The double burden of malnutrition in Brazil
On our blog, we want to provide more information about the double burden of malnutrition in South America. We also want to highlight different countries to give an insight into the situation of the double burden of malnutrition of South American countries. This blogpost will highlight the situation in Brazil.
Brazil is the biggest and most populated country in South America, with more than 8 million square kilometers and 211 million inhabitants. The official language in Brazil is Portuguese, this is because Brazil has been under Portuguese rule for more than three centuries. Brazil is considered to be an upper-middle-income country.
The most important part of the health care system in Brazil is primary health care. This has only been established after 1996, before that time most of the population had little to no access to health care services. This system provides care for about 70% of the population. The other 30% is part of the population that can afford the private care system. This health care system in Brazil is free and provides healthcare to everyone legally living in Brazil, leading to very long queues and waiting times.
DBM at the population level
Over the past 35 years, the nutrition status of the Brazilian population has changed. The percentage of undernourished has decreased, while the percentage of overweight/obese has increased. To show some numbers, in the 1970s, 55% of the children under 5 in northeast Brazil were stunted. This has reduced to only 6% in 2006. This has led to a low prevalence of the double burden of malnutrition at a population level. The decrease of undernutrition in children can be attributed to different factors. First of all, the minimum wage has increased, leading to an improvement in purchasing power. Second, female education rates have increased. Third, maternal and child health services have been expanded and improved. Fourth, the water and sanitation systems have been expanded. Last, the quality and quantity of food produced by small family farms have improved. More importantly, the Brazilian government has shown a strong political will to combat malnutrition. This can be seen in the fact that the state set up the zero-hunger program (fome zero), which ensures the right to food for all the Brazilian citizens. This approach is seen as a powerful example in combating stunting and reducing regional differences.
To tackle the upcoming prevalence of overweight and obesity, Brazil was the first country to come up with actions for the United Nations Decade of Action 2016–2025 in 2017. These commitments have three goals: (1) stop the growth of the adult obesity rate, (2) reduce the consumption of sugar-sweetened beverages among adults by at least 30%, and (3) increase the percentage of the population that eats fruit and vegetable regularly to 17.8%. Unfortunately, there are no results yet from these interventions.
DBM at the household level
Even though there is a low prevalence of the DBM at the population level, there is a DBM at the household level. This can be seen by the association between overweight mothers and stunting in their children, which has been found in Brazil. Another study showed that, in Brazil, food insecurity is a risk factor for this DBM on the household level.
DBM at the individual level
At the individual level, a DBM is also existing in Brazil. Part of the population that was stunted as a child, is now overweight or obese. Due to the nutritional transition, the diet of the population has changed tremendously. At the same time, stunting causes changes in the biological process of fat oxidation versus storage. Resulting in a higher risk of overweight and obesity. Therefore, it is not a surprise that over the life course someone can experience stunting and obesity in Brazil.
As can be seen, the double burden of malnutrition at the population level is small in Brazil. As the nutritional transition is still in place and obesity is increasing, the double burden of malnutrition at both the household and individual level are increasing and thus need attention. The Brazilian government is also working to lower the prevalence of overweight and obesity with their plan under the United Nations Decade of Action 2016–2025. Thereby, reducing the double burden of malnutrition.
