Denise Oliveira e Silva

Concepções de profissionais de saúde da atenção básica sobre a alimentação saudável no Distrito Federal, Brasil

Dietary changes in Western society highlight the need for individual and collective health providers to use their strategic positions to actively promote healthy eating habits. Using the research-action methodology in various clinics in the Federal District of Brazil, the present study aimed to identify what these professionals consider a healthy diet. The results indicate an apparent conceptual dichotomy: on the one hand, an idealized version of eating for good health based on the scientific literature; on the other, a concept derived from the ideal, but based on peoples day-to-day reality. In their pursuit of the latter concept, people in social situations make connections between various pieces of information, and what emerges are the eating habits most closely associated with a particular lifestyle. However, both concepts tend to transcend the implicit biological character of the conceptual constructs and to find support in the sociocultural conditions that shape them and which in turn are shaped at the concrete level of reality.

Mortalidade Infantil em Remanescentes de Quilombos do Município de Santarém - Pará, Brasil

Este trabalho e uma analise preliminar da mortalidade infantil em areas quilombolas do municipio de Santarem-Para. Trata-se de uma Pesquisa Domiciliar Censitaria realizada no periodo de marco/abril de 2006, por meio de procedimentos de busca ativa de obitos em menores de um ano de idade, com identificacao de sub-registro na populacao das comunidades de terra firme e de varzea. Os niveis de mortalidade foram obtidos pela tecnica indireta de estimacao. Encontrou-se diferencial na mortalidade de menores de um ano de idade para os quilombos da area de terra firme e varzea, de 30,4 obitos/por mil nascidos vivos e de 50,2 obitos/por mil nascidos vivos, respectivamente. Os resultados evidenciam profundas desigualdades, na medida em que as taxas de mortalidade das comunidades quilombolas sao maiores quando comparadas com as do pais (27,0 obitos/por mil nascidos vivos), da regiao Norte (26,2 obitos/por mil nascidos vivos), e da populacao negra rural do estado do Para (32,9 obitos/por mil nascidos vivos). Observa-se que nenhuma das taxas de mortalidade dos quilombos alcancou niveis considerados satisfatorios quando comparadas com os parâmetros preconizados pelo Ministerio da Saude em 2005 (menos de 20 obitos/por mil nascidos vivos). Constata-se que, enquanto a mortalidade infantil vem diminuindo no pais como um todo, nos quilombos de Santarem, principalmente os da area de varzea, a probabilidade de uma crianca quilombola morrer antes de completar o primeiro ano de vida e bastante elevada, superando a media nacional, regional e estadual e classificando-se como alta, conforme os criterios definidos pelo Ministerio da Saude.

Vigilância nutricional em adultos: experiência de uma unidade de saúde atendendo população favelada

The nutritional surveillance team of the Centro de Saude Escola Germano Sinval Faria (CSEGSF) collects anthropometric (body mass and stature) as well as socioeconomic and morbidity data of low-income adults (age > 20 years) from seven slums in Manguinhos, Rio de Janeiro. This report presents data on 1352 people (1111 women and 241 men) seen between August and December 1989. Nutritional status (NS) was determined according to the value of body mass index (BMI = Kg.(m2)-1): underweight (UW; EMI 30). The frequency (%) of NS was: UW = 9.5 e 17.5; normal = 37.2 and 46.9; OW = 31.3 e 29.0; obesity = 22.0 e 6.6 for women and men, respectively. These data indicate that among these low-income women at least 50% are OW. The authors speculate that this high frequency of OW may be associated not only with dietary intake (quality and quantity) but also with the number of pregnancies and maybe an adaptation to low energy intake during infancy. As far as the service is concerned, a nomogram to calculate BMI was introduced in the routine to be used by the professionals of the PA1SA (Adult Health Program).

A rede de causalidade da insegurança alimentar e nutricional de comunidades quilombolas com a construção da rodovia BR-163, Pará, Brasil

Objective This work describes results based on the participative and encompassing development of a model of causal determination done in six quilombola communities of Santarem, Para State, regarding the causality of food and nutrition insecurity with the construction of the BR-163 highway. Methods The research process used socio-anthropological approach methods based on the development of a causality model constructed by forming focal groups with community representatives. Result The results of the study show that the use of participative approaches stimulates the community’s self-esteem and takes control of the factors that determine its problems. The causal model reveals that, for the communities, nutrition and food insecurity establish that historical factors associated with land ownership and current use based on predatory practices are essential to understand the causal determination of food and nutrition insecurity. Conclusion Racism and its social nuances have contributed for the social invisibility of these communities in public Brazilian policies. The quilombola communities consider themselves in a state of nutritional and food insecurity and indicate that the construction of the BR-163 highway can be a threat to the sustainable ethnic development in the region. They also state that the economic development expected with the construction of this highway can increase hunger, poverty and racism if the communities do not participate.

