LA OBESIDAD Y LA ECONOMÍA DE LA PREVENCIÓN

Este nuevo informe de la Organzación para la Cooperación y el Desarrollo Económicos (OCDE) examina la situación actual de la epidemia de la obesidad a través de nuevos datos comparativos, tendencias y proyecciones en los países de la OCDE y hace énfasis en sus causas y costos. También menciona algunas acciones del sector privado y de los gobiernos que han favorecido la obesidad al tiempo que formula recomendaciones para que los mismos contribuyan a combatirla.

Tiene 265 paginas pero podemos acceder en español a un resumen en la URL ( hipervinculo del titulo)

Preventive services for children and adolescents.

Preventive services for children and adolescents.
Institute for Clinical Systems Improvement (ICSI). Preventive services for children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2010 Sep. 84 p. [193 references]

Las recomendaciones 2010 sobre actividades preventivas en niños y adolescentes

Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding

Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding
Jaafar SH, Jahanfar S, Angolkar M, Ho JJ
Cochrane Database of Systematic Reviews 2011, Issue 3. Art. No.: CD007202. DOI: 10.1002/14651858.CD007202.pub2

Effect of pacifier use on duration of breastfeeding in full-term infants
Breast milk is superior to other baby foods in providing balanced nutrition and protection against allergy and infection to newborns. Breastfeeding is recommended by the World Health Organization, exclusively in the first six months and then as a dietary supplement. Breastmilk production and supply are maintained by frequent suckling of the breast and nipple stimulation. A pacifier is a non-nutritive sucking device used to calm an infant that has become a cultural norm in many parts of the world. However there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.

Our review concluded that for mothers who are motivated to breastfeed their infants, pacifier use before or after breastfeeding was established did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. The review provided moderate evidence from three randomised controlled trials (involving 1915 babies) comparing pacifier use and no pacifier use by healthy, full-term breastfeeding infants; two of the trials (1302 babies) were included in the analysis. However, there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.
Abstract
Background
To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear.

Objectives
To assess the effect of pacifier use versus no pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health.

Search strategy
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010).

Selection criteria
Randomised and quasi-randomised controlled trials comparing pacifier use versus no pacifier use in healthy full-term newborns who have initiated breastfeeding regardless of whether they were born at home or in the hospital.


Data collection and analysis
Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction.

Main results
We found three trials (involving 1915 babies) for inclusion in the review but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.00; 95% confidence interval (CI) 0.95 to 1.06), and at four months of age (RR 0.99; 95% CI 0.92 to 1.06) and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.97 to 1.02), and at 4 months of age (RR 1.01; 95% CI 0.98 to 1.03).

Authors' conclusions
Pacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. However, evidence to assess the short-term breastfeeding difficulties faced by mothers and long-term effect of pacifiers on infants' health is lacking.

Long-term Results of an Obesity Program in an Ethnically Diverse Pediatric Population

Long-term Results of an Obesity Program in an Ethnically Diverse Pediatric Population.
Savoye M, Nowicka P, Shaw M, Yu S, Dziura J, Chavent G, O'Malley G, Serrecchia JB, Tamborlane WV, Caprio S.
Pediatrics. 2011 Mar;127(3):402-10
Abstract
OBJECTIVE: To determine if beneficial effects of a weight-management program could be sustained for up to 24 months in a randomized trial in an ethnically diverse obese population.

PATIENTS AND METHODS: There were 209 obese children (BMI > 95th percentile), ages 8 to 16 of mixed ethnic backgrounds randomly assigned to the intensive lifestyle intervention or clinic control group. The control group received counseling every 6 months, and the intervention group received a family-based program, which included exercise, nutrition, and behavior modification. Lifestyle intervention sessions occurred twice weekly for the first 6 months, then twice monthly for the second 6 months; for the last 12 months there was no active intervention. There were 174 children who completed the 12 months of the randomized trial. Follow-up data were available for 76 of these children at 24 months. There were no statistical differences in dropout rates among ethnic groups or in any other aspects.

