Print version ISSN 0103-4014
Estud. av. vol.21 no.60 São Paulo May/Aug. 2007
FOOD AND EDUCATION II
Education and the right to eat
José Eduardo Dutra de Oliveira
Food consumption is a human right, a state duty and a personal responsibility of everyone. Food intake and its consequences as nutritional status are social and biological areas. It is a multi-sectorial subject. Basic studies and inter-sectors programs have been going on in several parts of our country. Acute and chronic malnutrition and its consequences on physical development, learning, capacity to work and their influence on chronic diseases, are present in low and high-income population. Social and economic factors are known to have influence on their presence but cultural and educational aspects of the problem are not taken in consideration, as much as it should and as a key cause and solution to the situation. Several food, government and nongovernmental programs, go on in the country. Lately, "Zero Hunger", our main social government program deals directly with the subject. Food security as food free from contamination and economics aspects, are considered main factors to be taken care of. But primary and universal food and nutrition education, knowledge on the area, teaching of nutrition, have not been having the attention as one of the main preventive and curative solutions to malnutrition.
Keywords: Food, Food and Nutrition, Safety, Right to Eat, Education.
he goal of nutrition or in its broader sense, the nutritional sciences, is the study of all the mechanisms through which living organisms receive and use the nutritive substances of food. That is an inter-sectorial and transprofessional area. Its principles and applications are both biological and social. Based on those assumptions, it is necessary to understand its different aspects and the reality in which the nutritional problems occur so that they can be solved. It is within this broad perspective that we want to place some of our feeding and nutritional problems, as well as those related to food security, education and the right to eat.
The interrelation of nutrition with agriculture, economy, health, education, culture, sociology, politics, psychology etc. makes the diagnosis, the indicators, the monitoring and the solutions to the problems more objective and more effective. For that to happen, it is very important to involve interaction and partnerships such as the ones proposed in an interprofessional workshop sponsored by the Institute of Advanced Studies of the University of São Paulo, Brazil, in August 2005, so as to obtain objective and practical results for the benefit of all.
The eating and nutritional security, for example, widely discussed nowadays, must be understood as the coordination and integration of the governmental and private mechanisms that may ensure the production, the availability and the daily and continuous food intake, in sufficient quantity and quality to make up for all the needs and the normal functioning of the human body. Unfortunately, its importance and its true sense have not been interpreted in the same way by rulers, politicians, managers, communities and, many times, not even within the academic and scientific community. There is, for example, a generalized concern about guaranteeing the fuel of cars, trucks and machines in general. Gasoline is used, alcohol is used, gasoline and alcohol are mixed, and it is known that the existent reserves in the country are enough for two or three months, everyone is afraid to talk about rationing, consumption is monitored by machine and by machines, on a monthly or yearly basis. And what do people say about food? What kind of food do they want? How much do people eat and how much do they produce? Is there a concern about food security and nutritional value? What about information and guidance on the subject? What about the right to eat?
The lack of knowledge on eating habits and nutrition, on its role for the physical and mental development and for the quality of life has justified the limited importance given to what must be done by everyone to eat well a basic and essential human right. Fortunately, nowadays the problem has been discussed more seriously, under different aspects biological, social, educational, economic. It is expected that greater knowledge and more precise diagnoses of the eating and nutritional situation will lead to better solutions. In that context we include both eating and nutritional security.
Food is the starting point of the food chain, and it comes from agriculture. As we know, Brazilian agriculture has been breaking records concerning production, export and trade of its products. But its a shame that, while the export agriculture and fuel alcohol are doing fine, has anyone heard anything about food agriculture? It has not been yet able to gain status and to play its role of ensuring whatever is necessary for the population to eat well. Production of our basic kinds of food rice and beans, milk, vegetables, meat, among others has been neglected, not to mention the inputs and facilities that export products receive...
The experts from the food, feeding and nutrition areas are able to calculate the food needs of our population (identifying them even in terms of age group, gender, occupation, etc.) and can point out which food needs to be produced and in what quantity to meet those needs. Unfortunately, it lacks a nationwide awareness, an organism that coordinates and integrates production, distribution and control of food consumption. Nobody is directly responsible for the national feeding, and solutions for that serious situation have been handled, in most cases, by assistance and paternalist programs: offering free food.
