Brazil

SUMMARY

The diversification of food patterns in Brazil is strongly related to differences in access to food and food habit. Except for the Amazon region and the arid northeast area of Sertão, no large differences in terms of agro-ecological characteristics or agricultural production throughout the country exist. This implies that the main food items, which provide most of the dietary energy supply, are similar from one region to another.

The national prevalence of underweight among children under five years in 1996 was of 6%, which showed an important decrease compared to the 18% in 1975 and the 7% in 1989.The prevalence was higher in rural areas with 9% of underweight compared to urban areas where there were only 5 % of underweight children. In 1992, among the nine states composing the northeast region, Maranhão and Piauí had the highest prevalence of underweight among children under five years (MOH, 1996; UNICEF, 1995).

Among the northeast states, Maranhão and Piauí showed the highest prevalences of stunting which corresponded to a high and medium prevalence in these states. Wasting was not a public health problem in Brazil: 5% in 1975, 2% in 1989 and 1996 (MOH, 1996; Monteiro, 1991; Monteiro, 1992).

Information concerning the prevalence of overweight showed a decrease from 8% in 1975 to 5% in 1996 (MOH, 1996; Monteiro et al., 1992). The improvement observed in the nutritional status of children under five years of age, between 1975 and 1989, can partly be explained by the important economic growth, the decrease of absolute poverty, as well as the improvement of health services, education and infrastructures.

The prevalence of chronic energy deficiency (BMI<18.5 kg/m²) among women between the ages of 15-49 was of 6%, which is close to the normal value of 5% (BEMFAM, 1997). Differences between urban and rural areas and among regions decreased from 1975 to 1996.The highest prevalence was found in Rio de Janeiro (9%) and rural area (8%), especially northeast rural (9%). However, the prevalence of CED is still considered to be low (MOH, 1996; Monteiro et al., 1992; UNICEF, 1995).

Among adults, the prevalence of CED is decreasing and the prevalence of overweight and obesity is increasing (BEMFAM, 1997).

A 1994-95 national study showed a national Total Goitre Rate (TGR) prevalence of 4% among school children (6 to 14 years). The most prevalent areas were detected in the states of Mato Grosso do Sul and Roraima (20%). A prevalence of TGR was found at the municipal level, allowing the identification of endemic area. Since 1983 the Ministry of Health has closely monitored the mandatory iodization of table salt by the industry and compliance is now almost universal. In 1996, measurements carried out by the DHS on salt iodization indicated that more than 95% of household salt was iodized (UNICEF, 1998).

Vitamin A deficiency (VAD) is public health problem in some areas of the country. In the north region, a study was carried out in 1998 among children under five years from the city of Belém (state of Pará). The results found a 12% prevalence of VAD. In the same year, in the southeast region, a study was carried out in health units located in the poor areas of the city of Rio de Janeiro. The prevalence of VAD on the basis of the serum retinol level varied from 14% in pregnant women to 56% in new-borns (Teixeria, 1998).

In the northeast region, the 1998 analysis of children under five years found that 48% of the children were anaemic (Hb<11g/dL), the prevalence being higher in rural (56%) than in urban areas (41%).In 1992, In the same year, 12% of pregnant women from São Paulo were anaemic (Guerra, 1992; INAN/MS IMI -DN/UFP SES/PE, 1998).

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