Issue 78 of IEA’s journal explores the relationship between public health and nutrition

The 78th issue of IEA’s journal ‘Estudos Avançados’ highlights texts dealing with two intertwined themes that are in tune with the current demands of Brazilian society: public health and the improvement of nutritional standards. According to Alfredo Bosi, editor of the publication, “the issue seeks to fulfill one of the core objectives of the IEA: to combine academic research and the interest in improving our public policies”.

The launch will take place on September 13, at 17 am, in IEA’s  event room,  at a meeting on Public Health and Nutrition. The exhibitors will be José Filippi Jr., Municipal Secretary of Health of São Paulo, and two authors of articles in issue 78: Carlos Augusto Monteiro, Professor of USP’s Public Health Faculty (FSP) and Ana Lydia Sawaya, Coordinator of IEA’s Nutrition and Poverty Research Group.

SUS

In ‘Public Health in Brazil’, opening article of issue 78, Dr. Gilson Carvalho discusses the objectives, principles and functions of the ‘SUS – Sistema Único de Saúde’ (Unified Health System), established by the 1988 Federal Constitution. From this, a retrospective of federal policy for the SUS in the past ten years is analyzed. According to the author, “there was an explicit hope that with the new government led by Lula law would be fulfilled, which did not occur in these ten years , eight with Lula and two which Dilma in charge”.

Carvalho says that the SUS has made little progress in the past decade because the government invested little in universal coverage, while stressed the fragmentation of the system, creating parallel health programs, increased the participation of the private sectorm, and continued to justify the problems of the area based on the contrast between funding and efficiency.

A somewhat more optimistic point of view on the SUS is offered by dentist Eugênio Vilaça Mendes in the interview ‘25 Anos do Sistema Único de Saúde: Resultados e Desafios’ (’25 Years of SUS: Achievements and Challenges’). According to him, who is Director of the Pan American Health Organization, "the institution of citizenship health through SUS incorporated immediately over fifty million Brazilians as having health rights and made disappear definitely the odious figure of indigent health".

In spite of highlighting the positive features of SUS, Mendes points out that there are many problems to be solved, some of them mentioned by Carvalho, such as the segmentation of the system, underfunding and the lack of a universal health care in the country. Therefore, he mentions a way to strengthen the ‘ESF – Estratégia de Saúde da Família’ (‘Family Health Strategy’) based on the guidelines of the ‘APS – Atenção Primária à Saúde’ (‘Primary Health Care’).

NUTRITION

Diseases associated with the nutritional status of the patient, related to lack or excess of food, are strongly linked to public health. In the article ‘Open Happiness: Implications for Food Addiction’, Ana Lydia Sawaya and Andrea Filgueiras argue that the techniques of production and sale used by food industry induce eating disorders related to obesity and chronic diseases such as diabetes.

The authors claim that drinks and foods - especially those high in salt , fat and sugar - activate neurotransmitters that control the state of pleasure and create conditioned reflexes associated with dependence. For them, this demonstrates the need of an improvement in legislation regulating the manufacture of these products.

Another facet of the relationship between health and nutrition, not linked to excess but the lack of food, is treated in the text ‘Socioeconomic, Nutritional and Intake Profile of Beneficiaries of Bolsa Família’, signed by Sawaya, Marcela Jardim Cabral, Karlla Almeida Vieira and Telma Maria Florêncio. The paper reports the results of the study to assess the nutritional status, consumption and food security of beneficiaries of the ‘Bolsa Família’ Program in the slums of Maceió, state capital of Alagoas.

According to the researchers, the food purchased with funds from the program is not always adequate regarding nutritional quality, which should ensure the health of beneficiaries. Examples are the high levels of malnutrition in children and adolescents and the presence of moderate or severe food insecurity in 67% of the surveyed families. The study also points out an inadequate intake of micronutrients found in fruits, vegetables and dairy products.

A seemingly paradoxical data has been brought up: the incidence of obesity among poor women above 40 years. According to the authors, this may be associated with the consumption of cheap and palatable food containing high glycemic and caloric density, such as biscuit, flour and pasta. For them, this situation reveals the urgency of "actions between the ‘Bolsa Família’ and sectors responsible for public policies in education and health to ensure nutrition education strategies to promote improvement in nutritional status and prevent non-communicable chronic diseases".

OTHER THEMES

Besides the nine texts on public health and nutrition, issue 78 ‘Estudos Avançados’ brings seven articles, divided between the areas of Environment and Criticism and Philosophy, one of them signed by Alfredo Bosi.

The issue also counts with five reviews, two interviews on Nuclear Energy and an interview on Energy Policy with Ildo Sauer, Director of USP’s Institute for Energy and Environment , in which the researcher provides an overview of the energy issue in Brazil, identifying pros and cons, and advocates the adoption of alternative and renewable sources of energy, such as wind and hydropower to replace nuclear power.