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Doubling of overweight in 5 years among Chilean preschool children in a social welfare program

Childhood obesity is being increasingly recognized as a major public health problem for developing countries but studies critically analyzing trends and contributing factors are limited. Chile is in the advanced stages of the nutrition transition and obesity is more common among the poor. We examined overweight prevalence (POW; WHZ >2, WHO1978) and trends, in children 2–6 y old enrolled in a social welfare program in the Santiago area of Chile, 1996–2001 (Mean n/year=28562). As part of the program, children receive day care and are offered breakfast, lunch and an evening snack 5 days/wk. After controlling for participants characteristics, POW increased from 5.7% (1996) to 11.2 % (2001); increases were similar across sex, age, mild stunting (HAZ <‐1; WHO 1978) and community poverty level. Girls, non‐stunted and older children consistently demonstrated higher POW (Mean adjusted %: 11.7 (girls) vs 9.5 (boys); 11.2 (HAZ >−1) vs 6.1 (HAZ<−1); 15.1 (5‐6y) vs 13.3 (4‐5y) vs 10.2 (3‐4y) vs 5.6 (2‐3y)). A longitudinal analyses of 19401 children measured for 3 consecutive y showed that after controlling for confounding factors, the degree of program participation was positively associated with POW (POR0‐1y=1.0; POR1‐2y=1.23; POR2‐3y=1.28; p<.0001). Overall, in these children, POW was greater and increased more rapidly than national levels for the same period (MINSAL, 2005), indicating that this is a population prone to overweight. Factors contributing to risk of overweight, and specifically the role of program participation, require further exploration in order to develop and implement effective preventive strategies.