The country might even get impressed when data on our high infant mortality rate, high school failure rate, low physical capacity of workers or the growing presence of overweight, obesity, cardiac diseases, hypertension, diabetes and even certain kinds of cancer in different population layers regardless of economic situation are published, but nobody relates those incidents, either directly or indirectly, to feeding.
However, the contrast between two serious Brazilian nutritional problems is starting to call greater attention: on the one hand is hunger and undernourishment; on the other hand is overweight and obesity. And those two problems are indeed directly related to food consumption. The former due to lack of food and the latter to its excess. In both cases poor eating habits are present.
What are Brazilians eating and what should they eat on a daily basis? Milk, meat, eggs, rice, beans, vegetables, fruit. And in what quantity and how good is it? Is it enough to guarantee desirable nutritional values?
In general, we are eating less rice and beans, our traditional daily foods, which, together, have a very good nutritive value and have been, for decades, good energy and protein sources, responsible for the survival of the Brazilians. We eat few vegetables and fruit and the intake of industrialized products, which are often very rich in terms of energy and have too much fat, is increasing. We are getting obese and undernourished! Brazil is undergoing a nutritional transition period. Malnutrition, lack of food and hunger are still present in many places, while gradual weight gain, in a general and worrying manner, is present in many Brazilian regions, and that occurs both in the rich and even in poor layers of the population. A similar phenomenon has already occurred in industrialized countries and we have not learned the lesson. In the United States and, in a lesser degree, in European countries, between 30% and 40% of the population are overweight and forecasts indicate that this figure might go over 80% if preventive feeding education measures are not implemented. It is worth pointing out that in those countries, for decades, the feeding programs were basically given away and paternalist, based on food distribution. That is what we also did and still do indiscriminately, and we will certainly also have to deal with the same consequences: overweight and obesity.
That reality malnutrition, bad nutrition of poor and rich alike, lack of food for some and its excess for others forces us to try to understand better the inter and transprofessional issue of food, feeding and nutrition, and that is where food security finds its role. But is it the security of food or of feeding? Or both?
According to the Food and Agriculture Organization (FAO), food security must be understood as national availability of food availability that is sufficient, stable, autonomous and sustainable in the long run, and of universal access necessary for the development of the biological and intellectual potentialities of all people. The World Bank, also worried about food security, adds specifically to the concept of universal access to food, the idea that it should be essential for an active and healthy life.
Certainly, the final goal of the global food security concept is to guarantee to all people the physical, conscious and economic access to food that includes all the vital nutrients to the normal functioning of the organism. Therefore, food security is based on three basic aspects: (1) food production; (2) flow stability of the food; (3) guarantee to each individual the access and intake of the food they need. It must necessarily include a food chain, beginning with the production of biologically and nutritionally healthy food, going through supply, storage and trading, offering basic hygienic conditions for its preparation and intake, having as an end result good or bad nutrition. Of course each of those aspects has its variables and must follow necessary processes and scientific principles to the functioning of the organic system, and which will ensure good nutrition.
In that food chain, nutritional, biological, economic and political aspects are extremely important, as well as educational actions and guidance to the communities. Having knowledge about the need for food and its production for self-consumption is as crucial as having resources to buy them. One cannot expect the food, basic needs grocery packages, or money donation programs to solve the daily and permanent problem of feeding the people. "Christmas without Hunger" does not solve anybodys problem...Those resources and campaigns ought to be used, and will continue to be used, but they should be left only for special and emergency situations.
Balanced and healthy feeding must be the basic goal of those programs. The eating behavior patterns include several factors, from individual habits, culture, traditions, taste, pleasure and social relations to the way it is made, the time and the adequate setting to the meals, as well as the necessary availability and quantity of the food. It is in that sense that information on them about its qualitative characteristics, its nutrient content, its effects not only on health, but also on working capacity, on learning and on all the organic functions are extremely important. More knowledge and more information certainly help to adequately plan good eating habits.
A balanced consumption of food must be varied, including several kinds of foods. Besides being balanced both in terms of quantity and of quality, it must be secure, without any physical-chemical contamination, without toxics, without pollutants. It must also be secure from the nutritional point of view. We often say that a colorful dish, containing foods with several colors, already ensures the presence of several necessary nutrients for a good nutrition. The presentation and the flavor also help a good and healthy meal. Processing and the cooking technique are other important issues; heating at high temperatures and for a long time, for example, destroys nutritive substances, such as some vitamins.
