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From child hunger to obesity: Brazils new health scourge

Since it was established in 1982, the Brazilian NGO Pastoral da Crianca used weight to ascertain whether a child was unhealthy. Recently, that had to change when they started to see more and more obesity in poor communities. "As we started noticing some children were overweight, we had to change our practices entirely," says nutritionist Paula Pizzatto. "Now height and the BMI [body mass index] are also taken into consideration."

 

When Pastoral da Criança first started its work, malnutrition and lack of basic childcare were the cause of high infant mortality rates – 8.3% in 1980. By engaging and training community leaders to carry out regular visits to local families, the organisation encouraged more breastfeeding and prenatal care. At the same time, the government's zero hunger programme took millions of Brazilians out of extreme poverty and more than halved the rates of child mortality. According to the World Food Programme, hunger affects only 6.9% of Brazil's population now. However, these impressive statistics do not mean that most Brazilians are healthy. The last figures released by the health ministry show that 51% of country's population are overweight and one in three children age five to nine is overweight.

A cash transfer scheme known called Bolsa Familia allowed many who were once excluded from the free market to become consumers. "Parents who were undernourished as children can now put a bottle of Coca-Cola on their tables. It is a matter of status. They feel proud," says Pizzato.

Companies quickly understood there was a market of new consumers to explore. Door-to-door selling of affordable products as well as tailor-made payment options allowed slum dwellers and remote communities to get food without travelling to the supermarket, so processed products became more accessible than fresh fruit and vegetables.

Most people in the poorest communities in Brazil are under-educated, making them more vulnerable to advertising. For instance, Nestle's floating supermarket navigates the Amazon with a powerful market campaign that claims to "offer access to nutrition, health and wellbeing to the remote community of the north region". But it mainly sells yoghurts, ice cream and chocolate.

"Quality of the food is now more of an issue than access to it," says Arnoldo de Campos, secretary for the National Secretariat for Food and Nutritional Security. "We still have a small fraction of people that don't have access to food, in isolated rural areas or indigenous communities, but the most serious problem now is obesity."

Pastoral's follow-up nutritional programme focuses on the first 1,000 days of life of the infant, including the time he or she is in the womb. Providing healthy nutrition during this first stage of life is essential to prevent both malnutrition and obesity. The programme is still new and has only been introduced in 23 of the 27 Brazilian states. "So far, we have nearly 13,000 children under the nutritional programme," says Pizzato. "Around 11% are overweight or obese and about 2% are undernourished." A lack of playgrounds in needy communities and national maternity leave of only four months, which means that babies cannot be breastfed exclusively for the first six months, contributes to the problem.

The full results of the nutritional programme haven't been published yet, but Pastoral is very aware of the challenges that lie ahead. "It is easier to introduce a new feeding habit when dealing with malnutrition, but it is definitely more difficult to correct existing ones, when the entire family is involved," said Pizzatto.

The government recognises the seriousness of the problem. In 2011, it created the Intersectoral Strategy for Control and Prevention of Obesity, which started, among other things, the promotion of health feeding habits in public schools. But despite all the efforts, combating obesity will be an arduous task.

"We have a poorly legislated production system which is addicted to bad-quality food and unregulated advertising practices," says de Campos. "For instance, the latest Coca-Cola slogan is 'open happiness', for a soft drink full of sugar. It is more difficult to tackle obesity than hunger."

Comments

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By: John
On: 05/25/2014 09:33:41
Great article! It is amazing how the world has transformed. Being too thin, and starving, used to be the concern of the poor - and the mark of poverty. With obesity, or any extra weight, being the sign of the provileged class. Now obesity is the problem of the poor - the sign of poverty, and wealthy peopkle visit their personal trainers, gyms and nutritionists to stay fit. I didn't realize the problem was the case in Brazil though. Looks like it is becoming a word-wide problem, not just that of the US.
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By: Anna
On: 05/25/2014 11:05:57
It seems so counter-intuitive that poverty leads to obesity. But countries like this really do prove that, as John notes, that is the new formula. Personally, as the article mentions, I blame marketing and corporations. Not that they are evil or intended this, but the sale of junk - totaly garbage like sugary bubbly water ( coke and other such softdrinks) or fast food is such a massive industry and the PR and branding and marketing has become so successful that it is part of culture now, is ubiquitous, and such "food" is treated like a staple. The article is right that the challenge is huge. How do you combat that? How do you undo that culture and that juggernuat of marketing? It will take a lot of time I think, and as we are at the beginning of this new world problem that is so much the opposite of what we have known throughout history, it is unfamiliar ground to have to tread. As one of the recent GC articles - the one about obesity in school children - mentioned - I think real change starts at home, and that really is the best hope
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By: Kevin
On: 05/25/2014 17:44:35
I have been to Brazil several times and can say first hand this is true. I had known before I ever went that there is some real poverty in some parts of the country, and was prepared to see the signs of it. I travel a lot and always try to have a feel for the culture before I go. I was surprised to find many kids that were on the chunky side (and adults too). I think this isn't just Brazil's problem. I think this is a problem of the world in this day and age. Lord knows that obesity transcends income in the US and you have to make an effort in a lot of cases not to fall prey to it. Good article.
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By: Catherine J
On: 05/27/2014 18:01:35
It really is a disturbing trend - how obesity is linked to poorer communities. It says a lot, I think, about how the world has changed, and what wealth means these days. In the past, to be poor meant to do without, to go hungry. Now it seems to be poor means to be thrust into a mass consumption, junk-food culture. Everyone loves to preach how lazy people are, how if you eat less and move more, there would be no problem. But how do they explain a global epidemic like this. Thoughtful article.. Thanks for sharing it.
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By: Diana J.W.
On: 08/24/2014 14:36:10
Really interesting article! I read a book recently, by Malcolm Gladwell, in which he cites a study that equated diet with breast cancer and how Western diets mess with women's hormones, lead to weight gain and cause more breast cancer. It made me think about the epidemic of obesity that has now become a global phenomenon. It is depressing and I think articles like this ar important to raise awareness that it isn't just the US. It is amazing to me how the new problem of the poor is obesity, and it makes me think somehting is really wrong with our culture - that mass produced and mass marketed food is to blame. That super fattening, highly salty, really sugary food prepared in a factory and shipped in a box or a can requiring little or no preparation is to blame. I am glad this article points out how widesperad it is.

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