THE NUTRITION TRANSITION IN BRAZIL

Objective: To describe and analyse changes in child and adult nutritio nal status in Brazil during the past several decades. Design: Two larg e nationally representative cross-sectional anthropometric surveys und ertaken in 1974 and 1989 are the primary source of information. Child nutritional status was described based on weight-for-age and weight-fo r-height indices using MCHS/WHO standards. Body mass index was employe d to assess adult nutritional status. Subjects. 27,960 children and 94 ,699 adults in 1974 and 5,969 children and 23,544 adults in 1989. Sett ing: All regions in Brazil. Results: Undernutrition, although still re levant particularly in children from lower income families, is declini ng among adults and children of all economic strata. Concurrent increa ses in adult obesity have been occurring among all groups of men and w omen 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 inversel y related among the 30% richest women; (2) a higher prevalence of fema le obesity (15.4%) occurs for the 40% middle-income group; and (3) the 30% poorest Brazilian women (9.7% prevalence) can no longer be consid ered to be protected from obesity. Conclusion: Brazil is rapidly shift ing from the problem of dietary deficit to one of dietary excess. Spon sorship: Grants from FAPESP (Fundacao de Amparo a Pesquisa do Estado d e Sao Paulo). CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico) and the US National Institutes of Health PO1HD18076-01). Descriptors: Brazil, income and obesity, nutrition transition, obesity trends, undernutrition trends