The nutrition transition in Brazil.

OBJECTIVE

To describe and analyse changes in child and adult nutritional status in Brazil during the past several decades.

DESIGN

Two large nationally representative cross-sectional anthropometric surveys undertaken in 1974 and 1989 are the primary source of information. Child nutritional status was described based on weight-for-age and weight-for-height indices using NCHS/WHO standards. Body mass index was employed to assess adult nutritional status.

SUBJECTS

27,960 children and 94,699 adults in 1974 and 5969 children and 23,544 adults in 1989.

SETTING

All regions in Brazil.

RESULTS

Undernutrition, although still relevant particularly in children from lower income families, is declining among adults and children of all economic strata. Concurrent increases in adult obesity have been occurring among all groups of men and women with a higher proportion of increase among lower income families. A profound change in the income-obesity relationship determines that in the most recent survey: (1) income and body mass index are inversely related among the 30% richest women; (2) a higher prevalence of female obesity (15.4%) occurs for the 40% middle-income group; and (3) the 30% poorest Brazilian women (9.7% prevalence) can no longer be considered to be protected from obesity.

CONCLUSION

Brazil is rapidly shifting from the problem of dietary deficit to one of dietary excess.