Catalina Castillo Montagut
Master Program in Food Technology
Nutrition and dietetics

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COLOMBIA

1. General Information.

1.1 Geographical items: Colombia is one of the American countries that is located in the northeast region of South America. Is the only nation in South America that has the privilege of have seas in the Caribbean sea and in the pacific Ocean. In the Caribbean has 3 islands San Andres, Providencia and Santa Catalina and in the Pacific coast Gorgona, Gorgonilla, Malpelo. Border with Panama in the Northweast, Venezuela and Brasil in the east, Perú un the south and Ecuador in the southwest. Colombia is organized as a unitary decentralized republic. Has 32 departments and the capital is Bogota. The area is 2’070.408 km2 in which 1’141.748km2 are continental and the 928.66n km2 are coast. Is the fourth nation in South América and with a population of 46 million people is the third one in Latin América after Brasil and México.

1.2 Economic Situation: Colombia is the fourth economy according to the International Monetary Fund and fifth according to the World Bank. The economy had been growingup with an annual average of 5.5% since 2002. In 2007 20, 5 million of people had work having a GDP per capita of US$ 9700 producing US $429. 500 millions for the GDP of the country. However 29.2% of the population lives in poverty. In 2007 the agriculture gives 11.5% to the National GDP and 22.7% of the people work in fishery, agriculture and livestock. However the main export product is petroleum. Another main industries are mining , textile, food, petrochemicals and transport machinery. Is one of the economical centers in Latin America and in 2009 was the 27 economy in the world.

2. Nutritional situation

2.1 Eating habits: In Colombia is common to have 5 meals per day, breakfast, mid- morning, lunch, mid afternoon and dinner. The bigger foods are Breakfast and lunch. The dishes change per region in the country. In general in Colombia is not common to have a healthy diet. The 39% of the population between 5 and 64 years, do not consume dairy products
The people with the lowest income the percentage is 47.3 In the rural areas the consumption is more than in the urban areas (50.3% vs 35.2%). The consumption of fruits and vegetables also is not appropriate. In the first case one of each 3 Colombians do not consume fruits all days. The population between 31-64 years have the lowest consumption( 38%). In the case of vegetables five of each seven (71.9%) between 5 and 64 years do not consume vegetables all days. In thepopulation under 18 each 3 of four do not eat vegetables all days. In the region where the consumption is the lowest in the central region. About the protein source one of each seven Colombians between 5 and 64 years do not eat meats or eggs everyday. In the urban areas the consumption is bigger than in the rural areas( Urban 87.3% and rural 79.2%). Bogota has the highest consumption.
One of each four (24.5%) between 5 and 64 years eat junk food every week. The people between 14 and 30 years have the highest rate and the consumption is higher in the urban areas. Another problem is the high consumption of soda; one of each five consume soda per day and one of each two per week. Finally in Colombia the consumption of candies is high. One of each 3 Colombians consumed dialy. 17.8% consume two or more times per day. The consumption is 12 percentage points bigger in the urban areas in comparison with rural areas

2.2 Breastfeeding and supplementary feeding.
In Colombia, 96% of the women start to breastfeeding their newborns and a little bit more of the half of the women does this practice in the first hour. In that practice the country had an improvement in the last 5 years (2005:49% 2010:56.6%). Nowadays the total duration in months of breastfeeding is 14 months, since 2005 that rate do not improve. The women who live in rural areas and with a low level in SISBEN breastfeed her children more time. The introduction ofsupplementary feeding start between 6 and 8 months. In the supplementary feeding of children under 3 years the most common foods are water, juices, agua de panela( traditional drink) and protein sources as beef, poultry, fish, egg. The consumption of fruits and vegetables is not common.

3. Nutritional deficiencies. The information that had National importance is taken from the National survey on Nutritional status Colombia (2005) (2010) (ENSIN 2005) (ENSIN 2010) and also the data that comes from the National survey on demography and health (ENDS). In these surveys the country was divided in 7 regions. East, Central, Pacific, Bogota, Orinoco and Amazon. SISBEN levels are used and those are related with the socio-economical capacity of the people.