RESULTS: Treatment effect was sustained at 24 months in the intervention versus control group for BMI z score (-0.16 [95% confidence interval: -0.23 to -0.09]), BMI (-2.8 kg/m(2) [95% confidence interval: -4.0-1.6 kg/m(2)]), percent body fat (-4.2% [95% confidence interval: -6.4% to -2.0%]), total body fat mass (-5.8 kg [95% confidence interval: -9.1 kg to -2.6 kg]), total cholesterol (-13.0 mg/dL [95% confidence interval: -21.7 mg/dL to -4.2 mg/dL]), low-density lipoprotein cholesterol (-10.4 mg/dL [95% confidence interval: -18.3 mg/dL to -2.4 mg/dL]), and homeostasis model assessment of insulin resistance (-2.05 [95% confidence interval: -2.48 to -1.75]).

CONCLUSIONS: This study, unprecedented because of the high degree of obesity and ethnically diverse backgrounds of children, reveals that benefits of an intensive lifestyle program can be sustained 12 months after completing the active intervention phase.

Dietary Guidelines for Americans 2010

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Ofice, December 2010

The new 2010 Dietary Guidelines for Americans focus on balancing calories with physical activity, and encourage Americans to consume more healthy foods like vegetables, fruits, whole grains, fat-free and low-fat dairy products, and seafood, and to consume less sodium, saturated and trans fats, added sugars, and refined grains.

The 2010 Dietary Guidelines for Americans include 23 Key Recommendations for the general population and six additional Key Recommendations for specific population groups, such as women who are pregnant. Key Recommendations are the most important messages within the Guidelines in terms of their implications for improving public health. The recommendations are intended as an integrated set of advice to achieve an overall healthy eating pattern. To get the full benefit, all Americans should carry out the Dietary Guidelines recommendations in their entirety.

This edition of the Dietary Guidelines comes at a critical juncture for America’s health and prosperity. By adopting the recommendations in the Dietary Guidelines, Americans can live healthier lives and contribute to a lowering of health-care costs, helping to strengthen America’s long-term economic competitiveness and overall productivity.

USDA and HHS have conducted this latest review of the scientific literature, and have developed and issued the 7th edition of the Dietary Guidelines for Americans in a joint effort that is mandated by Congress. The Guidelines form the basis of nutrition education programs, Federal nutrition assistance programs such as school meals programs and Meals on Wheels programs for seniors, and dietary advice provided by health professionals.

The Dietary Guidelines, based on the most sound scientific information, provide authoritative advice for people 2 years and older about how proper dietary habits can promote health and reduce risk for major chronic diseases.

The Dietary Guidelines aid policymakers in designing and implementing nutrition-related programs. They also provide education and health professionals, such as nutritionists, dietitians, and health educators with a compilation of the latest science-based recommendations. A table with key consumer behaviors and potential strategies for professionals to use in implementing the Dietary Guidelines is included in the appendix.

Effectiveness of Preventive Dental Treatments by Physicians for Young Medicaid Enrollees

Pahel BT, Rozier RG, Stearns SC, Quiñonez RB
Pediatrics. 2011;127(3):e682-e689 (doi:10.1542/peds.2010-1457)

OBJECTIVE To estimate the effectiveness of a medical office–based preventive dental program (Into the Mouths of Babes [IMB]), which included fluoride varnish application, in reducing treatments related to dental caries.

METHODS We used longitudinal claims and enrollment data for all children aged 72 months or younger enrolled in North Carolina Medicaid from 2000 through 2006. Regression analyses compared subgroups of children who received up to 6 IMB visits at ages 6 to 35 months with children who received no IMB visits. Analyses were adjusted for child and area characteristics.

RESULTS Children enrolled in North Carolina Medicaid with 4 IMB visits experienced, on average, a 17% reduction in dental-caries–related treatments up to 6 years of age compared with children with no IMB visits. When we simulated data for initial IMB visits at 12 and 15 months of age, there was a cumulative 49% reduction in caries-related treatments at 17 months of age. The cumulative effectiveness declined because of an increase in treatments from 24 to 36 months, an increase in referrals for dental caries occurred with increasing time since fluoride application, and emergence of teeth not initially treated with fluoride.

CONCLUSIONS North Carolina's IMB program was effective in reducing caries-relatedtreatments for children with 4 IMB visits. Multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. Referrals to dentists for treatment of existingdisease detected by physicians during IMB implementation limited the cumulative reductions in caries-related treatments, but also contributed to improved oral health.