1. Building training capacity for addressing the obesity epidemic in the Americas June 6th 2013

2. Building strong post graduate nutrition programs: The case of Brazil Gilberto Kac 50.nutr@capes.gov.com.br gilberto.kac@gmail.com

3. 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

4. Part I Obesity and overweight profile in Brazil

5. Brazilian Nutritional Scenario National surveys since (1970, 1980, 1990, 2003, 2006 & 2009) ENDEF 1974-75; PNSN 1989; PNDS 1996 e 2006; POF 2008-2009; VIGITEL 2006 a 2009. Overweight Undernutrition

6. Nutritional status – children under 5 years Demographic Health Survey (DHS, 1996-2006)

7. Trends of overweight – children and adolescents (1974 – 2009) Children 5 to 9 years Adolescents StuntingObesityOverweight boys girls OverweightObesityUndernutrition boys girls

8. Trends of overweight and obesity among adults (1974 – 2009) UndernutritionOverweightObesity MaleFemale

9. Obesity and excessive weight (>= 18years) Vigitel 2006-2010. Excessive weight: average population increase 1.08%/yr Obesity: average population increase 0.72%/yr

10. Prevalence of overweight and obesity – beneficiaries from “Bolsa Família” Brazilian cash transfer program (Brasil - SISVAN, 2010) girls boys female Under 5 years5 – 9 years adolescents adults overweight obesity

11. Part II The role of CAPES and CNPq agencies

12. 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

13. 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

14. Main actions/mission Promotion of international scientific cooperation/internationalization Access and dissemination of scientific information: Journals Portal

15. CNPq – National Council of scientific and technology development Mission: Focused on research and scientists funding To promote the development of scientific and technologic research on all knowledge areas To promote and foment technologic innovation

16. 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

17. Part III Important indicators of the Brazilian science

18. CAPES – Brazilian Coordination Body for the Training of University Level Personnel

19. Capes Geo system 1.Provides information on selected indicators year by year 2.http://geocapes.capes.gov.br/geocapesds/http://geocapes.capes.gov.br/geocapesds/

20. 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

21. Concepts A program includes both a master and a doctoral A course includes only a master

30. CNPq – National Council of scientific and technology development

31. Brazil’s scientific trends Dados ISI Web of Science cu=Brazil AND Document Type=(Article) 0,6% da prod. global 2% da prod. global

32. Scientific Production 2010 All areas

33. Medicine 2010 All categories

34. 34 Scientific Production 2010 6 ParasitologyDentistry

35. Beauchesne scientific collaboration map

37. 11,4 mil doutores titulados em 2009 38,8 mil mestres * titulados em 2009 Masters and PhD degrees granted by Brazilian institutions 38,800 masters in 2009 11,4 mil Phd’s in 2009

38. Investigators per million inhabitants Baseado em dados do UNESCO Report, 2010 2002 2007

39. A low researcher per labor force ratio

40. Scientific specialization, 2008

41. Phd frequency and and HDI. Brazilian states Dados de 2005

42. Part IV Building training capacity in nutrition

43. How to evaluate capacity building

44. 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)

45. Indicators/sources 2.1 CAPES thesis database 2.1.3 Number of dissertations on obesity (1987-2012) 2.1.4 Number of dissertations on childhood obesity (1987- 2012) 3. Disciplines on obesity or correlated areas 4. Research lines and projects on obesity or correlated areas 5. Publications

46. Number of graduate programs in nutrition, how many we are and how we are distributed

47. Decade 70 – 1 Program UFPE (1971)

48. Decade 80 – 2 Programs UFPE (1971) UFRJ (1985)

49. Decade 90 – 5 programs UFPE (1971) UFRJ (1985) UFPB (1995) USP (1991) UNIFESP (1991)

50. Decade 2000 (until 2006) – 11 Programs UFPE (1971) UFRJ (1985) UFPB (1995) USP (1991) UNIFESP (1991) UNB (2000) UFV (2001) UFSC (2002) UFRN (2001) UFBA (2005) UFAL (2005)

51. Decade 2000 (until 2008) – 15 Programs UFG (2008) UFPE (2008) ( Campus Avançado) UERJ (2007) UFMT (2008) UFPE (1971) UFRJ (1985) UFPB (1995) USP (1991) UNIFESP (1991) UNB (2000) UFV (2001) UFSC (2002) UFRN (2001) UFBA (2005) UFAL (2005)

52. Decade 2000 (until 2009) – 17 Programs UFPEL UFOP UFG UFPE ( Campus Avançado) UERJ UFMT UFPE (1971) UFRJ (1985) UFPB (1995) USP (1991) UNIFESP (1991) UNB (2000) UFV (2001) UFSC (2002) UFRN (2001) UFBA (2005) UFAL (2005)

53. 23 graduate programs (2013) UFMG UFPR UFRN UFPEL UFOP UFG UFPE ( Campus Avançado) UERJ UFMT UFPE (1971) UFRJ (1985) UFPB (1995) USP (1991) UNIFESP (1991) UNB (2000) UFV (2001) UFSC (2002) UFRN (2001) UFBA (2005) UFAL (2005) UECE

54. 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

55. Number of professors, thesis, dissertations and papers according programs

57. Total number of professors 181

58. Total number of thesis 154

59. Total number of dissertations 670

63. CAPES thesis database

64. Masters dissertations Nutrition

65. Masters dissertations Obesity

66. 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.

67. Masters dissertations Childhood obesity

68. 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

69. Doctorate thesis Nutrition

70. Doctorate thesis Obesity

71. 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

72. Doctorate thesis Childhood obesity

73. 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.

74. Disciplines tought 1.Nutritional epidemiology 2.Nutrition and health in different life cycles 3.Genetics of obesity 4.Obesity across the life-course

75. 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

76. 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

77. 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

78. Programs - Bibliographic production Short stature of mothers from an area endemic for undernutrition is associated with obesity, hypertension and stunted children: a population- based study in the semi-arid region of Alagoas, Northeast Brazil. British Journal of Nutrition. 12-18.

79. Programs - Bibliographic production Perinatal undernutrition-induced obesity is independent of the developmental programming of feeding. Physiology & Behavior. 96:481-492

80. 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

81. 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 (under- and overnutrition).

82. 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.

83. 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 of kwnoledge (scientific, popular and traditional) Ability to connect the different stakeholders

84. 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

85. Gilberto Kac Professor Titular gilberto.kac@gmail.com Observatório de Epidemiologia Nutricional Universidade Federal do Rio de Janeiro