3.1 Children under 5 years:
Those surveys show that the percentage of Chronical Malnutrition is about 13.2% that in an International level is considered as low prevalence. Between 2005- 2010 the reduction was about 17%. That leaves Colombia to 5.2% percentual points to accomplish the goal that was propose for the country in the objective of the development of the millennium to reduce the chronic malnutrition in children less than 5 years to 8.0%. The major proportion of chronic malnutrition are in the people that is in the 1, 2 level of SISBEN, in children with mothers that had less level of education and that lives in the Atlantic, Amazon Orinoco and Pacific region. The data showsthat Colombia is in the third pace of lower prevalence in Latin American countries.

3.2Children between 5 and 17 years:
The situation between the children of 5 years and 17 years shows an improvement; the growth retardation decrease 28%. Nevertheless 1 of each 10 children and teenagers between at those ages has retardation in growth. The high prevalence is in level 1 of SISBEN (13.4%), in children with mothers that does not have education (24.1%). In the rural area the prevalence is double in comparison with the urban area (15.2% vs. 7. 9). The departments with more problems are located in the Pacific and Amazon region. On the other hand the prevalence of obesity has increased a 25.9%. One of six children and teenagers
presents overweight or obesity and this relation increase with increasing the level of SISBEN and the educative level of the mother (9.4% for mothers without education and 26.8% with mothers with high education). In the urban area the percentage is about 19.2% and in the rural area about 13.4%

3.2 Adults (18-64 years
An increase in the weight of adult population is obtained in the surveys. One of two Colombians has overweight. The data shows an increase of 5.3 percentual points (2005: 45.9% and 2010: 51.2%). Is more common in females (55 % vs 45.6%). All the levels of SISBEN show high prevalence that is over 45%. The proportion is the same for all the departments and the prevalence is higher inurban areas (52.5%) that are over the national mean.

3.4 Anemia
One of each 6 children between 1 to 4 years and 1 of 6 pregnant women of the sample has anemia; this proportion is of 11% in teenagers between 13 and 17 years. Is frequently t in rural areas and in the population that is classified in 1 and 2 levels of SISBEN. The regions with the highest prevalence are Pacific region in children between 5-12 years and the Atlantic region in pregnant women. The level or prevalence of Anemia in Colombia in the group of 6 to 59 months is similar to the rates that were found in Cuba, Chile and Paraguay. In the group of children between 1 to 4 years the values are similar to Costa Rica, Dominican Republic, El Salvador, Nicaragua and Panama and are low values that in Guatemala, Honduras, Jamaica and Perú.
One of each 4 children between 1 to 4 years has vitamin A deficiency and 1 of each 2 in this group has Zinc deficiency; this situation is considered as a public health problem according to WHO.

4. Policies and actual plans
Nowadays Colombia has 4 policies that have objectives related with the improvement of the nutritional situation, each one of that policies have different plans and important interventions.

4.1 National policy of food security and Nutrition.
This policy was approved in 2008. The policy said “Enough availability and stable of food, opportune access and consumption and permanent of those in quantity,quality and safety by everyone under conditions that enable the biological utilization, in order to have a healthy and active life”. This policy is directed to all the population and the main objective is guarantee that all the population has access and consumes food in permanent and opportune in enough quantity, variety, quality and safety (1). This policy is based on the concept of food and nutrition security that involves 5 aspects
1. Availability: Refers to the amount of foods that are available at national, regional and local level; related with the supply in front of the requirements of the population. Strongly dependant on the production and importation of products
2. Access: Refers to the food that a family, community or country can get. Is the possibility that all the people can reach an adequate and sustainable feed.
3. Consumption: Refers to the food that the people eat and the selection, believes, attitudes and feed practices.
4. Use or biological utilization: How and How much the body take advantage of the intake of food that consumes and how those food is transform in nutrients and the assimilation process
5. Quality and security: Characteristics of the products that guarantee that can be consume by humans, require compliance of a series of conditions during the supply chain until the consumption.

