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Improving Preschool Nutrition in Chile

Stopping the Problem Before it Starts:
Reducing the Rise of Childhood Obesity in Chile

Background
The Pan American Health and Education Foundation (PAHEF) is committed to helping children throughout the Americas to learn healthy behaviors that will set them on a path to good health for life. Since 2008, PAHEF has funded projects to fight childhood obesity across the Americas. To date, PAHEF-funded projects have been carried out in Brazil, Jamaica, Mexico, Guatemala, and Trinidad & Tobago.

In Chile, childhood obesity is the largest and most pressing nutritional issue among children. PAHEF financed a research project for the Chilean Institute of Nutrition and Food Technology (INTA) to study the Chilean National Nursery Schools Council Program (JUNJI) and develop a nationwide plan to improve the diet of young Chileans.

About JUNJI
JUNJI is a Chilean national program that provides free childcare, education, and meals to low-income children between 6 months to 5 years of age. The program serves more than 130,000 children throughout the country, and the numbers are constantly growing.

A preliminary study found that nearly half of 4-year-olds in JUNJI were overweight and 13 percent were obese. Overweight children often become overweight adults with a host of health problems and a diminished quality of life. Despite the children’s young age, a majority of them had a lipid disorder. It was evident that action needed to be taken to help these children curtail their caloric intake and increase their amount of exercise.

A Program to Combat Obesity
Nearly two-thirds of children in JUNJI attend the classical nursery school program, which is offered 11 months per year, five days per week. Unfortunately, many of the attendees are already putting on too many pounds. The nursery school serves breakfast, lunch, and a snack—providing an ideal setting to implement changes in the children’s diet and patterns of physical activity as well as to monitor how these changes would impact their health.

The PAHEF-supported two-year research project was lead by Dr. Camila Corvalan from the School of Public Health at the University of Chile. It explored how the Chilean nursery school program could be improved to optimize the monitoring of the children’s nutritional status, provide more nutritious food, and ensure the children’s healthy growth (i.e., reducing childhood obesity without increasing under-nutrition problems).

The project focused on several activities, including:

• implementing the World Health Organization’s (WHO) growth standards in the monitoring system of the program as well as developing a Web page for data collection and retrieval of nutrition information;
• measuring the amount and types of fats provided to children while they are at nursery school;
• evaluating the impact on body mass index and stature by reducing caloric intake 15 percent in infants six to 24 months; and
• recognizing the challenges and barriers to implementing obesity prevention at home.

The Results
The project found that JUNJI was ready to implement a system to register weight and height measurements of the children and inform teachers and parents whether their children were underweight or overweight compared to healthy children. The study also found that JUNJI leaders successfully influenced the children’s diet while they were at JUNJI during the day and that the type of fats provided in the program’s meals could be substantially improved. However, once the children went home, it was up to their families to continue implementing the healthy practices. This often did not happen, especially when mothers were ineffective at ensuring their children received a nutritionally-balanced diet at home.

In November 2009, PAHEF supported a session on childhood obesity at the Latin American Nutrition Society XV Nutrition Congress in Santiago, Chile.  There, investigators of various PAHEF-funded projects presented their findings. At the session, Dr. Corvalan highlighted the Chilean project’s achievements to an audience of nutrition experts from throughout the Americas.

The Future
The initiative’s legacy lives on. Information found during the research period will be used to redesign the JUNJI nursery school program. In 2010, new leadership will be appointed and trained in the improved health standards. It is hoped that by 2011, the new monitoring system and the proposed program changes will be fully implemented into the JUNJI nursery school system. Dr. Corvalan’s research group plans to further pursue their project and continue an assessment of the changes implemented.

The JUNJI program’s ultimate goal is to ensure the healthy growth and long-term well-being of all of its beneficiaries. PAHEF is proud to have financially supported this research to create a sustainable program to help the next generation of children in Chile maintain healthy habits for life.