Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T09:52:37.463Z Has data issue: false hasContentIssue false

Part I. What has happened in terms of some of the unique elements of shift in diet, activity, obesity, and other measures of morbidity and mortality within different regions of the world?

Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil

Published online by Cambridge University Press:  22 December 2006

Carlos A Monteiro*
Affiliation:
São Paulo University, Department of Nutrition, School of Public Health and Center for Epidemiological Studies in Health and Nutrition, Av. Dr Arnaldo 715, São Paulo 01246-904, SP-Brazil
Wolney L Conde
Affiliation:
São Paulo University, Department of Nutrition, School of Public Health and Center for Epidemiological Studies in Health and Nutrition, Av. Dr Arnaldo 715, São Paulo 01246-904, SP-Brazil
Barry M Popkin
Affiliation:
School of Public Health, Carolina Population Center, CB # 8120, University Square, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516-3997, USA
*
*Corresponding author: Email carlosam@usp.br
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To describe time trends in under- and overnutrition in different regional and income strata of the child and adult population of Brazil.

Design:

Nation-wide surveys conducted in 1975, 1989 and 1996/7 in probabilistic samples of 1–4-year-old children and adults 20 years and over. Time trends refer to stunting, wasting and overweight prevalences among children and age-adjusted underweight and obesity prevalences among adults (95% confidence intervals included).

Subjects:

Individuals examined by each survey in each age group ranged from 1796 young children in 1996 to 78 031 adults in 1975.

Setting:

North-eastern and south-eastern regions of Brazil.

Results:

Undernutrition indicators declined intensively and continuously among children and adults in all region and income strata. Obesity remained low and relatively stable among children, but increased intensively and continuously in all regions and income strata among adult males. Obesity also increased intensively and continuously among adult women from the less economically developed region of Brazil (the north-eastern region) and among lower-income women from the more developed region (the south-eastern region). Higher-income women from the more developed region had a significant increase in obesity from 1975 to 1989, followed by a significant decline from 1989 to 1997.

Conclusions:

