Building training capacity for addressing
the obesity epidemic in the Americas
June 6th 2013
Building strong post graduate nutrition
programs: The case of Brazil
Gilberto Kac
[email protected]
[email protected]
Presentation outline
1. Obesity and overweight profile in Brazil
2. The role of CAPES and CNPq agencies
3. Important indicators of the Brazilian science
4. Building training capacity in nutrition/obesity
Part I
Obesity and overweight profile in Brazil
Brazilian Nutritional Scenario
National surveys since (1970, 1980, 1990, 2003,
2006 & 2009)
Overweight
Undernutrition
ENDEF 1974-75; PNSN 1989; PNDS 1996 e 2006; POF 2008-2009; VIGITEL
2006 a 2009.
Nutritional status – children under 5 years
Demographic Health Survey (DHS, 1996-2006)
16
14
13.4
12
10
8
6.8
7.3
7.4
1996
2006
6
4
2.5
2
1.6
0
Déficit
de altura para a
Stunting
idade
Excesso
de peso
overweight
Déficitwasting
de peso para a
idade
Trends of overweight – children and adolescents
(1974 – 2009)
Adolescents
Children 5 to 9 years
boys
girls
Stunting
boys
girls
Overweight
boys
girls
Obesity
boys
girls
Undernutrition
boys
girls
Overweight
boys
girls
Obesity
Trends of overweight and obesity
among adults (1974 – 2009)
Male
Female
Undernutrition
Male
Female
Overweight
Male
Female
Obesity
Obesity and excessive weight (>= 18years)
Vigitel 2006-2010.
47.2
52.1
38.5
44.3 42.7
48.1
11.4
masculino
feminino
total
14.4
masculino
excesso de peso
2006
11.4
15.5
11.4
feminino
obesidade
2007
2008
2009
2010
Excessive weight: average population increase 1.08%/yr
Obesity: average population increase 0.72%/yr
total
15
Prevalence of overweight and obesity – beneficiaries
from “Bolsa Família” Brazilian cash transfer program
45.0
(Brasil - SISVAN, 2010)
27.2
23.5
18.1
16.2
8.1
17.3
9.5
9.9
15.7
13.0
4.0
Meninas
Meninos
girls
boys
Menores
5 anos
Under 5deyears
Meninas
Meninos
girls
boys
anos
5 –5 a9 9years
overweight
Excesso
de peso
Feminino
female
Feminino
female
Adolescentes
adolescents
Adultos
Obesidade
obesity
adults
Part II
The role of CAPES and CNPq agencies
Capes
is a foundation linked to the Ministry of Education
whose mission is to build capacity in higher education
and support the training and development of
teachers of Basic Education
Main actions/mission
• Evaluation of the Brazilian Post Graduate system
• Fostering human resources qualification of high
level in Brazil and abroad
• Initial and continuing training of Basic Education
Teachers
Main actions/mission
• Promotion of international scientific
cooperation/internationalization
• Access and dissemination of scientific information:
Journals Portal
CNPq – National Council of scientific
and technology development
Mission: Focused
scientists funding
on
research
and
• To promote the development of scientific and
technologic research on all knowledge areas
• To promote and foment technologic innovation
CNPq – National Council of scientific
and technology development
• To promote agreements, protocols, programs and
interchange projects of technology among public
and private, national and international institutions
Part III
Important indicators of the Brazilian
science
CAPES – Brazilian Coordination Body for
the Training of University Level Personnel
Capes Geo system
1. Provides information on selected indicators year by
year
2. http://geocapes.capes.gov.br/geocapesds/
Coordination of personnel for graduate
studies – CAPES indicators
1. Number of post graduate scholarships (master and
doctoral)
2. Number of post graduate programs
3. Number of professors of post graduate programs
4. Number of post graduate students
Concepts
• A program includes both a master and a doctoral
• A course includes only a master
CNPq – National Council of scientific
and technology development
Brazil’s scientific trends
2% da prod. global
0,6% da prod. global
Dados ISI Web of Science cu=Brazil AND Document Type=(Article)
Scientific Production 2010
All areas
Medicine 2010
All categories
Scientific Production 2010
Parasitology
Dentistry
6
34
Beauchesne scientific
collaboration map
Masters and PhD degrees granted by Brazilian institutions
38,800 masters in 2009
38,8 mil mestres*
titulados em 2009
11,4 mil Phd’s in 2009
11,4 mil doutores titulados
em 2009
Investigators per million inhabitants
2002
2007
Baseado em dados do UNESCO Report, 2010
A low researcher per labor force ratio
Scientific specialization, 2008
Phd frequency and and
HDI. Brazilian states
Dados de 2005
Part IV
Building training capacity in nutrition
How to evaluate capacity building
Indicators and sources
1. Number of post graduate programs in nutrition in
Brazil
1.1 how many we are (map)
1.2 how we are distributed across the country
2.1 CAPES thesis database
2.1.1 Number of thesis on obesity (1987-2012)
2.1.2 Number of thesis on childhood obesity (1987-2012)
Indicators/sources
2.1 CAPES thesis database
2.1.3 Number of dissertations on obesity (1987-2012)
2012)
2.1.4 Number of dissertations on childhood obesity (1987-
3. Disciplines on obesity or correlated areas
4. Research lines and projects on obesity or correlated
areas
5. Publications
Number of graduate programs in nutrition,
how many we are and how we are
distributed
Decade 70 – 1 Program
UFPE (1971)
Decade 80 – 2 Programs
UFPE (1971)
UFRJ (1985)
Decade 90 – 5 programs
UFPB (1995)
UFPE (1971)
USP (1991)
UFRJ (1985)
UNIFESP (1991)
Decade 2000 (until 2006) – 11 Programs
UFRN (2001)
UFPB (1995)
UFAL (2005)
UFPE (1971)
UFBA (2005)
UNB (2000)
UFV (2001)
USP (1991)
UFRJ (1985)
UNIFESP (1991)
UFSC (2002)
