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“Our goal must be a world in which good health is a pillar of individual well-being, national progress, and international stability and peace. This cannot be achieved without partnerships involving governments, international organizations, the business community, and civil society.”

— Kofi A. Annan, ex-Secretary-General of the United Nations

Grants Program » Pan American Health and Education Foundation (PAHEF) Grants Program 2008 

A. Combating Childhood Obesity and Improving Nutrition

The Childhood Obesity Epidemic
According to the World Health Organization (WHO), childhood obesity is increasing worldwide at an alarming rate with the countries of Latin America and the Caribbean among the most affected. In many of the countries of the region stunting and micronutrient deficiencies are also common, giving rise to a dual nutrition agenda. Countries need to prevent the new problems of obesity and related chronic diseases while eliminating yesterday’s unsolved problems of nutritional deficiencies.  This is a difficult challenge for countries with limited resources.

The consequences of obesity for adults are well known. Obesity contributes to the development of many diseases, including diabetes, hypertension, stroke, cardiovascular disease, and some cancers while increasing the mortality rate from all causes.  Childhood obesity is a serious problem because it is an important predictor of adult obesity and its negative health impact.  One third of obese preschool children and one half of obese school-age children become obese adults.  A recent collaborative study by the National Institutes of Health found that children who were overweight from ages 2 to 4.5 years were 5 times more likely to be overweight at age 12 when compared to children who were not overweight during the same age span. 

Obesity also affects child health. The risk of hyperlipidemia, hypertension, and abnormal glucose tolerance is somewhat higher among obese children. Type II diabetes, formerly observed only among adults, is increasingly being diagnosed among children, in association with obesity. There are also important psychosocial consequences: obese children frequently are targets of systematic discrimination and, by adolescence, many suffer from low self-esteem.

The causes of the obesity epidemic are complex and linked to economic development and the nutrition transition. The absence of breastfeeding, the consumption of energy dense foods and snacks and beverages containing sugar, reductions in physical activity and the rise of sedentary recreation, are among the causes cited. It is also possible that malnutrition in utero and in infancy may increase the risk of obesity among adolescents and adults, but this mechanism is likely to be less important than the changes in diet and physical activity that accompany the nutrition transition.

The need for action
Countries need to take a number of actions to prevent obesity and related chronic diseases. Examples of actions include information systems to collect data about chronic diseases to help define policies and programs and support advocacy activities. Professionals must be trained to design, monitor, and evaluate programs aimed at preventing chronic diseases. Nutrition and healthy lifestyles should be addressed in the school curriculum and physical activity should be promoted in schools and in the general population. Urban planners can support increased physical activity by building recreational facilities, such as parks and playgrounds.  Public education must be aggressive and effective in promoting healthy diets and lifestyles. Food and agricultural policies can stimulate greater availability and affordability of fruits, vegetables, unrefined cereals and grains, and fish. Industry can also help developing healthier processed foods with lower salt, fat and sugar content. 

The call for proposals about childhood obesity
PAHEF wishes to contribute to the development of policies and programs to combat childhood obesity in Latin America and the Caribbean and invites proposals in the area of childhood obesity and nutrition. Successful proposals will be linked to corrective actions and can refer to preschool children, school-age children and adolescents. PAHEF will not fund studies that seek solely to assess the extent of obesity in populations and/or to investigate its predictors. Examples of topics of interest to PAHEF include the following: 

• Addressing nutrition and healthy lifestyles in the school curriculum.  There is agreement that physical activity should be promoted in schools and in the general population and that the quality of foods and beverages offered in schools should be improved. However, how best to do this and in ways that can be scaled up? 

• Promoting food and agricultural policies that stimulate consumption of healthy diets.  Governments need to implement policies that increase the affordability of healthy foods, such as fruits and vegetables. Industry’s role in developing healthier food products and in promoting public health and nutrition should be recognized and encouraged;

• Evaluating the effectiveness of existing policies and nutrition programs, such as feeding programs, and assessing their impact on child health and efforts to prevent obesity;

• Developing information systems to collect data about obesity or nutrition related chronic diseases in order to better support advocacy activities and to help define policies and programs;

• Educating the public and particularly health care providers in the area of nutrition and how to improve the diets of  children; and

• Social marketing in support of childhood obesity prevention.

The list above is intended to be illustrative.  PAHEF is looking for novel approaches to address the problem of childhood obesity and does not wish to restrict the call for proposals beyond insisting that a link to programs and action be very clear.  Since the level of funding is capped at to $25,000 per year for up to two years, PAHEF recognizes that successful proposals may not complete the progression from designing an intervention to fully testing its impact. This may take years.  PAHEF expects to support the initial steps in such a plan, provide an opportunity to launch a pilot intervention or serve to evaluate and/or existing actions.