestas para medir el cambio en acceso, disponibilidad y consumo de alimentos saludables. Con las escuelas de campo se desarrollaron cinco módulos de formación con una intensidad de siete horas cada uno. Resultados: Sembrando Salud contó con la participación de 100 personas, 40 % menores de 18 años y 60 % adultos; 74 % mujeres y 26 % hombres. El acceso, disponibilidad y consumo de frutas y verduras es limitado, por los elevados costos de los alimentos y por el desconocimiento de su preparación. El cambio en la inclusión y consumo de frutas y verduras se evidenció en el 59,4 %, que realizó cambios en la producción, 51,9 % en la preparación y 43 % en adquirir verduras por otra vía. Conclusión: Sembrando Salud demostró que los procesos de participación y educación rural permiten el mejoramiento en el acceso, la disponibilidad y el consumo de alimentos saludables en poblaciones rurales.

Abstract: Background: Farmer field schools are a methodology in which participants share prior knowledge to supply solutions to agrarian problems. Objective: To strengthen the availability, access, and consumption of healthy food through Sembrando Salud strategy in two rural villages and the town center of the municipality of Soracá, Boyacá, Colom bia, in 2017. Materials and Methods: A mixed study was conducted including participant observation to show the phenomenon of food access and surveys to measure the change in access, availability, and consumption of healthy foods. With the farmer schools were developed five training modules with seven hours of intensity each. Results: Sembrando Salud involved 100 participants, 40 % under 18 years of age and 60 % adults; 74 % female and 26 % male. Access, availability, and consumption of fruits and vegetables are limited, due to the high cost of food and lack of knowledge on how to prepare them. The change in the inclusion and consumption of fruit and vegetables was showed by 59.4 % making changes in production, 51.9 % in preparation, and 43% in acquiring vegetables by other means. Conclusion: Sembrando Salud demonstrated that rural participation and education processes allow the improvement of access, availability, and consumption of healthy food in rural populations.

Prácticas de alimentación del lactante y del niño pequeño en tres instituciones de salud en el Caribe colombiano, bajo la estrategia "Instituciones amigas de la mujer y la infancia integral" / Feeding practices of the infant and child, in three health institutions in the Colombian Caribbean / Práticas de alimentação do lactante y del niño pequeño en tres instituciones de salud en el Caribe colombiano, bajo la estrategia "Instituciones amigas de la mujer y la infancia integral "

Resumen Objetivo: Describir las prácticas de alimentación de niños lactantes y de niños pequeños atendidos en instituciones de tres municipios del Caribe colombiano, incluidos en el proceso de implementación de la estrategia "Instituciones amigas de la mujer y la infancia integral" de la Unicef. Metodología: Estudio cualitativo enmarcado en la etnografía, llevado a cabo mediante entrevistas semiestructuradas, cartografía social y grupos focales, dirigido a madres beneficiarias de instituciones de salud priorizadas. Resultados: Las madres reconocieron los beneficios nutricionales de la lactancia materna, y en dos de los territorios, los beneficios emocionales. Además, presentan apropiación en lo relacionado con la alimentación perceptiva. No obstante, no cumplen con el periodo de exclusividad de la lactancia, refieren algunas creencias populares acerca de la misma y se observa un inicio temprano de la alimentación complementaria. También reconocieron la importancia de las redes de apoyo familiar y social, como, por ejemplo, del Instituto Colombiano de Bienestar Familiar. Conclusión: Esta investigación permitió reconocer factores que favorecen y limitan las adecuadas prácticas de alimentación del lactante y del niño pequeño, en madres gestantes y lactantes y su red de apoyo, las cuales viven en condiciones de vulnerabilidad social y económica, y son atendidas en tres instituciones de salud del Caribe colombiano que se encuentran en proceso de implementación de la estrategia enunciada. Lo anterior brinda elementos para la formulación de procesos educativos en salud para la población materno infantil, tanto en la población objetivo como en instituciones que se encuentren en proceso de implementación de dicha estrategia, y de requerimientos políticos acerca de la salud materno infantil.

Abstract Objective: Describe the infant and young child feeding practices of children cared for in institutions of the Colombian Caribbean, includes in implementing the baby friendly hospital strategy. Methodology: Qualitative study framed in ethnography through semi-structured interviews, aimed at beneficiary mothers of prioritized health institutions. Results: The mothers recognized the nutrtitionals benefits of breastfeeding, in two territories also the emotional benefits. They also show appropriation in relation to perceptual feeding. However, they do not comply with the exclusive period of breastfeeding, they refer to some beliefs around it, an early start of complementary feeding is observed. In turn, the mothers recognized the importance of family and social support networks, such as the Instituto Colombiano de Bienestar Familiar. Conclusion: This research made it possible to recognize factors that favor and limit the adequate feeding practices of infants and young children, in pregnant and lactating mothers and their support network, who live in conditions of social and economic vulnerability and are cared for in three health institutions of the Colombian Caribbean that are in the process of implementing the baby-friendly hospitals initiative. The foregoing provides elements for the formulation of educational processes in health in the maternal and child population, both in the target population and in institutions that are in the process of implementing the baby-friendly hospitals initiative and policies to maternal and child health.

Resumo Objetivo: Descrever as práticas alimentares de lactentes e crianças atendidas em instituições de três municípios do Caribe colombiano, incluídas no processo de implementação da estratégia do Unicef "Instituições Amigas da Mulher e Infância Integral". Metodologia: Estudo qualitativo enquadrado na etnografia, realizado por meio de entrevistas semiestruturadas, cartografia social e grupos focais, dirigido a mães beneficiárias de instituições de saúde priorizadas. Resultados: As mães reconheceram os benefícios nutricionais da amamentação e, em dois dos territórios, os benefícios emocionais. Além disso, apresentam apropriação em relação à alimentação perceptiva. Porém, não cumprem o período exclusivo de aleitamento materno, referem-se a algumas crenças populares a respeito, e observa-se o início precoce da alimentação complementar. Também reconheceram a importância das redes de apoio familiar e social, como o Instituto Colombiano de Bem-Estar Familiar. Conclusão: Esta pesquisa permitiu reconhecer fatores que favorecem e limitam as práticas alimentares adequadas de lactentes e crianças pequenas, em gestantes e lactantes e sua rede de apoio, que vivem em condições de vulnerabilidade social e econômica, sendo atendidas em três. Instituições de saúde do Caribe colombiano que estão em processo de implementação da estratégia declarada. O exposto fornece elementos para a formulação de processos educativos em saúde para a população materno-infantil, tanto na população-alvo como nas instituições que estão em processo de implementação dessa estratégia, e de requisitos políticos relativos à saúde materno-infantil.