Stable Isotope Techniques: Tackling Childhood Obesity in Chile

Published Date: 10 July 2013

People need food and water to survive but nutritious food is central to healthy living. Energy-dense fat, protein and carbohydrates need to be accompanied by vitamins and minerals (micronutrients) to ensure proper nutrition. Malnutrition -too much or too little- can be equally bad. The coexistence of under- and over-nutrition represents the double burden of malnutrition. (Photo: S. Gorisek/IAEA) Obesity has become a major health problem, driven by changes in diet and physical inactivity. It is a key risk factor and non-communicable diseases, such as diabetes, cardiovascular disease, hypertension, osteoporosis and some cancers. Obesity in children, in particular, is on the rise. This is why intervention programmes need to start early. (Photo: S. Gorisek/IAEA) The IAEA works with Member States to address their needs in relation to malnutrition through the use of stable isotope techniques. Capacity building through training and provision of equipment enables laboratories worldwide to use these methods in community settings as they are safe, non-invasive and can be applied in adults and children of all ages. (Photo: C. Slater/IAEA) Compared to conventional techniques, these methods, which do not involve radiation, offer much more sensitive and specific measurements to evaluate nutritional and lifestyle interventions, for example food fortification, healthy eating and physical activity programmes. (Photo: E. Aguilar/Ecuador) Stable isotope techniques help scientists determine whether the right amount of micronutrients is received, utilized and retained by the body, establish the ratio of lean tissue to fat in body composition, estimate the number of calories spent each day, can tell whether breastfed babies are exclusively breastfed according to the WHO recommendations, and how much milk they take in. This provides Member States with information to design or improve their national health and nutrition programmes. (Photo: S. Gorisek/IAEA) Stable isotope techniques play an important role in development and monitoring of interventions against malnutrition. Gabriela Salazar Rodríguez, the project counterpart in Chile said “Stable isotope techniques also save time and money, as they are done quickly and are relatively inexpensive; the cost is about US $10 per child.” (Photo: C. Slater/IAEA) The increasing prevalence of childhood obesity in Latin America has been a cause for concern. The IAEA has worked with the University of Chile, Institute of Nutrition and Food Technology (INTA) since 1997 to address malnutrition in the country. (Photo: S. Gorisek/IAEA) In Santiago, the Energy Metabolism and Stable Isotopes Laboratory (EMSIL) was established in 1998 under a national TC project CHI/7/007. It provided an isotope ratio mass spectrometer and training in the use of stable isotope techniques to assess body composition, infant feeding practices and total daily energy expenditure. (Photo: S. Gorisek/IAEA) Christine Slater, IAEA nutrition specialist said ”The laboratory is a Centre of Excellence in the region, hosting numerous fellowships, scientific visits, meetings and training courses for IAEA regional and national TC projects.” Many of them are organized by the Regional Cooperative Agreement for the Advancement of Nuclear Science and Technology in Latin America and the Caribbean (ARCAL). (Photo: C. Slater/IAEA) Close links between INTA, the Ministries of Health and Education, the National Board of Day Care Centres (JUNJI), the National Board of School Support (JUNAEB), and the National Sports Council have ensured that the information collected in IAEA projects has been used to inform policy decisions relating to school feeding programmes and physical activity in schools. (Photo: S. Gorisek/IAEA) In Chile, JUNAEB plans and provides food for schools and day care centres. Planned nutritious school feeding programmes target vulnerable families and include food fortifications and school breakfasts. To avoid an unintended increase in childhood obesity due to the feeding programmes, they are combined with scheduled physical activity. (Photo: S. Gorisek/IAEA) In collaboration with the Ministry of Health and JUNJI, Chile took part in the regional project RLA/7/008 on ‘Using Isotopes to Evaluate Nutrition Intervention Programmes’ from 1999 to 2004 to assess the impact of an iron fortified program on anaemia in children from six to 18 months. This programme helped reduce the rate of iron deficiency anaemia from 28% to 8%. (Photo: S. Gorisek/IAEA) Within the same regional project, a pilot study focussed on energy expenditure in children, aged 4-5 years, attending day care centres in Santiago. The children had an energy intake of 10% over recommended values and they were also found to be physically inactive. (Photo: S. Gorisek/IAEA) An intervention programme was developed and evaluated as part of two more regional projects RLA/6/052 and RLA/6/059 between 2005 and 2012, supported by the Ministry of Health. (Photo: S. Gorisek/IAEA) The results showed that intervention is easier and more effective with child care centres as children older than six are more difficult to control. Outside factors, such as the socio-economic status of the students’ families also contributed to whether or not the school intervention programme was successful. (Photo: S. Gorisek/IAEA) The National Institute of Sports reinforced the intervention with a grant of US $200 000 over the course of three years, starting in 2001. The Institute also printed educational materials for the children and didactic guides for the teachers. A physical activity programme was incorporated into the curriculum of day care centres in half of the country.  (Photo: S. Gorisek/IAEA) Chile is the only country in Latin America that has successfully halted the rise in childhood obesity in preschool children. The latest statistics show that between 2000 and 2010, the rate of obesity in children attending day care centres dropped from 10.4% to 8.4%.” (Photo: S. Gorisek/IAEA) To ensure sustainability, the intervention programme, initially supported by the IAEA technical cooperation programme has been adopted by the national authorities in Chile. Currently, about seven regions are taking part in the project, with plans to roll it out in the rest of the country. (Photo: S. Gorisek/IAEA)