Movimientos sociales, democracia y gobernabilidad neoliberal en América Latina

A lo largo de la década de los 90, numerosos países de América Latina y el Caribe vivieron el inicio de un nuevo ciclo de protestas sociales que, en cuestionamiento de las políticas neoliberales imperantes, fue protagonizado en gran medida por movimientos sociales y populares distintos de aquellos que habían ocupado la escena de la contestación social en décadas pasadas. Esta irrupción en la ciudadela de la gobernabilidad política neoliberal de los sectores sociales más castigados por la aplicación de este recetario (campesinos e indígenas, los sin trabajo y sin tierra, los trabajadores y sectores urbanos empobrecidos) no sólo abrió nuevos horizontes de futuro -agrietando la hegemonía del pensamiento único- sino que significó también el desarrollo de una intensa experimentación democrática, de reconstitución de alternativas societales, de reapropiación social de lo público y revitalización y ampliación de la autonomía que caracterizaron la emergencia de estos movimientos

Regiones y distribución espacial de las actividades económicas en Sonora

El objetivo del trabajo es demostrar que la distribución espacial de los sectores no siem- pre responde a la presencia de externalida- des regionales. Se analiza el comportamien- to de veintitrés sectores agregados para el caso de Sonora, considerando inicialmente su distribución en el espacio y, posterior- mente, la infl uencia del espacio en esta dis- tribución, con base en las herramientas ana- líticas “I de Moran global” y LISA (Local Indicators of Spatial Association). Se obser- va una alta concentración o especialización espacial, a la vez que una muy baja correla- ción espacial, lo que nos lleva a concluir que la localización de los sectores estudiados no responde a externalidades regionales, sino más bien a economías de urbanización u otras no regionales

Avaliação da ementa, adequação do consumo alimentar e desperdício em creches públicas concessionadas no Brasil

Introdução: A garantia de uma alimentação adequada, em seu aspecto quantitativo e qualitativo, éde suma importância para a promoção do crescimento e desenvolvimento das crianças que frequentamcreches.Objectivos: Avaliar qualitativamente as ementas, em termos nutricionais e sensoriais, a adequaçãodo consumo alimentar e o desperdício de alimentos oferecidos às crianças frequentadoras de crechespúblicas de gestão concessionada no município de São Paulo, Brasil.Metodologia: Este estudo é transversal e os dados foram recolhidos nos berçários de quatro creches,que recebiam 200 crianças entre 12 e 36 meses. Cada creche foi avaliada durante três dias, totalizando24 dias e 120 refeições. A qualidade da ementa foi avaliada segundo o método Análise Qualitativadas Preparações de Ementas e o consumo alimentar foi avaliado pelo método de pesagem directa dosalimentos, sendo calculada a adequação segundo recomendações do Programa Nacional de AlimentaçãoEscolar para energia, hidrato de carbono, proteína, gordura, fibra, vitamina A e C, cálcio, ferro esódio. O desperdício de alimentos foi analisado pelo Índice de Resto-Ingestão (IR).Resultados: Os resultados reflectiram que a oferta de hortícolas foi insuficiente em mais de 90%dos dias e, a quantidade de hortícolas folhosas e alimentos ricos em enxofre foi compatível com orecomendado em 62% e 54% dos dias analisados, sendo expressiva a oferta de doces e alimentoscontendo ácidos gordos trans. O consumo de energia, macronutrientes, fibra, vitamina A, cálcio e ferrofoi inferior ao recomendado e o de vitamina C e sódio foi de duas a três vezes superior. O IR varioude 27 a 42% nas creches e de 10 a 49% nos alimentos analisados.Conclusões: Salienta-se a necessidade de revisão das preparações das refeições visando melhorara aceitação pelas crianças, e do planeamento das ementas propostas no que concerne ao aportenutricional e porcionamento per capita estipulados

Risk Factors for Anemia among Brazilian Infants from the 2006 National Demographic Health Survey

Iron deficiency is an important public health problem. An understanding of anemia risk factors is essential to informed health policies. We performed a cross-sectional study of 1,382 infants from the 2006 Brazilian National Survey on Demography and the Health of Women and Children. Mild and moderate anemia was characterised by hemoglobin levels below 11.0 and 9.5 g/dL, respectively. Rates for mild and moderate anemia were 25.9% and 9.9%, respectively. The logistic model included three risk factors for mild anemia—urban residence area (OR = 2.5; P = 0.004), fever in the past 2 weeks (OR = 2.4; P < 0.001), and age less than 12 months (OR = 1.7; P = 0.024). Strategies to control infant anemia should include health promotion and nutritional education for families from all socioeconomic levels. Lifestyle quality improvement based on adequate food consumption must be achieved by communities in all macroregions, and especially in urban areas

Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review

OBJETIVO: Avaliar a efetividade da educação nutricional em escolas na redução ou prevenção de sobrepeso e obesidade em crianças e adolescentes. FONTES DOS DADOS: Busca sistemática em 14 bases de dados e cinco revisões sistemáticas por ensaios controlados randomizados realizados em escolas com o objetivo de reduzir ou prevenir o sobrepeso em crianças e adolescentes. O índice de massa corporal e o consumo de frutas e verduras foram utilizados como desfechos primário e secundário, respectivamente. Não houve restrição de data de publicação ou idioma, exceto para idiomas com logogramas. Excluímos estudos em populações com distúrbios alimentares, dislipidemia, diabetes e deficiência física ou mental, e que utilizassem medicamentos ou suplementos alimentares. A avaliação por título e resumo e a avaliação de qualidade foram realizadas de forma independente por dois pesquisadores. Utilizamos as orientações do Centre for Reviews and Dissemination para a elaboração de artigos de revisão em saúde e o programa EPPI-Reviewer 3. SÍNTESE DOS DADOS: Das 4.809 referências inicialmente encontradas, 24 artigos preencheram os critérios de inclusão. Os dados extraídos apresentam evidências de efeitos antropométricos positivos e de aumento no consumo de frutas e verduras. As intervenções com as seguintes características demonstraram ser efetivas: duração > 1 ano, introdução como atividade regular da escola, envolvimento dos pais, introdução da educação nutricional no currículo regular e fornecimento de frutas e verduras pelos serviços de alimentação da escola. CONCLUSÃO: As intervenções para reduzir o sobrepeso e a obesidade e aumentar o consumo de frutas e verduras foram efetivas nos estudos bem conduzidos.OBJECTIVE: To evaluate the effectiveness of school-based nutrition education in reducing or preventing overweight and obesity in children and adolescents. SOURCES: Systematic search in 14 databases and five systematic reviews for randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. Body mass index and fruit and vegetable intake were used as primary and secondary measures of outcome, respectively. There was no restriction by date of publication or language, except for languages with structured logograms. We excluded studies on specific populations presenting eating disorders, dyslipidemia, diabetes, and physical or mental disabilities, as well as studies that used drugs or food supplements as components of the intervention. The assessment by title and abstract and the quality assessment were performed independently by two researchers. We used the Centre for Reviews and Dissemination's guidance for undertaking reviews in health care and the software EPPI-Reviewer 3. SUMMARY OF THE FINDINGS: From the initially retrieved 4,809 references, 24 articles met the inclusion criteria. The extracted data show that there is evidence of positive effects on anthropometry and of increase in fruit and vegetable consumption. Characteristics of the interventions that demonstrated effectiveness are: duration > 1 year, introduction into the regular activities of the school, parental involvement, introduction of nutrition education into the regular curriculum, and provision of fruits and vegetables by school food services. CONCLUSION: Interventions in schools to reduce overweight and obesity, as well as to increase fruits and vegetable consumption, have demonstrated effectiveness in the best-conducted studies

Frequency of nutritional disorders and their risk factors among children attending 13 nurseries in São Paulo, Brazil. A cross-sectional study.

CONTEXT AND OBJECTIVE: Nutritional disorders are associated with health problems earlier in life. The objective here was to estimate the frequency of nutritional disorders and their risk factors among children. DESIGN AND SETTING: Cross-sectional study in nurseries at 13 day-care centers in São Paulo, Brazil. METHODS: The mothers of 482 children were interviewed, with anthropometry on these children. Children whose anthropometric indices for weight and height were greater than two standard deviations were considered to have nutritional disorders. RESULTS: Children in families with lower per capita income (odds ratio [OR]: 2.25; 95% confidence interval, CI: 1.08-4.67) and who presented neonatal risk (OR 8.08; 95% CI: 2.29-28.74), had incomplete vaccinations (OR 3.44; 95% CI: 1.15-10.31) or were male (OR 3.73; 95% CI: 1.63-8.56) were more likely to be malnourished. Children in families with lower per capita income were also less likely to be overnourished (OR 0.40; 95% CI: 0.19-0.88). Children who were exclusively breastfed for less than two months (OR 2.95; 95% CI: 1.35-6.44) or who were male (OR 2.18; 95% CI: 1.02-4.65) were also at greater risk of being overnourished. Children who presented neonatal risk (OR 3.41; 95% CI: 1.04-11.23), had incomplete vaccinations (OR 3.18; 95% CI: 1.307.76), or were male (OR 2.76; 95% CI: 1.56-4.90) were more likely to have a nutritional disorder. CONCLUSIONS: Nutritional disorders remain present in children attending nurseries in São Paulo. Actions should focus on boys, children who were exclusively breastfed for less than two months and those without up-to-date vaccinations

Repositioning of the global epicentre of non-optimal cholesterol

Artículo con numerosos autores, sólo se mencionan el primero, los de la UAM y el grupo colectivoHigh blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk— changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.This study was funded by a Wellcome Trust (Biomedical Resource & Multi-User Equipment grant 01506/Z/13/Z) and the British Heart Foundation (Centre of Research Excellence grant RE/18/4/34215). C.T. was supported by a Wellcome Trust Research Training Fellowship (203616/Z/16/Z