The field of nutrition, originally included in the area of biological sciences, has been advancing in the thematic areas of Social, Human and Environmental Sciences, constituting a complex and paradoxical nutritional epidemiological scenario in the country, ranging from hunger to obesity, and characterized by presenting multidimensional themes11 Vasconcelos FAG, Batista Filho M. História do campo da Alimentação e Nutrição em Saúde Coletiva no Brasil. Cien Saude Colet 2011; 16(1):81-90..
In this issue, Ciência & Saúde Coletiva presents some population-based approaches and others that address local issues. Among the most all-encompassing are two articles on the Brazilian National Food and Nutrition Policy (PNAN). One of them shows that there has been an evolution in Brazilian reference documents, which have expanded from the biological-nutritional and hygienic-sanitary aspects of cooking to include considerations about the association of food with biopsychic, sociocultural and environmental factors. This is particularly evident in the publication of the second edition of the Dietary Guidelines for the Brazilian Population22 Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Guia alimentar para a população brasileira. 2ª ed. 1ª reimp. Brasília: MS; 2014.. In the second article, the authors discuss the 51 recommendations of the Policy, identifying possible innovations, actions and strategies to be promoted at the national level, according to the collective opinion of a group of food and nutrition specialists in the health sector. This is the case with the defense of guaranteed public funding, the presence of nutritionists at the various levels of health care and the training of these professionals.
Living conditions continue to exert a strong influence on diet, as discussed in the study on the dietary patterns of adults in urban regions. Among the main problems mentioned in the article is the consumption of ultra-processed foods. In the same vein, linking social deprivation to food insecurity, one of the texts highlights the consequences of this situation for several generations. It is common knowledge that hunger and poverty among pregnant women have an impact on their lives and those of their children, hindering changes that could result from prenatal care, including schooling.
Some of the authors in this issue have focused on new aspects in the food environment: geographical and spatial accessibility, as in the case of the role of street markets; difficulties in accessing healthy food due to socio-ethnic and racial issues; factors that compete with a healthy diet, such as easy access to ultra-processed foods in and schools and surrounding areas; and culinary preparations in digital environments.
The issue also features two articles on the diet of the quilombola population. The first maps the temporal trend of the nutritional status of children under five in various Brazilian municipalities between 2008 and 2019, in a survey by the Food and Nutrition Surveillance System (SISVAN). The second discusses health and living conditions and factors associated with the quality of the diet of women and children under five years of age in nine rural quilombola communities. It reveals that greater diversity and quality of diet is associated with higher income, non-participation in cash transfer programs and more schooling.
Some studies highlight the changes in lifestyles, habits and behaviors, namely conditions resulting from COVID-19, such as the increase in weight of people who worked remotely during this period. The pandemic also highlighted food insecurity in almost half of the children treated in reference services at this time of historic collective suffering, due to the deterioration in diet quality, an increase in the weekly frequency of consumption of ultra-processed foods, and the reduced consumption of fruit and vegetables. Reduced access to meat and milk and increased intake of ultra-processed foods were more frequently reported by families experiencing food insecurity, suggesting that precarious living situations are associated with a deterioration in diet quality during the critical phase of social isolation.
References
- 1Vasconcelos FAG, Batista Filho M. História do campo da Alimentação e Nutrição em Saúde Coletiva no Brasil. Cien Saude Colet 2011; 16(1):81-90.
- 2Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Guia alimentar para a população brasileira. 2ª ed. 1ª reimp. Brasília: MS; 2014.
