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dec 09, 2022
In his medical practice in Santiago de Chile, family physician Diego García-Huidobro observed a worrying trend among families and children in recent years.
“I would see parents for a health issue or a preventive check-up, and often observed issues around overweight and an unhealthy lifestyle. As they brought their children to the consultation, I noticed that many were overweight, too, and at risk of developing health problems”, Diego recalls.
In 2016, more than half of pre-school children in Chile were reportedly overweight or experienced obesity, one of the highest rates among countries in the Organization for Economic Cooperation and Development (OECD). Children who are overweight are more likely to remain overweight or develop obesity as adults, and they are at greater risk of developing noncommunicable diseases (NCDs) and poor health.
“As a family physician, I quickly realized that overweight and obesity are not just caused by individual behaviour. The school and family environments play a major contributing role. This is where families and their children interact, eat, snack, play sports or engage in physical activity the most, Diego recounts.
With support from the city of Providencia, Diego teamed up with Oriana Diaspro, a sociologist and researcher, to develop the ¡Juntos+Saludables! programme, recruiting a team of dieticians, personal trainers, psychologists, and champions on-the-ground. Together, they designed a project to promote a healthier lifestyle and to reduce obesity amid children’s family and school environments.
“¡Juntos+Saludables! emphasizes that we need to work together to be healthy. Our team works with the children to identify unhealthy behaviours and mental health issues. For families, we offer counselling for health and dietary questions in their homes or with a hotline. And in schools, we work with teachers and management to make healthier meals and snacks available, improve playground and sport facilities and introduce health topics into the curriculum”, Oriana explains.
Diego’s and Oriana’s intervention demonstrates how holistic and inclusive health literacy approaches can effectively reduce childhood obesity, while engaging and empowering young people, their families and educators in a meaningful way. “A key success factor is that we recognize community members as experts in identifying and addressing their health needs, and families as the true champions of healthy behaviour”, notes Diego.
After three years of pilot implementation, ¡Juntos+Saludables! significantly reduced childhood obesity in a study group and increased healthy nutrition, physical activity and mental health among students compared to other schools.
“Our children have started to eat better, and we have stopped buying certain drinks at home because my daughter tells me they are not healthy. Now we drink water, that has never happened in my life”, reported a parent whose child participates in the programme.
“The programme has become part of the school's identity. You can feel that it has generated change, and that change is felt and shared among students,” one school coordinator adds.
Addressing obesity and Noncommunicable diseases through grassroots innovation
More than a billion people worldwide are living with obesity. They are at higher risk of noncommunicable diseases (NCDs) such as type 2 diabetes, cardiovascular disease, hypertension, stroke and cancer, and also more likely to experience mental health issues.
The global rise in obesity particularly affects low- and middle-income countries, where the number of people living with obesity has doubled since 2010. Responding to these alarming trends, WHO’s Acceleration Plan to STOP Obesity supports countries in preventing and managing obesity throughout the life course, including through fiscal policies, regulations on food and beverage marketing, food labelling and public education and awareness.
The NCD Lab is a platform launched by WHO’s Global Coordination Mechanism on NCDs (GCM/NCD) to crowdsource and promote grassroots innovation for NCD prevention and control. Accounting for local context and building on strong community ownership, bottom-up health initiatives often prove highly effective and have the potential to scale.