RESUMENIntroducción: Paraguay no escapa a la epidemia global de obesidad. Este estudio describió la prevalencia y los determinantes sociodemográficos, clínicos y conductuales asociados en el país. Métodos: Estudio transversal tipo encuesta poblacional con representatividad nacional, incluyó personas entre edades de 15 y 74 años. El muestreo fue probabilístico, trietápico sin reemplazo. STEPSwise fue la metodología y encuesta aplicada durante junio-setiembre 2011. Se consideró obesidad un índice de masa (IMC) corporal >=30. Este valor se distribuyó según las variables sociodemográficas, clínicas y conductuales. Por regresión logística se estimó asociación entre las variables, en odd ratios (OR) con intervalos de confianza del 95%(IC95%). Resultados: Se incluyeron 2501 participantes. Fueron obesos 23,5% de la población, 20,2% y 26,0% hombres y mujeres, respectivamente. Además del sexo, mostraron diferencias significativas: tener >35 años 3,17(2,11-4,76) que los menores; hombres con residencia urbana 1,94(1,35-2,79) veces más que los del área rural. Los hombres en pareja 2,52(1,80-3,53) veces más obesos que los solteros; funcionario público 2,57(1,57-4,26) veces más que otros trabajos. Baja actividad física presentó obesidad 1,75(1,19-2,57) veces más que tener una actividad física mínimamente aceptable. En hombres el quintil de ingreso superior presentó 3,87(2,17-6,92) más obesidad que el quintil inferior. En mujeres el bajo nivel educativo es 2,01(1,43-2,83) veces más que un mayor nivel. Conclusiones: El patrón observado de la distribución de la obesidad describe entornos y conductas más obesogénicos que otros en Paraguay. Estos resultados sirven para tomar decisiones e intervenciones específicas en salud pública, más allá de las medidas poblacionales.Palabras Clave: obesidad, estilo de vida, determinantes de la salud. 18 ABSTRACTIntroduction: Paraguay has not escaped from the global epidemic of obesity. This study described the prevalence and socio-demographic, clinical and behavioral determinants associated to obesity. Methods: Cross-sectional study with a nationally representative survey, included people among 15 and 74 years old. The sampling was probabilistic, three-stage without replacement. STEPSwise was the methodology and survey applied during June-September 2011. Obesity was considered a body mass index (BMI) >=30 kg/m2. This value was distributed by sociodemographic, clinical, and behavioral variables. A logistic regression among obesity and variables was estimated for obtain odd ratios (OR) with confidence intervals of 95% (95% CI) of association. Results: 2501 participants were included. Were obese 23.5%, men and women were 20.2% and 26.0%, respectively. In addition to gender, showed significant differences: >35 years-old 3.17(2.11-4.76) than younger; men in urban residence 1.94(1.35-2.79) odds more than those in rural areas. No single men 2.52(1.80-3.53) odds more obese than single; civil servants 2.57(1.57-4.26) odds more than other jobs. Low physical activity 1.75(1.19-2.57) odds were more obese t...

Through focus groups, we explored 22 third- to fifth-grade teachers' perceptions about their eating habits, including barriers and facilitators to healthy eating. It also explored teachers' thoughts about how to teach students healthy eating habits. The information was transcribed and treated using the content analysis technique. Results were evaluated using the concept of majority and minority group and presented in a sequential way: teachers' perceptions about eating habits, barriers to healthy eating, teacher's culinary habits, abilities to teach students healthy eating habits through Information and Communication Technologies, and cooking activities. Teachers' eating habits were poor, with lack of time, money, and will to improve. They had culinary habits skills and the desire to instruct and guide their students in eating healthier food. They need a program with Information and Communication Technologies and cooking workshops to apply in the classroom.

The objective of this study is to describe the process and results of a three-year project designed to create a nutrition education intervention model that promotes healthy dietary habits among teachers, students and their families. The methodology consisted in surveys, focus groups and Delphi method to assess teachers', students' and parents' dietary habits, followed by an intervention for parents, and a participative nutritional education intervention with information and communication technologies applied to teachers, with the purpose to transfer nutritional knowledge and habits to school children and their families. Qualitative results were measured in all the phases of the project with positive results, and quantitative results demonstrated significant changes in food knowledge and healthy dietary habits in parents, teachers and students, compared with the control groups, without changes in students' nutritional status during the short period of the intervention. With the results, an integral school nutrition education model in healthy eating was developed with children, parents, teachers and support for school management. This model should be applied in the educational sector to address the problem of unhealthy diet and childhood obesity that affects Chile and the world.

