While many communities in Latin America and the Caribbean still struggle with the issue of malnutrition, there is a growing number of others facing the problem of obesity. Since 1980, the number of people suffering from obesity around the world has more than doubled and Latin America has been no exception.^[1] Once thought to be an issue only touching those in the developed world, the obesity epidemic has effectively spread to developing nations. In 1999, a United Nations study found that all developing regions were affected by obesity and in the past three decades, the prevalence of obesity increased more in lower and lower-middle-income countries than it did in upper-middle and high-income countries.^[2],[3]

Obesity is defined by the World Health Organization (WHO) as an “abnormal or excessive accumulation of fat that may impair health” and can be caused by an overconsumption of saturated fats and foods high in salt and sugar as well as a lack of physical activity. There are other health factors that contribute to obesity, such as genetic predisposition. Also, unhealthy maternal weight during pregnancy can cause a fetus to reach an unhealthy weight and later contribute to the risk of developing obesity during the early years of an infant’s life.^[4] Obesity can result in an increased risk of cardiovascular disease, musculoskeletal disorders, diabetes, and certain forms of cancer.^[5] While obesity may affect women and men at any age, the occurrence of obesity and overweight in children is especially alarming. Children who are obese are prone to developing obesity-related health concerns earlier in their lives and have higher chances of suffering from obesity through their adolescence and into their adult lives.^[6]

Increased obesity rates in Latin America can be attributed to several factors. Improving economies and increased household incomes has augmented the purchasing power of populations in many recently developed countries, which in turn has increased the amount processed foods high in fat and carbohydrates as well as televisions bought. This, in addition to urbanization has contributed to increasingly sedentary lifestyles, creating an environment where children are consuming more calories than they are using.^[7] Globalization has also allowed the flow of food across borders from developed Western countries into developing countries, which has caused communities to stray from their traditional diets and explore foods from restaurants and fast food chains that have expanded to Latin American and Caribbean countries. Fast food chains offer quick and convenient meals at low cost meaning that nutritional decisions depend more and more on the selection of foods available at restaurants.^[8]

The growing obesity rates in developing nations is building stress on governments and healthcare systems that are already having to manage the burden of malnourishment in developing nations. With the increasing prevalence of obesity, developing nations may not be able to meet the needs of a population with higher occurrences of chronic diseases due to this condition. The threat of obesity will increase as more and more nations reach their development goals, adding urgency to the need for addressing this growing issue.^[9]

Certain Latin American governments have made efforts to create policies to encourage healthy eating and to promote physical activity in daycare centers and primary schools.^[8],[10] However, curbing the obesity epidemic will require a “whole society approach” as defined by WHO, in order to influence the various social, economic, and environmental determinants of child obesity and other noncommunicable diseases. Educating entire communities to inform individuals about the impacts of their choices will be key to encouraging them to make healthy decisions regarding their diets and exercise habits. Increased education with respect to diet and the importance of proper nutrition and an awareness of childhood obesity will empower individuals and societies to take control of their own health.

As a response to the challenge of the rising rate of obesity, the first Pan-American Conference on Obesity, with Special Attention to Childhood Obesity (PACO I) was held from June 8-11, 2011 in Aruba. This conference, convened by the Ministry of Health and Sports of Aruba, provided an opportunity for representatives from the health, education, and sports sectors in various governments and academic institutions and organizations to come together and discuss experiences and lessons learned with regard to childhood obesity and prevention strategies. Throughout the course of the conference, participants identified a need for continued discussion and increased international cooperation in order to support the efforts being made at local and national levels to educate populations and promote healthy eating habits and physical activity. The need for multi-sectorial systemic changes at multiple levels to reduce obesogenic environments in communities was also identified.

In an effort to continue the discussions from PACO I, the Ministry of Health and Sports of Aruba held a second Pan-American Conference on Obesity, with Special Attention to Childhood Obesity (PACO II), which took place on June 15 and 16, 2012 in Aruba. At this conference, experts from various fields relating to childhood obesity and prevention gathered to develop a specific platform for obesity prevention through research and interventional action. The conference also provided an opportunity to further increase awareness of non-communicable diseases. PACO II was preceded by two courses and seven workshops which provided a framework for the conference by examining various factors contributing to childhood obesity and different approaches to obesity prevention.

In support of the conference’s goals, the Pan American Health and Education Foundation (PAHEF) and PAHO sponsored a workshop entitled, Education for Childhood Obesity Prevention: A Life-Course Approach, which took place one day prior to PACO II. This workshop examined the issue of childhood obesity using a life-course framework. This framework states that efforts must be made to reduce the likelihood of childhood obesity before children reach school age as this may be too late for those who are epigenetically inclined to develop obesity. Obesity must be addressed at every level starting as early as the pre-natal period, through the breastfeeding period, the toddler years, kindergarten and primary school. The workshop served as a forum where experts from various fields could analyze the current status of obesity and obesity prevention strategies and identify feasible and successful strategies to use health and nutrition education to promote a healthy environment.

The workshop consisted of a panel of experts, who presented on topics related to the overall theme of the workshop, the use of the life-course approach as a preventive method for childhood obesity, followed by a question and answer period. The workshop speakers represented organizations such as PAHEF, PAHO, the Rio de Janeiro Federal University, Pelotas Federal University, Caribbean Food and Nutrition Institute, and the ministries of health of Brazil and Mexico. Approximately 30 to 40 experts from different fields, representing academia, private industry and public health associations, attended the workshop. Under the leadership of PAHEF and PAHO, a workshop report was drafted and presented at PACO II. Conclusions from the workshop suggest that in order for education about obesity to be an effective component of the life-course approach, societies must ensure that there are mechanisms in place for individuals to put their knowledge about obesity prevention into practice throughout the course of their lives. Public policies must also reflect the importance of reducing obesogenic environments and involve the environmental, agricultural, economic, and transportation sectors. A multi-sectorial approach will help individuals to change their eating habits as well as their whole lifestyles, from using public parks as a place to exercise to accessing bike and walking paths for transportation before and after school or work. The policies should promote interventions in multiple areas of the community and should strive to engage the public sector as much as possible.^[11]

The conclusions and recommendations resulting from the workshops and PACO II will promote further discussion concerning the childhood obesity and strengthen political leadership to affect positive change in the policies influencing childhood obesity in the Americas and the Caribbean.