Addressing the double burden of malnutrition in Peru: using a community-based system dynamics approach to improve food systems

解决秘鲁营养不良的双重负担：利用基于社区的系统动力学方法改善粮食系统

• 批准号: BB/T009004/1
• 负责人: Christopher Joseph Millett
• 金额: $ 87.9万
• 依托单位: Imperial College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=BB%2FT009004%2F1
• 关键词: Addressing; double; burden; malnutrition; Peru

The Peruvian people suffer from what has been described as a "double burden" of malnutrition. This means that they simultaneously experience undernutrition and over-nutrition. Undernutrition includes inadequate intake of vitamins, low height for age, or low weight for height. Over-nutrition is the result of high consumption of unhealthy and processed foods, which are high in fat, sugar and salt, and includes overweight and obesity and other diet-related diseases such as diabetes and heart disease. The way that food is produced, sold and consumed in the country ("the food system") is a major driver of this problem. While Peru has undertaken some bold actions to address malnutrition over the past two decades most policies have a one-sided focus, targeting either under or over-nutrition and fail to address both aspects. The process of identifying and evaluating policies to address this problem needs to take into account the complex economic, social, and cultural factors that influence food systems.We will use innovative research methods to identify drivers of the double burden of malnutrition in Peru and potential policy solutions which take these complex factors into account. The specific objectives of this project are: 1. Map the drivers of the food system that contribute to the double burden of malnutrition in three diverse regions in Peru; 2. Identify policies and interventions that would address the double burden of malnutrition through changes in the food system; 3. Quantify the impacts of identified policies and interventions on the double burden of malnutrition; 4. Prioritise identified policies and interventions and actively disseminate recommendations Our research project is characterised by the active involvement of members of the community throughout all its stages. The projects starts with workshops in three regions of Peru (Lima, Tumbes and Huancavelica) during which our research team will guide small groups of community stakeholders to conceptualise and map the drivers of the food system that contribute to the double burden of malnutrition. Community stakeholders will include lay members of the community, policymakers at local and national government authorities, and academics, with a deep understanding of the community issues and experiences, either as residents or organisers, leaders, and service providers. At the next stages of the project, stakeholders will guide the research team to identify relevant policy options that are appropriate at national and regional level. They will also be consulted throughout the quantitative evaluation of these policies to ensure that it accurately represents stakeholder views as expressed during the workshops. Finally, they will have an active role in prioritising and recommending appropriate policy options, disseminating the results of the project to other members of the community, and acting towards policy change.Our research project is a collaboration between universities in Peru, the United Kingdom and Brazil. The research team have expertise in policy evaluation, food systems and public heath nutrition, modelling and health economics. The project will strengthen academic collaboration between these institutions and build research capacity in Peru. It will also strengthen collaboration between Peruvian institutions and members of the local community by establishing long-term working relationships between parties.

秘鲁人民遭受着被称为营养不良的“双重负担”。这意味着他们同时经历营养不足和营养过剩。营养不良包括维生素摄入不足，身高低于年龄，或体重低于身高。营养过剩是大量食用不健康和加工食品的结果，这些食品脂肪、糖和盐含量高，包括超重和肥胖以及糖尿病和心脏病等其他与饮食有关的疾病。该国生产、销售和消费粮食的方式（“粮食系统”）是造成这一问题的主要原因。虽然秘鲁在过去20年中采取了一些大胆的行动来解决营养不良问题，但大多数政策的重点都是片面的，不是针对营养不足就是针对营养过剩，未能解决这两个方面。确定和评估解决这一问题的政策的过程需要考虑到影响粮食系统的复杂的经济、社会和文化因素。我们将使用创新的研究方法来确定秘鲁营养不良双重负担的驱动因素以及考虑到这些复杂因素的潜在政策解决方案。本项目的具体目标是：1.绘制导致秘鲁三个不同地区营养不良双重负担的粮食系统驱动因素图; 2.确定政策和干预措施，通过改变粮食系统解决营养不良的双重负担; 3.量化已确定的政策和干预措施对营养不良双重负担的影响; 4.优先确定政策和干预措施，并积极传播建议我们的研究项目的特点是社区成员在其所有阶段的积极参与。该项目首先在秘鲁的三个地区（利马，通贝斯和万卡韦利卡）举办研讨会，在此期间，我们的研究团队将指导社区利益相关者小组概念化并绘制导致营养不良双重负担的粮食系统驱动因素。社区利益相关者将包括社区的外行成员，地方和国家政府当局的决策者以及学者，对社区问题和经验有着深刻的理解，无论是作为居民还是组织者，领导者和服务提供者。在项目的下一阶段，利益攸关方将指导研究小组确定适合国家和区域一级的相关政策选择。在对这些政策进行定量评价的整个过程中，还将征求他们的意见，以确保评价准确反映利益攸关方在讲习班期间表达的意见。最后，他们将在优先考虑和建议适当的政策选择，向社区其他成员传播项目的结果，并采取行动实现政策变革方面发挥积极作用。我们的研究项目是秘鲁，英国和巴西大学之间的合作。该研究小组在政策评估、粮食系统和公共卫生营养、建模和卫生经济学方面具有专长。该项目将加强这些机构之间的学术合作，并建设秘鲁的研究能力。它还将通过在各方之间建立长期工作关系，加强秘鲁机构与当地社区成员之间的合作。

项目成果

Modelos Mentales

莫德洛斯·门塔莱斯

• 发表时间: 2022
• 作者: Gaona Romero C

Peru initiates the IMPACT project.

秘鲁启动了 IMPACT 项目。

• DOI: 10.1016/s1474-4422(23)00239-9
• 发表时间: 2023
• 期刊: The Lancet. Neurology
• 作者: Lúcar,MiriamG;VeraTudela,JoséCarlos;Anza-Ramirez,Cecilia;Miranda,JJaime;Butler,ChristopherR;IMPACTDementiaStudyGroup
• 通讯作者: IMPACTDementiaStudyGroup

Effect of preterm birth on growth and blood pressure in adulthood in the Pelotas 1993 cohort.

• DOI: 10.1093/ije/dyad084
• 发表时间: 2023-12-25
• 期刊: International journal of epidemiology
• 影响因子: 7.7

Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon.

• DOI: 10.1186/s12939-022-01773-7
• 发表时间: 2022-12-19
• 期刊: INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
• 影响因子: 4.8
• 作者: Bressan, Tiana;Valdivia-Gago, Andrea;Silvera-Ccallo, Rosa M.;Llanos-Cuentas, Alejandro;Condor, Daniel F.;Padilla-Huamantinco, Pierre G.;Vilcarromero, Stalin;Miranda, J. Jaime;Zavaleta-Cortijo, Carol
• 通讯作者: Zavaleta-Cortijo, Carol

Iceberg del Pensamiento Sistémico: Buceando Bajo la Superficie

Iceberg del Pensamiento Sistémico: Buceando Bajo la Superficie

• 发表时间: 2022
• 作者: Gaona Romero C