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. 2017 Jan 9;20(7):1286–1296. doi: 10.1017/S1368980016003323

Table 1 .

Examples of programmatic approaches to address overweight and obesity in low- and middle-income countries in the context of existing nutrition programmes largely focused on undernutrition

Food systems Education systems Health systems
Existing nutrition programmes
  • Restrict marketing of breast-milk substitutes

  • Invest in food distribution infrastructure

  • Increased access to legumes/pulses and grains high in protein and micronutrients

  • Public procurement and distribution of fruits and vegetables

  • Schools should develop dietary guidelines that promote and provide healthy foods and, where feasible, provide healthy breakfast and/or lunch to students

  • Counselling by community health workers on appropriate dietary intake during pregnancy

  • Breast-feeding promotion

  • Appropriate complementary feeding that emphasizes quantity, quality and diversity of foods according to age, and ensures intra-household allocation of foods to infants and young children

Integration of overweight and obesity
  • Restrict marketing of unhealthy foods to children

  • Food-based dietary guidelines

  • Nutrition label standards

  • School curricula should include what constitutes a ‘healthy diet’, the health consequences of overweight/obesity and the importance of physical activity

  • Adolescent girls are an important target population

  • Schools should reduce access to sugary, high-fat snacks and beverages

  • The importance of a healthy weight should also be discussed in preparation for pregnancy, with non-pregnant women and adolescents, through community channels or schools

  • Develop overweight and obesity polices and guidelines and provide budgetary allocations for implementation at district and health facility levels

  • Integrate overweight into pre-service and in-service training curricula of health providers

  • Incorporate promotion of ‘healthy diets’ in nutrition behaviour change activities

  • Heath-care providers should provide counselling on maternal diet and appropriate gestational weight gain during antenatal care

  • Counselling should be based on an understanding of cultural beliefs and food choice related to high-energy foods (i.e. sugary foods and fried foods) and nutritious foods (i.e. fruits and vegetables)

  • Counsel mothers, caregivers, family members and influential community members to feed children appropriately and to not consume junk foods

  • Avoid providing sugar-sweetened beverages during community/mothers’ support group sessions and postnatal care visits

  • Develop monitoring and evaluation indicators and targets for national, district/health facility and community levels

  • Include overweight indicators in national development plans