Ministério da Saúde Secretaria de Atenção à Saúde Departamento de Atenção Básica

1. Ministério da Saúde Secretaria de Atenção à Saúde Departamento de Atenção Básica Coordenação-Geral de Alimentação e Nutrição EDUCATION FOR CHILDHOOD OBESITY PREVENTION: A LIFE-COURSE APPROACHNational ProgramsThe Brazilian experience WORKSHOPEDUCATION FOR CHILDHOOD OBESITY PREVENTION: A LIFE-COURSE APPROACH

2. BrazilianNutritionalScenario Nationalsurveyssince(1970, 1980, 1990, 2003, 2006 & 2009) ENDEF 1974-75; PNSN 1989; PNDS 1996 e 2006; POF 2008-2009; VIGITEL 2006 a 2009.

3. Nutritional status – childrenunder 5 yearsDemographicHealthSurvey (DHS - 1996, 2006)

4. Trendsofoverweight – childrenandadolescents(1974 – 2009) Adolescents Childrende 5 to 9 years boys girls boys girls boys girls boys girls boys girls boys girls Stunting Overweight Obesity Undernutrition Overweight Obesity

5. Trendsofoverweightandobesityamongadults (1974 – 2009) Male Female Male Female Male Female Undernutrition Overweight Obesity

6. Evolução da prevalência de adultos (18 ou mais anos de idade) com excesso de peso e obesidade, Vigitel 2006 a 2010. Excesso de peso: aumento populacional médio de 1,08% ao ano Obesidade: aumento populacional médio de 0,72% ao ano

7. Prevalenceofoverweightandobesity – beneficiariesfrom “Bolsa Família” Braziliancashtransferprogram (Brasil - SISVAN, 2010) femalefemale girls boys girls boys Under 5 years 5 – 9 years adolescentsadults overweight obesity

8. BrazilianNutritionalScenario • Nutritionalcarency: • Anemia • Vitamin A deficiency • Vitamin B deficiency • Specialfeedingnecessities

9. GUIDELINES OF NATIONAL POLICY OF FOOD AND NUTRITION 9. Cooperation and Articulation for Food and Nutrition Security

10. National Strategies to Promote Breastfeedingand Healthy Complementary Feeding +

11. Between 2008 and 2011, the two strategies have capacitated over 4,000 tutors and involved over 30,000 primary health care professionals in Brazil.

12. New NationalStrategyfor Breastfeeding and Healthy Complementary Feeding Promotion

13. What is intended? Encourage the nutritional guidance as routine practice in health services, contemplating the formation of healthy eating habits from childhood, with the introduction of complementary feeding in a timely and quality, while respecting the cultural identity and food from various regions of Brazil

14. Infectiousdiseases, respiratorydiseases, dental caries, malnutrition, micronutrientdeficiencies. Inadequate feeding practices during the first years of life: Formation of unhealthy eating habits. Overweight and their comorbidities in childhood and adulthood .

15. Medianof exclusive breastfeeding (in days) childrenunder 6 months. Brazilian cities, 2008 Exclusive breastfeeding Median 1999 – 23,4 days 2008 – 54,1 days

16. School Health Program Schools: 56,848Students: 11 946 .778Primary Health Care Teams: 14,439

17. How the school could contribute?

18. SchoolHealthProgram

19. PRINCIPLES Theprogram is basead in thegarantyofrights, rightoflifeandit´s grounded in 3 principles: • Intersectoral: performed by the challenge of shared management, in which scientific knowledge, popular and places are taken into consideration, including the subjects and participation in a dialogic exchange (dialogue), a meeting that is produced again. • Territoriality: respect for local diversity, the local languages​​, local foods, to art sites, with the inclusion of what is diverse and different and the face of security vulnerabilities / territories vulnerable • 3) Integrality: knowledge gathering guided by policies ensuring the health and education as a universal right.

20. Programactions ComponentI – Healthconditionsevaluation Avaliação das condições de saúde ComponentII – Actionsofpreventionandpromotion ComponentIII – Permanenteducation ComponentIV – Monitoringandevaluationofhealthconditions ComponentV - Monitoringandevaluationoftheprogram

21. AnnualweekofmobilizationSchoolHealthProgram 2012 – preventionofobesityatschoolcontext Targetoftheweek: start theactionsthatwillbedevelopeddurindalltheyear.