Descrição das noções conceituais sobre os grupos alimentares por professores de 1ª a 4ª série: a necessidade de atualização dos conceitos

Com base na realizacao de entrevistas individuais com professores de 1a a 4a series em uma amostra de escolas publicas e privadas no Distrito Federal, procurou-se apontar a atualizacao da classificacao dos grupos alimentares segundo exemplos e funcoes, alem da execucao de atividades de nutricao e fontes de informacao consultadas pelos educadores. Os resultados mostraram associacao do consumo dos alimentos energeticos e energeticos extras com uma alimentacao inadequada, ao passo que os alimentos construtores e reguladores sao identificados como prioritarios na alimentacao diaria. Os livros didaticos destacaram-se como a principal fonte de informacao e, em menor destaque, os manuais tecnicos de alimentacao e profissionais de saude. Conclui-se que as acoes educativas em nutricao precisam ser subsidiadas por professores bem formados e atualizados, alem da revisao dos Parâmetros Curriculares Nacionais (PCNs) na perspectiva de um ensino interdisciplinar e intersetorial em alimentacao na escola.

Desnutrição em crianças de áreas faveladas: Manguinhos, Rio de Janeiro

Utilizando-se de dados de peso e altura coletados em um Dia Nacional de Vacinacao, os autores estudaram o estado de nutricao de criancas residentes em cinco areas faveladas na area de Manguinhos, no Rio de Janeiro. Mediante o emprego das classificacoes de Gomez (relacao peso/idade), Ariza-Macias (relacao peso/altura) e Seoane-Latham modificada (peso/altura e altura/idade), evidenciaram que a prevalencia da desnutricao em criancas apresentou, provavelmente, um acentuado declinio nos ultimos 13 anos. O grupo de criancas de seis a doze meses de vida constituiria, segundo o levantamento, a faixa etaria mais exposta a desnutricao, em sua fase patogenica. A partir desta idade, os deficits antropometricos seriam do tipo sequelas, refletindo a chamada desnutricao pregressa.

Um olhar sobre a agenda de alimentação e nutrição nos trinta anos do Sistema Único de Saúde

Food and nutrition are basic requirements for the promotion and protection of health. Nutrition monitoring and dietary recommendations are included in the mission of the Unified Health System (SUS, in its Portuguese acronym), as established by the Organic Health Law no. 8,080 of 1990. This article presents and discusses the food and nutrition agenda of the SUS and its interface with Food and Nutrition Security, its benchmarks, progress and challenges. This essay was guided by biographical and documentary research and, above all, by the experiences and perceptions of the authors, who, at various times and in various contexts, have been and continue to be actors of Brazils food and nutrition agenda. We emphasise the idea of the SUS, with its accomplishments and shortcomings, as a living system derived from the technical, ethical and political commitments of its administrators, workers, academics and society as a whole. Thus, we seek to contribute to the debate about the Brazilian path to the construction of a public social welfare system committed to health and adequate nutrition as a human rights.Food and nutrition are basic requirements for the promotion and protection of health. Nutrition monitoring and dietary recommendations are included in the mission of the Unified Health System (SUS, in its Portuguese acronym), as established by the Organic Health Law no. 8,080 of 1990. This article presents and discusses the food and nutrition agenda of the SUS and its interface with Food and Nutrition Security, its benchmarks, progress and challenges. This essay was guided by biographical and documentary research and, above all, by the experiences and perceptions of the authors, who, at various times and in various contexts, have been and continue to be actors of Brazils food and nutrition agenda. We emphasise the idea of the SUS, with its accomplishments and shortcomings, as a living system derived from the technical, ethical and political commitments of its administrators, workers, academics and society as a whole. Thus, we seek to contribute to the debate about the Brazilian path to the construction of a public social welfare system committed to health and adequate nutrition as a human rights.