Objective To analyze public policies on food and nutrition in Brazil, with emphasis on the last fifteen years (2003-2018). Methods Historical-documentary analysis based on a bibliographical survey on indexed bases and exploratory visits to websites of government agencies. Results The scientific and governmental findings were organized according to the Lula, Dilma and Temer governments. They explore the development of several public policies and welfare programs in food and nutrition, focusing mainly on Brazilian Hunger Eradication Program, Assistance for Needy Families Program, National Policy on Food and Nutrition Security, Food Acquisition Program, National School Nutrition Program, National Food and Nutrition Security Policy, National Food and Nutrition Surveillance System and Brazilian Misery Eradication Program. The centrality of the idea of the fight against hunger and misery in public policies during Lula’s first and second terms and Dilma’s first term stand out. Dilma’s second term is marked by the focus on healthy eating, as well as presenting the first signs of fragilization of public policies on food and nutrition. Currently, the Temer government is characterized by processes of institutional and programmatic rupture, budget cuts and setbacks in acquired rights. There is evidence of the need to activate national and international instruments to enforce the human right to adequate food and consequent strengthening of public policies on food and nutrition. Conclusion This period presents an expansion and qualification of public policies on food and nutrition, mainly in the Lula and Dilma administration, with setbacks in the Temer administration, in which continuous budget cuts weaken social, hunger reduction, poverty reduction and food and nutrition security policies.

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This scientific note presents preliminary developments of the Covid-19 pandemic on unemployment, poverty, and hunger in Brazil. The data on unemployment rate, un employment insurance claims, contingent of families in extreme poverty, and food insecurity was collected in government information systems, research published by public agencies, scientific articles, and in news portals. In an upward trajectory since 2015, the increase in unemployment and the number of families in extreme poverty was exacerbated after the pandemic began, drastically reducing the purchase power and access to healthy and adequate food, affecting mainly women and the populations of the Northern and Northeastern regions. Between January and September 2020, there was a 3% increase in unemployment in Brazil and, in October 2020, there were almost 485 thousand more families in extreme poverty compared to January of the same year. There are inadequate and insufficient responses from the Brazilian government to the articulated set of problems. The Covid-19 pandemic is a new element that potentiates the recent increase in hunger in Brazil, which occurs in parallel with the dismantling of the Food and Nutrition Security programs and the expansion of fiscal austerity measures, started with the political-economic crisis in 2015. There is an urgent need to recover the centrality of the agenda to fight hunger in Brazil, associated with the development of more robust contributions on the impact of the pandemic on the phenomena of poverty and hunger.

Objective: Describe and evaluate the nutritional care provided for overweight adults by the Primary and Secondary Health Care services of Santos, São Paulo, Brazil. Methods: This study was carried out between 2013 and 2015 integrating quantitative and qualitative approaches; it was divided into two phases: (1) characterization and (2) evaluation. In phase 1, a census of Primary Health Care Units (n=28) and Secondary Health Care Units (n=4) was conducted using interviews with health service managers and/or health professionals. Data were analyzed using exploratory data analysis. In phase 2, in-depth interviews were conducted with health service managers and/or health professionals investigating a sample of the Primary Health Care services and the totality of Secondary Health Care services provided. Thematic analysis was carried out using the theoretical framework for comprehensive health care proposed by Pinheiro & Mattos. Results: A total of 40 professionals were interviewed: 36 in the primary health care services and 4 in the secondary health care services. Nutritional care in the Primary Care services is focused on individual care and referrals to other services; nutrition diagnosis and health promotion occur only when overweight is associated with another disease. It was observed that the referral and counter-referral system and intersectorial collaborations were ineffective. In Secondary Care services, nutritional care is focused on clinical care using traditional approaches to nutrition education. Limiting factors for promoting comprehensive care were identified at the two levels of care: unproductive actions, lack of actions for health promotion and protection, and little dialogue between the Primary and Secondary care services. Conclusion: Overweight is not an outcome based on Primary and Secondary Care, but rather on prescriptive practices, which are not very effective in promoting users’ autonomy. It is necessary to guide the actions taken in these two levels of care to ensure the promotion of effective nutritional care.

A prevalência de insegurança alimentar é importante para a avaliação das condições de vida e para o planejamento de políticas públicas de combate à fome. A pesquisa foi realizada com 177 famílias de São José dos Ramos-PB, no ano de 2005, por meio de entrevista. A análise dos dados, por regressão logística e ODDS RATIO, utilizou como variável dependente estar ou não em segurança alimentar, avaliação resultante da aplicação da EBIA; e, como variável independente dicotômica, o consumo de 15 conjuntos de alimentos. O modelo em regressão logística e o odds ratio mostraram associação de leite integral, manteiga, biscoito, bolacha e bolo com a segurança alimentar. Contudo, deve-se levar em consideração o conceito ampliado de Segurança Alimentar e Nutricional, que enfatiza outros fatores relevantes além do consumo alimentar, como a disponibilidade de alimento, que se incorpora às condições de renda e padrão de vida.

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Background Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon. Methods A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome. Results A prevalence of 76.5% (CI 1.36–2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31–2.83) and severe (CI 1.10–1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children. Conclusions The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

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