Undernutrition in young children is being controlled in Brazil without evidence of increasing obesity. However, obesity is rapidly replacing undernutrition in most gender, region and income strata of the adult population. Adult obesity is already more frequent than adult undernutrition in the more economically developed region, among all higher-income groups, and also among lower-income women living in the more developed region. These lower-income women are significantly more exposed than their higher-income counterparts to both undernutrition and obesity.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1Popkin, BM. Nutritional patterns and transitions. Popul. Dev. Rev. 1993; 19: 138–57.CrossRefGoogle Scholar
2Popkin, BM. The nutrition transition and its health implications in the lower income countries. Public Health Nutr. 1998; 1: 521.CrossRefGoogle ScholarPubMed
3Instituto Brasileiro de Geografia e Estatística (Ibge). Síntese de Indicadores Sociais 2000. Rio de Janeiro: Ibge, 2001.Google Scholar
4Monteiro, CA, Benicio, MHD'A, Iunes, RF, Gouveia, NC, Taddei, JAAC, Cardoso, MA. Nutritional status of Brazilian children: trends from 1975 to 1989. Bull. World Health Org. 1992; 70: 657–66.Google ScholarPubMed
5Monteiro, CA, Benicio, MHD'A, Gouveia, NC. Secular growth trends in Brazil over three decades. Ann. Hum. Biol. 1994; 21: 381–90.CrossRefGoogle ScholarPubMed
6Monteiro, CA, Mondini, L, Medeiros de Souza, AL, Popkin, BM. The nutrition transition. Eur. J. Clin. Nutr. 1995; 49: 105113.Google ScholarPubMed
7Monteiro, CA, Benicio, MHD'A, Conde, WL, Popkin, BM. Shifting obesity trends in Brazil. Eur. J. Clin. Nutr. 2000; 54: 342–6.CrossRefGoogle ScholarPubMed
8Monteiro, CA, Benicio, MHD'A, Freitas, ICM. Evolução da mortalidade infantil e do retardo de crescimento nos anos 90: causas e impacto sobre desigualdades regionais. In: Monteiro, CA, ed. Velhos e Novas Males da Saúde no Brasil: a Evolução do País e de Suas Doenças. 2nd ed. aumentada. São Paulo: Hucitec/Nupens-USP, 2000; 393420.Google Scholar
9Monteiro, CA, Benicio, MHD'A, Popkin, BM. Economic and cultural–educational predictors of overweight in urban and rural Brazilian women. Rev. Bras. Nutr. Clin. 2000; 15: 253–60.Google Scholar
10Monteiro, CA, Mondini, L, Costa, RBL. Mudanças na composição e adequação nutricional da dieta familiar nas áreas metropolitanas do Brasil entre 1988 e 1996. Rev. Saúde Públ. 2000; 34: 251–8.CrossRefGoogle Scholar
11Monteiro, CA, Conde, WL, Popkin, BM. Independent effects of income and education on the risk of obesity in the Brazilian adult population. J. Nutr. 2001; 131: 881s–6s.CrossRefGoogle ScholarPubMed
12Monteiro, CA, Conde, WL. Time trends in overweight prevalence in children, adolescents and adults from lessand more developed regions of Brazil. In: Ailhaud, G, Guy-Grand, B, eds. Progress in Obesity Research. 8th International Congress on Obesity. London: John Libbey & Company Ltd, 1999; 665–71.Google Scholar
13Mondini, L, Monteiro, CA. Mudanças no padrão da alimentação da população urbana brasileira (1962–1988). Rev. Saúde Públ. 1994; 28: 433–9.CrossRefGoogle ScholarPubMed
14Instituto Brasileiro de Geografia e Estatística (Ibge)/United Nations Children's Fund (UNICEF). Perfil Estatéstico de Crianças e Mães no Brasil: Aspectos Nutricionais, 1974–75. Rio de Janeiro: Ibge, 1982.Google Scholar
15Instituto Brasileiro de Geografia e Estatística (Ibge)/United Nations Children's Fund (UNICEF). Perfil Estatístico de Crianças e Mães no Brasil: Aspectos de Saúde e Nutrição de Crianças no Brasil, 1989. Rio de Janeiro: Ibge, 1992.Google Scholar
16Sociedade de Bem Estar Familiar (Bemfam). Pesquisa Nacional sobre Demografia e Saúde 1996. Rio de Janeiro: Bemfam, 1997.Google Scholar
17Instituto Brasileiro de Geografia e Estatística (Ibge). Pesquisa sobre Padrões de Vida 1996–1997. Rio de Janeiro: Ibge, 1998.Google Scholar
18Lavinas, L, Magina, M, co-ords. Atlas Regional das Desigualdades. Banco de Dados com Indicadores sócio-econômicos por RF e Macrorregiões. Rio de Janeiro: IPEA/DIPES, 1996.Google Scholar
19World Health Organization (WHO). Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva: WHO, 1995.Google Scholar
20Stata Corporation. Stata Statistical Software: Release 5.0. College Station, TX: Stata Corporation, 1997.Google Scholar
21Wang, Y, Monteiro, C, Popkin, BM. Obesity trends in older children and adolescents. Am. J. Clin. Nutr. [in press].Google Scholar
22de Onis, M, Monteiro, CA, Akre, J, Clugston, G. The worldwide magnitude of protein-energy malnutrition: an overview from the WHO global database on child growth. Bull. World Health Org. 1993; 71: 703–12.Google ScholarPubMed
23de Onis, M, Blössner, M. Prevalence and trends of overweight among preschool children in developing countries. Am. J. Clin. Nutr. 2000; 72: 1032–9.CrossRefGoogle ScholarPubMed
24Martorell, R, Kettel Khan, L, Hughes, ML, Grummer-Strawn, LM. Overweight and obesity in preschool children from developing countries. Int. J. Obes. 2000; 24: 959–67.CrossRefGoogle ScholarPubMed
25Ogden, CL, Troiano, RP, Briefel, RR, Kuczmarski, RJ, Flegal, KM, Johnson, CL. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics 1997; 99: 111.CrossRefGoogle ScholarPubMed
26World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva: WHO, 1998.Google Scholar
27Popkin, BM, Doak, C. The obesity epidemic is a worldwide phenomenon. Nutr. Rev. 1998; 56: 95103.Google ScholarPubMed
28Martorell, R, Kettel Khan, L, Hughes, ML, Grummer-Strawn, LM. Obesity in women from developing countries. Eur. J. Clin. Nutr. 2000; 54: 247–52.CrossRefGoogle ScholarPubMed
29Pietinen, P, Vartiainem, E, Mannisto, S. Trends in body mass index and obesity among adults in Finland from 1972 to 1992. Int. J. Obes. 1996; 20: 114–20.Google ScholarPubMed
30Birch, LL, Deysher, M. Caloric compensation and sensory specific satiety: evidence for self-regulation of food intake by young children. Appetite 1986; 7: 323–31.Google ScholarPubMed
31Birch, LL, Johnson, SL, Graciela Andresen, MS, Peters, JC, Schulte, MC. The variability of young children's energy intake. N. Engl. J. Med. 1991; 324: 232–5.CrossRefGoogle ScholarPubMed
32Ministério da Saúde. Política Nacional de Alimentação e Nutrição. Brasília: Ministério da Saúde, 2000.Google Scholar
33Ministério da Saúde. Estratégia Nacional para Promoção da Alimentação Saudável e da Atividade Física. Fase 1. Brasília: Ministério da Saúde, 2001.Google Scholar
34Matsudo, VKR. Passport for health. World Health 1997; 50: 16–7.Google Scholar