22. AnnualweekofmobilizationSchoolHealthProgram March/2012 – preventionofobesityatschoolcontext Targetoftheweek: start theactionsthatwillbedevelopedduringattheyear. • Cities: 1.938 • schools: 22.096 • Healthteams: 10.240 • Schoolars: 9.651.985

24. MATERIAIS DE DIVULGAÇÃO DA SEMANA DE MOBILIZAÇÃO SAÚDE NA ESCOLA (ENCARTE PARA REVISTA VOLTADA AOS PROFESSORES)

25. MATERIAIS DE DIVULGAÇÃO DA SEMANA DE MOBILIZAÇÃO SAÚDE NA ESCOLA (MATERIAL PARA ORIENTAR NAS ATIVIDADES)

26. Schoolmealprogram • Laws that restricit the participation of processed food on the school meal program (30%) • Increase of fresh food from familiar agriculture at the school meal program (30%) • Nutritional parameters from menus

27. Goal:  joining forces to work together and implement actions aimed at promoting quality of life and prevention factors and / or limitations of diseases and health problems in the school environment Specific Objectives:I-planning, implementation and evaluation strategies with these approaches;II - plan and implement public campaigns and information on health and quality of life aimed at the whole school community;III - develop, define and implement protocol for healthy eating for school canteens, including improving the nutritional quality of meals and snacks offered;IV - establish and define strategies for the recognition of healthy school canteens. AgreementbetweenHealthMinistry& Privateschoolsfederation

28. FOOD AND NUTRITION SURVEILLANCE

29. FOOD AND NUTRITION SURVEILLANCE Allows the analysis of the population’s food and nutrition situation since the 1970s ENDEF 1974-75; PNSN 1989; PNDS 1996 and 2006; POF 2008-2009; VIGITEL 2006 to 2009.

30. Monitoring the beneficiaries of the BolsaFamilia Program Food and Nutrition Surveillancein Health services Commitment of the beneficiary families + Commitment of SUS

31. Regulation on food advertisement: Establishing specific regulation to theadvertising of food, especially for children. • Publication of RDC No. 24/2010 - Provides for the offer, advertising, publicity, information and other related practices of foods with high amounts of sugar, saturated and trans fat, sodium, and beverages of low nutritional value. • Placement of consumer alerts visible, legible, prominent and contextualized in printed pieces, television, internet, samples and other advertising materials: • “The (name / trademark of food) contains lots of sugar and, if consumed in large quantities, increases the risk of obesity and tooth decay”. • “The (name / trademark of food) contains too much saturated fat and, if consumed in large quantities, increases the risk of diabetes and heart disease”. • “The (name / trademark of food) and contains a lot of trans fat, if consumed in large quantities, increases the risk of heart disease”. • “The (name / trademark of food) contains too much sodium, and if consumed in large quantities, increases the risk of high blood pressure and heart disease”. • “The (name / trademark food or set) contains a lot (a) [nutrients that are present in high quantities], and is consumed (as) in large amounts increase the risk of obesity and heart disease”.

32. Regulation of advertising of unhealthy foods • Suspension of RDC No. 24/2010 by the Federal Court of Brasilia in favor of theABIA, ANR; ABIR; AFREBRAS; Brazilian Association of Chocolate, Cocoa, Peanut, Candy and Derivatives; ABIMA; CNT; Industry Union of Corn, Soybean and derivatives in the state of SP; ANIB; ABESI and ABF. • AGU Agency recommended the suspension for the same reason

33. Regulation of advertising of unhealthy foods Other movements: • WHO Regional Consultation on Recommendations for the marketing of food andnonalcoholic beverages to children (Brasilia, Jun / 2009) • Release Front in Defense of Food Regulatory Advertising (New York, Dec / 2011) • Launch of publication "Recommendations of the Expert Consultation of PAHO on the Promotion and Advertising of Foods and Non-Alcoholic Beverages to Children in the Americas"