People must still have the right to choose what they will eat, and also for that reason it is crucial to ensure information and guidance about the need and the effects of the food, about the importance of eating for the physical and psychic development of children, for learning, for the working capacity, for the greater protection against diseases. It is necessary to speak and to teach the people that many of the diseases related to eating will only appear between 50 and 60 years old such as heart diseases, hypertension, diabetes and even certain kinds of cancer , but that they began almost at birth, being directly or indirectly related to the kind of eating habit, to the environment and to genetic factors.
It is necessary never to forget that its education that will ensure and foster a good eating habit. Information, guidance and eating education integrate a process that must be developed daily in the most varied conditions, in the households, at school, at work and in the entire community. People are involved with eating everyday. The media radios, newspapers, television tell us all the time, what we should eat, but they dont teach, or tell us in a very limited way what a good eating habit should be. At the same time, the current life style favors sedentary life and the lack of a physical activity, which have a negative influence on good nutrition.
Countless studies in Brazil have shown different aspects of eating and nutrition. They are often specific, fragmented; other times they have no continuity, but still bring us information on the eating and nutritional status of the Brazilians. One of the most interesting of them the National Study on Family Expense (ENDEF) was carried out in 1974/1975 and gathered data on the food intake by the Brazilian people, providing information that justified the high incidence of protein and calorific malnutrition found within certain population groups and in several parts of the country.
Fifteen years later, in 1989, the Ministry of Health carried out a survey on the nutritional status of children, adults and elderly people, the so-called National Survey on Health and Nutrition (PNSN). A trend towards the reduction of the infant malnutrition rates was verified, but the survey also showed a complex nutritional framework, with clear regional differences. A hunger map, containing estimates of the extremely poor Brazilian families, showed that over thirty million Brazilians lived like that. It should be noticed that drawing the "indigence line" according to the cost of a basic-needs grocery package has been highly challenged. That indicator, income, is still almost always pointed out as the main factor responsible for the bad eating habit of the poor. However, it must be clear that, even though scarcely mentioned, education is also an important factor and must be acknowledged as such. That is demonstrated by malnutrition among the rich: many people earn enough money to buy food and eat badly, having poor knowledge about eating habits. Therefore, they are undernourished people.
Indicators used for a long time such as food availability, buying power of the minimum wage, food intake profile by age group, incidence of underweight, overweight and obesity, weight and height of children under five years old confirm that malnutrition actually occurs in Brazil. Some studies used as much as forty indicators to show bad nutrition. Excess weight, for example, started to be demonstrated in Brazil as a public nutrition problem just over ten years ago. A nutritional study on women between 15 and 44 years old, carried out by means of interviews and with an anthropometric evaluation of children under five years old, showed that 11% of women suffered from obesity and, at the same time, much of their children suffered from chronic malnutrition.
A multi-centered study carried out in seven cities from many parts of the country by the former National Institute of Feeding and Nutrition (Inan), in 1996-1997, showed in detail the food intake profile and the family income of Brazilian families. There was low energy consumption in the per capita income range up to one minimum wage and the risk of macro and micronutrient deficiency in families with income up to two minimum wages.
In recent years, some other social indicators related to eating habits have been well characterized. For example, it was shown that even among poor individuals there is enough income to buy a certain package of key goods if they know what they must eat. According to the criteria of the Family Fund, "extreme poverty" corresponds to a per capita income equivalent to one-fourth of a minimum wage and "poverty" corresponds to the per capita income of half a minimum wage. And without education, the fund or the money is used for cookies, sweets or white cane alcohol...
Another important aspect of the current feeding status concerns studies on food and nutritional security and food and nutritional monitoring systems which, by acknowledging the complexity of the issue, have generated for the feeding area information on the nutritional status, as well as the implementation of programs as the Feeding and Nutritional Vigilance System (Sisvan). That program gathers and follows anthropometric data of children and pregnant women cared for in health units. It has already been implemented in several Brazilian towns and it is, no doubt, an important mechanism for monitoring the nutritional status of fertile women and of children up to five years old, both in the urban and in the rural area. That monitoring should enable us to evaluate the effect of the programs on the feeding and on the nutrition of the people, as well as on food production, supply and trade. The people must understand it and use it.