Background In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children’s food environments. This study’s objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile’s Law of Food Labeling and Advertisement. Methods Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to consumption at the pre-policy 2016 baseline. Nutrient intakes are expressed as percent of total energy. Results Compared to 2016 (pre-policy), total sugars consumed by children at school decreased 4.5 [-8.0, -0.9] percentage points (pp) and 11.8 [-15.4, -8.3] pp in 2018 and 2019 respectively. In 2019, children’s saturated fats and sodium intake at school also decreased (1.1 [-1.9, -0.2] pp and 10.3 [-18.1, -2.5] mg/100 kcal respectively). Likewise, in adolescents, total sugars and saturated fats consumed at school decreased in 2018 (5.3 [-8.4, -2.2] pp and 1.5 [-2.7, -0.3] pp respectively). However, consumption of key nutrients of concern at other locations increased after implementation of the policy. Conclusions After initial implementation of Chile’s Labeling Law, intake of most key nutrients of concern significantly declined at school. However, we found evidence of compensatory behavior in out-of-school settings. Further research is needed to evaluate what other actions are needed to impact overall diets in the long term both at schools and out of school.

Food is inextricably linked to human health and environmental sustainability; however, very little is known about children’s perceptions of the concept of sustainability in the context of food choices. We aimed to explore the perceptions of Chilean schoolchildren about environmental sustainability, food, and nutrition. Eight online focus groups were conducted with boys and girls aged 8–9 (n = 30). Questions related to environmental sustainability, pocket money, and food characteristics such as price, front-of-package (FOP) warning label, and eco-labels were included. Data analysis was conducted using ATLAS.ti through a hybrid content analysis approach. Five central themes were identified: (1) children’s favorite snacks, (2) knowledge of sustainability, (3) sustainability and eco-labels use, (4) healthfulness of food products, and (5) pocket money and food prices. Most children were not aware of the meaning of “environmental sustainability”, but the concept was understood when it was explained in plain language. Participants showed awareness about the environmental impact of their eating behavior, had a positive perception of eco-labels, and identified food with fewer warning labels as “better” options. Results indicate that children understand the concept of sustainability in food if it is communicated clearly, and that eco-labels may be an effective tool in that effort.

Food and beverage companies are increasingly aware of the risks posed by climate change and many are interested in addressing them by building resilience along their supply chains. Financial incentives for environmental, social, and governance criteria further motivate mitigation action by firms. To achieve sustainable outcomes, human and ecological systems must be managed for resilience. The scientific community and food and beverage firms must collaborate in the development of measurable and verifiable indicators that support adaptation and mitigation action along food supply chains. This commentary identifies three areas in which synergistic progress would set a resilient trajectory toward sustainability: 1) incentives for sustainable intensification, 2) expanded reporting standards, and 3) pre-competitive collaborations. Incremental, clear, and measurable steps can be taken to adapt food supply chains to the pressing challenges imposed by climate change, mitigate further emissions, and bring producers and consumers along in the journey towards planetary health.

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Introducción: el objetivo fue diseñar un estudio comunitario randomizado controlado multi-componente y evaluar su efecto en la prevención de obesidad en escolares del departamento de Caaguazú, Paraguay.Material y métodos: Diseño: ensayo comunitario randomizado controlado. Lugar: 16 escuelas públicas y privadas del área urbana y rural del Departamento de Caaguazú, Paraguay. Participantes e intervención: 16 escuelas serán asignadas aleatoriamente a dos grupos. Grupo intervención, recibirán un programa de educación nutricional y actividad física en el entorno escolar durante 6 meses. Grupo control, recibirán 3 charlas educativas en el mismo periodo. Medición de las principales variables: primaria (espesor de pliegues cutáneos), secundarias (z índice de masa corporal, conocimientos nutricionales, consumo de frutas y verduras, nivel de actividad física) y variables demográficas (sexo, edad, zona de residencia). Todas las variables serán medidas en la línea base y al final del estudio, utilizando herramientas calibradas, cuestionarios validados y protocolos de procedimiento. Análisis: se utilizará estadística descriptiva, además de los test t Student y chi2 para establecer diferencias. Se correrán modelos de regresión lineal y logística crudos y ajustados.Ética y diseminación: el protocolo de estudio ha sido evaluado y aprobado por el Comité de Ética en Investigación de la Universidad Nacional de Caaguazú. Se utilizarán consentimientos informados institucionales (escuelas) e individuales (padres) y asentimiento de los niños.