The compliance of this policy is being carried out through plans that are managed by SocialAction, Social Protection ministry and, Colombian Family Welfare Institute (ICBF). Into the plans of the policy we can find.
* School feeding program: This program is carried out by the ICBF and the Education ministry. In this program breakfast or lunch plus another food in the morning or afternoon is given. The plan is intended to children that study in public schools in urban or rural areas that are in the lower socio-economical status.
* Comprehensive health care units and recovery nutrition for infants: Carried by ICBF. The main objective is the reduction of the prevalence of acute malnutrition in children of less than 5 years.
* Outpatient recovery: Carried by ICBF. The main objective is the reduction of the prevalence of acute malnutrition in children of less than 5 years.
* National feeding program for the elderly: This plan is managed by ICBF and Social Protection minisitry; in this plan the objective is improve the consumption of food. The program is intended to the elderly of low income and also to the elderly that had been displaced by violence.
* Membership to compensation places: This program is on charge of Superintendence of familiar subsidy. In this plan the compensation places offers nutrition services, feeding education programs and also they give money and food.
* Care program for those displaced by the protracted relief operation: This program is available in 20 departments and the mainobjective is to improve the conditions of food vulnerability of displaced populations to contribute to socio economic and physiological recovery.
* Food Safety net program: Stimulation of food production projects for home consumption to encourage the permanence of the population with risk of displacement in the rural areas and also increase the return of displaced populations to their land.
* Draft comprehensive family care Wayuu. Contribute to improve the quality of life and strengthening Wayúú families, through nutritional support, basic sanitation, health and hygiene, productive projects and community organizations.

4.2 National public policy of early childhood. “Colombia for the early childhood”
This policy is included in the National plan of development. The general objective of this policy is to promote the integral development of the children from gestation until 6 years old, responding their needs and their specific characteristics, contributing to the equity and social inclusion in Colombia. In this policy the social protection ministry develop and promote the social mobilization around the protection and support of breastfeeding and promote the organization of institutional and community groups. In 2008 the ministry and the ICBF launch the “Breastfeeding week” where they sought to increase awareness regarding the value of breastfeeding and the creation of optimal conditions for providing support in mothers inall stages. The programs that are related with this policy are coordinated by ICBF, Social protection ministry and National Education ministry.
* Comprehensive care program for early childhood. Promote integral development of children from gestation to 6 years through educational, care and nutrition components.
* Children with love breakfast programs. Coordinated by ICBF. This program seeks to develop activities that promote health and prevention of childhood diseases. Social practices were feeding, health and nutrition are promoted.
* Plan of family welfare group homes: This program provides food supplement, also promotes psychosocial activites. Managed by ICBF.
* Home FAMI: Care of pregnant women and nursing mothers and children less than 2 years, in this program Bienestarina is given to the women and children and also promotes nutrition education plans.
* Social kindergardens: ICBF give attention to children between 6 months and 4 years old.

4.3 Together network and families in action. The network “together” is a strategy of integral intervention that is into the Social protection system that was created by the law 789 of 2002 ). This strategy is defined as the plubic policies that help to decrease the vulnerability and improve the quality of life of Colombian population. The objective is motivating 1.5 millions of Colombian families to get over the poverty situation through 45 basic achievements.This policy only has one plan that is Families in action program in which the main objective is the formation of the people that lives in extreme poverty conditions. The intervention that is made in this plan cover educative subsidy for families that have children between 7 and 17 years. In health and nutrition they make actions to mothers and children between 0 and 6 years.

4.4 Obesity law. This law was approved in 2009. This law gives guidelines in the regulation for sale and advertising of food supply and protect special the advertising for children.  Regulation of production and industrial controls. Laws and regulations related to labeling and food guides. Promotion of healthy lifestyles, including education in control of food intake and physical activity. Modification of environments for healthy lifestyles.

5. Bibliography
1. ICBF. https://www.icbf.gov.co/icbf/directorio/portel/libreria/php/decide.php?patron=03.0101020
2. Red Juntos https://web.presidencia.gov.co/especial/juntos/index.html
3. National survey of Nutritional situation in Colombia 2005. ENSIN. Protection Social Ministry. ICBF, National Institute of Health, Profamilia.
4. National survey of Nutritional situation in Colombia 2010. ENSIN.Protection Social Ministry. ICBF, National Institute of Health, Profamilia.
5. Nutrition in Colombia. Strategy 2011-2014. Technical notes number 243. Inter- American development Bank. December 2010.