Anyway, there are several ongoing feeding programs in Brazil. Some of them have been in force for many years, such as the School Snack, the Feeding in Nurseries, the Worker Feeding, the Feeding Fund, which has now been incorporated to the Family Fund, the Popular Restaurants, the Food Banks, the Food Checks and others. Even though especially the programs in force have emphasized their emancipating and citizenship function, unfortunately serious feeding education is far from being one of their goals. The goal to provide food or to transfer income prevails over the right and the need of each person to eat properly everyday.
Finally, it is worth pointing out the importance of national meetings on food and nutritional security (including indicators, diagnoses and programs), such as those recently carried out in 2005, at the Institute of Advanced Studies of the University of São Paulo (IEA/USP) and the National Amazon Research Institute, in Manaus XXVI Consortium of the Brazilian Institutions in the Feeding and Nutrition Areas, CIBRAN. Such meetings have collaborated to call the attention to consumption of food and nutrition. But, besides the access to secure nutritive foods, one must say that the Right to Eat must be ensured. That materializes itself in the daily and ongoing intake of quantity and quality of the food needed for well-balanced and healthy feeding and nutrition.
Based on data and facts, it is necessary to call the attention to the following issue: the basic problem of feeding in Brazil is the lack of knowledge, the ignorance, and the lack of education concerning the subject. That problem occurs in all social levels, among poor and rich people alike. Its solution calls for information, guidance, education, and behavioral changes concerning eating habits. Along with and even before Food Security, the Right to Eat must be ensured, it is necessary to fight for the right for education and for the daily consumption of Good Food. Studies on food consumption and on nutritional status indicators must include the perception, the knowledge and the concepts on what to eat, and that the implementation of the feeding programs always include information, guidance and feeding education with secure, balanced and nutritive foods.
Defending and respecting the Universal Right to Eat and adapting the concepts of Food and Nutritional Security to that of Good Eating Habit, we could say that: "Good Eating Habit means ensuring the conditions for access and for the intake of various secure foods in necessary quantities and with good quality to all, in a permanent and sufficient manner to meet the nutritional requirements, based on healthy eating practices, thus contributing for a dignified existence, in a context of full development of the human being".
And education must be considered a basic and crucial factor of any feeding program, together with other inter-sectorial aspects. A sustained production of basic foods and respect to the peoples eating habits, for example, is crucial. Thus, one must treat and acknowledge feeding both as a right and a public good. Obtainment, intake, maintenance and universalization of the Good Eating Habit are duties of the government, of society and of each one. Feeding requires the convergent articulation of several areas and political and administrative actions, with social participation and control.
It is necessary to make available through education the possibility of a good feeding that is necessary for all, in a stable (not subject to seasonal, economic or geopolitical variations), autonomous (in which each region can ensure, at least, its typical basic-needs grocery package), sustainable (with the preservation of the natural resources so that the future generations can also have access to balanced and healthy foods) and equal manner, ensuring to all, without discrimination, a good nutritional status. And the information, guidance and the correct and modern feeding education are the key elements for all this to take place.
Finally, we would like to reiterate that education must be considered the key factor for good feeding, and that the food and nutritional security is, together with education, another very important factor to ensure the right to that feeding. Aware of that, let us unite and face the challenge to defeat bad food habits and to ensure a balanced and healthy feeding for everyone.
Received on 5.22.2006 and accepted on 7.10.2006.
José Eduardo Dutra de Oliveira is a full professor of Clinical Medicine, an expert in Nutrology and a Member of the Study Group on Nutrition and Poverty of the Institute of Advanced Studies of the University of São Paulo (IEA/USP), Brazil. He was President of the Latin American Nutrition Society (SLAN) and of the International Union of Nutritional Sciences (IUNS). @ email@example.com
This text has been translated by Rodrigo Sardenberg. The original in Portuguese "Educação e direito à alimentação" is available at http://www.scielo.br/scielo.php/script_sci_serial/lng_pt/pid_0103-4014/nrm_iso.