Decade 2000 (until 2008) – 15 Programs
UFRN (2001)
UFPB (1995)
UFAL (2005)
UFPE (1971)
UFPE (2008)
UFMT
(2008)
UFBA (2005)
(Campus Avançado)
UNB (2000)
UFV (2001)
UFG
(2008)
USP (1991)
UFRJ (1985)
UNIFESP (1991)
UFSC (2002)
UERJ (2007)
Decade 2000 (until 2009) – 17 Programs
UFRN (2001)
UFPB (1995)
UFAL (2005)
UFPE (1971)
UFPE
UFMT
UFBA (2005)
UNB (2000)
UFV (2001)
UFG
UFOP
USP (1991)
UFRJ (1985)
UNIFESP (1991)
UFSC (2002)
UFPEL
UERJ
(Campus Avançado)
23 graduate programs (2013)
UFRN
UFRN (2001)
UECE
UFPB (1995)
UFAL (2005)
UFPE (1971)
UFPE
UFMT
UFBA (2005)
UNB (2000)
UFV (2001)
UFG
UFOP
USP (1991)
UFRJ (1985)
UNIFESP (1991)
UFPR
UFSC (2002)
UFPEL
UFMG
UERJ
(Campus Avançado)
Comments
1. History of graduate programs in Brazil
1. First master course was inaugurated only in 1971
2. Second course opened only in 1985 (14 years apart)
1. Recent increase on the number of programs (from
2000 on)
2. Network among coordinators
3. New area in CAPES. Very important issue
Number of professors, thesis, dissertations
and papers according programs
Total number of professors
181
Total number of thesis
154
Total number of
dissertations
670
CAPES thesis database
Masters dissertations
• Nutrition
Masters dissertations
• Obesity
CAPES thesis database (examples of
master’s dissertations on obesity)
1. Evaluation of markers of inflammation and vitamin in
obese patients with and without bariatric surgery
indication.
2. The influence of obesity and body fat location in
cardiovascular risk factors among adolescents in the
central region in Juiz de Fora.
Masters dissertations
• Childhood obesity
CAPES thesis database (examples)
1. The exclusive breastfeeding until 6 months, as a
protective factor in the development of childhood
obesity;
2. Childhood Obesity: Prevalence, Environmental
Influences, Metabolic Alterations and Quality of Life
in School from Pontal do Araguaia
Doctorate thesis
• Nutrition
Doctorate thesis
• Obesity
CAPES thesis database (examples)
1. Relationship
between physical
activity
and
nutritional status and biochemical markers in
adolescents from public schools in Piracicaba, São
Paulo;
2. Overweight and Metabolic Syndrome in teens:
prevalence and associated factors
Doctorate thesis
• Childhood obesity
CAPES thesis database (examples)
1. Study of body image, stress and food preferences in
adolescents and their caregivers;
2. Effect of nutrition education based on the
adequacy of the portioning of food, change in
body composition in obese adolescents treated in
an outpatient clinic.
Disciplines tought
1. Nutritional epidemiology
2. Nutrition and health in different life cycles
3. Genetics of obesity
4. Obesity across the life-course
Research lines
1. Epidemiology of nutritional problems
2. Descriptive epidemiology of health, food and
nutritional problems
3. Nutrition epidemiology
4. Epidemiology of the nutritional problems
Projetcs
1. Metabolic Syndrome and Childhood Obesity
2. Eating and Nutritional Disorders: the Polarization
Between the New and the Old Evils in the Context
of the Epidemiological Transition
3. Fatty acid concentrations during pregnancy and
excessive weight gain
Programs - Bibliographic production
• Ten-year increase in the prevalence of obesity and
reduction of fat intake in brazilian women 35 years
and older. Journal of Epidemiology and Community
Health (1979), V. 64, 3, 252-254
Programs - Bibliographic production
• Short stature of mothers from an area endemic for
undernutrition
is
associated
with
obesity,
hypertension and stunted children: a populationbased study in the semi-arid region of Alagoas,
Northeast Brazil. British Journal of Nutrition. 12-18.
Programs - Bibliographic production
• Perinatal
undernutrition-induced
obesity
is
independent of the developmental programming of
feeding. Physiology & Behavior. 96:481-492
Developing leadership programs
• A comprehensive approach to capacity building is
required.
– This needs to recognise the importance of workforce
development,
– Leadership development
– Academic institutional strengthening
– Organisational development and partnerships
Developing leadership programs
• There
is
merit in
developing international
competency standards specific to public health
nutrition workforce development that recognise
different workforce tiers (frontline, manager,
specialist) and different practice contexts (underand overnutrition).
Developing leadership programs
• There is considerable overlap in the competencies
needed by a public health nutritionist in dealing with
over- or under nutrition. A core set of competencies
are equally valid in either setting, with different
emphases depending on the context.
Profile of potential lidearships
• Broad vision of nutrition (there is no need to be a
specialist on all aspects on nutrition, but know well
the complex determination)
• Sense of opportunity,
• Capacity of dialogue with several fields
kwnoledge (scientific, popular and traditional)
• Ability to connect the different stakeholders
of
Conclusions
1. Overweight and obesity are important epidemiologic
problems in Brazil
2. Brazilian agencies such as Capes and Cnpq play a very
important role on the recent positive trends of indicators
such as number of masters and phds granted, scientific
papers published, grants and others
3. There is a lack of a program of leadership on capacity
building either on nutrition or obesity
Gilberto Kac
Professor Titular
[email protected]
Observatório de Epidemiologia
Nutricional
Universidade Federal do Rio de Janeiro