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4 Managing the Global Epidemic: Challenges and Cross-Cultural Insights
Pages 41-52

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From page 41...
... • Indigenous Peoples' food systems and practices can inform solutions to the global obesity epidemic. Cultivating self-­ determination is key to preventing obesity in Indigenous popu lations, as is understanding the ecology and the environment in their home territories.
From page 42...
... , scarce resources to invest in obesity prevention and in evaluation of interventions, and primary health care systems that were created when infectious diseases were the main concern and thus lack the resources to handle chronic diseases. Barquera highlighted as another challenge that Mexico experiences interference from industry, such as aggressive marketing of unhealthy foods in poor communities.
From page 43...
... He cited research suggesting that this label is not well understood by Mexican nutrition students at the university level (Stern et al., 2011) , and that only 13.8 percent of respondents in a Mexican national survey said they understood it.
From page 44...
... It's high in something." Barquera then turned to the Mexican Observatory for Obesity, describing it as a government-appointed advisory council that makes decisions about obesity prevention actions in Mexico. About half of the council members are associated with the food industry, he said, adding that these members opposed public health and obesity prevention initiatives that were submitted to the council.
From page 45...
... Apparently, she continued, within high-income countries these forces operate differentially for minority populations, and the question is why. Kumanyika went on to review data on obesity prevalence stratified by racial/ethnic group for adults in Australia, England, the Netherlands, New Zealand, and the United States (Australian Bureau of Statistics, 2013; CDC, 2016; Hales et al., 2017; New Zealand Ministry of Health, 2018; Public Health England, 2016; Schmengler et al., 2017)
From page 46...
... Accordingly, she observed, environmental explanations now dominate the discussion. She added that cross-national studies within Western environments indicate effects of national contexts, and she reminded participants of Meeks's data on the differences among Ghanaian populations living in three European cities (see Chapter 2)
From page 47...
... M •  istorical and ongoing trauma H Socioeconomic status; •  eighborhood access (poverty) N social position •  ood purchasing power F • Activity patterns • Housing •  ccess to health care A Migration and migration •  dverse circumstances prior to or during migration A stress •  brupt exposure to obesogenic environment A •  oss of connections with home environment L • Downward mobility Language/literacy •  ccess to nutrition information A •  ccess to quality education A •  etter social integration B Cultural assets and •  reservation of traditional healthy behaviors P protection •  uffering from aggressive promotion of unhealthy foods B and beverages •  oping mechanisms, including faith C Structural empowerment •  bility to benefit from new opportunities A and resilience •  ocial capital and social support S Stress •  ating and physical activity E • "Embodiment" •  onstant need to cope C • Sleep NOTE: Stress is highlighted to denote that its influence is moderated through pathways related to all of the other variables.
From page 48...
... where we are today." THE CONTRIBUTION OF TRADITIONAL CULTURES TO RESOLVING THE OBESITY PANDEMIC Harriet Kuhnlein, emerita professor at McGill University, focused on Indigenous Peoples as she explored how traditional cultures can inform solu­ions for the obesity pandemic. Although many countries lack census t data disaggregated by ethnicity, she began, the United Nations has on record ­ 370 million Indigenous and tribal people in more than 90 countries, repre FIGURE 4-2  Pathway for production of racial/ethnic and migrant inequities in obesity and potential points to intervene.
From page 49...
... They tallied the number of species used as food in each culture, finding that it reached nearly 400 in some tropical locations. Based on dietary records collected in the field, Kuhnlein noted, those traditional local foods represented anywhere from 10 to 98 percent of the energy consumed by people in these 12 cultures (Kuhnlein et al., 2009)
From page 50...
... "Indigenous Peoples understand that food use touches every­ thing," she remarked, including mental, physical, social, and spiritual well-being. She proposed building an international platform for gathering knowledge of traditional and Indigenous holistic food systems and health systems with ecological sustainability, and urged intercultural education as a way to help resolve the obesity pandemic.
From page 51...
... She proposed that it may be more productive for people to retain their cultural group perspectives and leverage the associated strengths, but acknowledged that the topic is extremely complex. Kuhnlein recounted her experience broaching the topic of obesity with Indigenous Peoples in British Columbia.
From page 52...
... As an example of how globalization of trade has impacted obesity prevention efforts, he cited the recent negotiation of a global trade agreement in North America, which included an attempt to limit countries' power to require warning labels on food products. This attempt was ultimately defeated, he noted, because public health and civil society groups spoke up.


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