Intersectoriality of food and nutrition initiatives: relationship with the prevalence of obesity in the State of Paraíba

MELO, Fernanda Caroline Tavares de; CARVALHO, Danielle Franklin de

doi:10.1590/1678-9865202235e220065

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ORIGINAL • Rev. Nutr. 35 • 2022 • https://doi.org/10.1590/1678-9865202235e220065 copy

Intersectoriality of food and nutrition initiatives: relationship with the prevalence of obesity in the State of Paraíba

Intersetorialidade das ações de alimentação e nutrição: relação com a prevalência de obesidade no estado da Paraíba

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the managerial profile and forms of intersectoral articulation in the framework of food and nutrition carried out in Primary Health Care and verify its association with the prevalence of obesity in the three health macro-regions of the State of Paraíba.

Methods:

Cross-sectional survey carried out in 151 municipalities in Paraíba, nested in a national population-based survey. Variables related to the manager, managerial profile, intersectoral forms of articulation, and obesity rates among adults were evaluated according to data from the Food and Nutrition Surveillance System.

Results:

All macro-regions presented a mean of adults obesity higher than the national reference for individual over 18 years of age described in the National Health Plan 2020-2023. The presence of the technician responsible for food and nutrition actions was associated with higher rates of obesity. The performance of food and nutrition education actions, and intersectoral practices related to the Food and Nutrition Security sector were associated with lower prevalence of obesity.

Conclusion:

The effectiveness of the actions cannot be guaranteed by the presence of a specific position for the actions. Food and Nutrition Education actions are recommended to reduce the prevalence of obesity.

Keywords:
Intersectoral collaboration; Nutrition programs and policies; Obesity

Variable	1^st Macro		2^nd Macro		3^rd Macro		Total		p-value
Variable	Mean±SD		Mean±SD		Mean±SD		Mean±SD
Age^*	38.7±10.2		38.0±8.4		36.8±8.4		37.8±8.9		0.542^a
	n	%	n	%	n	%	n	%
Gender
Female	37	82.2	45	91.8	44	77.2	126	83.4	0.125^a
Male	8	17.8	4	08.2	13	22.8	25	16.6	0.125^a
Skin color/Race^**
Yellow	0	00.0	0	0.0	2	03.5	2	01.3	0.122^a
White	18	40	28	57.1	19	33.3	65	43.0
Brown	26	57.8	21	42.9	35	62,5	82	54.3
Black	1	02.2	0	00.0	0	00.0	1	00.7
Position
PC and/or FN coordinator or reference	38	84.4	42	85.7	38	66.7	118	78.1	0.029^a
Others	7	15.6	7	14.3	19	33.3	33	21.9	0.029^a
Link
Civil Servant	18	40	19	38.8	24	42.1	61	40.4	0.939^a
Others	27	60	30	61.2	33	57.9	90	59.6	0.939^a

Variable	Total				1^st Macro				2^nd Macro				3^rd Macro				p
	Yes		No		Yes		No		Yes		No		Yes		No
	n	%	n	%	n	%	n	%	n	%	n	%	n	%	n	%
Presence of the Municipal Food and Nutrition Coordination	33	21.9	118	78.1	9	20	36	80.0	12	024.5	37	75.5	12	21.1	45	78.9	0.856
Presence of a technician in charge of food and nutrition actions	88	58.3	63	41.7	27	60	18	40.0	24	049.0	25	51.0	37	64.9	20	35.1	0.243
Articulation of the food and nutrition area with other municipal sectors	120	79.5	31	20.5	35	77.8	10	22.2	38	077.6	11	22.4	47	82.5	10	17.5	0.778
Development stages with intersectoral articulation
Action planning	102	85.0	18	15.0	31	88.6	4	11.4	33	086.8	5	13.2	38	80.9	9	19.1	0.581
Resource investment for action	52	43.3	68	56.7	13	37.1	22	62.9	18	047.4	20	52.6	21	44.7	26	55.3	0.659
Action execution	104	86.7	16	13.3	33	94.3	2	05.7	33	086.8	5	13.2	38	80.9	9	19.1	0.209
Evaluation and monitoring	79	65.8	41	34.2	27	77.1	8	22.9	25	065.8	13	34.2	27	57.4	20	42.6	0.177
Actions developed in an intersectoral manner
Food and nutrition education	113	94.2	7	5.8	34	97.1	1	02.9	35	092.1	3	07.9	44	93.6	3	06.4	0.643
Variable	Total				1^st Macro				2^nd Macro				3^rd Macro				p
	Yes		No		Yes		No		Yes		No		Yes		No
	n	%	n	%	n	%	n	%	n	%	n	%	n	%	n	%
Promotion of Adequate and Healthy Food	88	73.3	32	26.7	26	74.3	9	25.7	29	076.3	9	23.7	33	70.2	14	29.8	0.809
Control and prevention of malnutrition	92	76.7	28	23.3	27	77.1	8	22.9	27	071.1	11	28.9	38	80.9	9	19.1	0.567
Control and prevention of micronutrient deficiencies	80	66.7	40	33.3	25	71.4	10	28.6	24	063.2	14	36.8	31	66.0	16	34.0	0.749
Control and prevention of obesity/overweight	107	89.2	13	10.8	30	85.7	5	14.3	35	092.1	3	07.9	42	89.4	5	10.6	0.679
Control and Prevention of Non-Communicable Chronic Diseases	92	76.7	28	23.3	27	77.1	8	22.9	30	078.9	8	21.0	35	74.5	12	25.5	0.886
Food and Nutrition Surveillance	89	74.2	31	25.8	26	74.3	9	25.7	28	073.7	10	26.3	35	74.5	12	25.5	0.996
Monitoring of families and users of the Bolsa Família Program	105	84.5	15	12.5	31	88.6	4	11.4	33	086.8	5	13.2	41	87.2	6	12.8	0.973
Food and nutrition actions in schools that joined the SHP	116	96.7	4	03.3	34	97.1	1	02.9	38	100.0	0	00.0	44	93.6	3	06.4	0.260
Sectors that articulate with the area of Food and Nutrition
Agriculture/ Agrarian Development	37	30.8	83	69.2	12	034.3	23	65.7	9	023.7	29	76.3	16	34.0	31	66.0	0.513
Social Assistance	106	88.3	14	11.7	33	094.3	2	05.7	33	086.8	5	13.2	40	85.1	7	14.9	0.415
Culture	20	16.7	100	83.3	6	017.1	29	82.9	4	010.5	34	89.5	10	21.3	37	78.7	0.416
Education	118	98.3	2	01.7	35	100.0	0	0.0	38	100.0	0	00.0	45	95.7	2	04.3	0.206
Private Initiative	12	10.0	108	90.0	4	011.4	31	88.6	3	007.9	35	92.1	5	10.6	42	89.4	0.866
Charitable or religious institutions	35	29.2	85	70.8	11	031.4	24	68.6	10	026.3	28	73.7	14	29.8	33	70.2	0.885
Environment	18	15.0	102	85.0	5	014.3	30	85.7	3	007.9	35	92.1	10	21.3	37	78.7	0.226
Public Ministry	29	24.2	91	75.8	13	037.1	22	62.9	8	021.1	30	78.9	8	17.0	39	83.0	0.094
NGOs	20	16.7	100	83.3	5	014.3	30	85.7	7	018.4	31	81.6	8	17.0	39	83.0	0.891
Food and nutrition security	65	54.2	55	45.8	20	057.1	15	42.9	19	050.0	19	50.0	26	55.3	21	44.7	0.812
Local legislative power	15	12.5	105	87.5	5	014.3	30	85.7	5	013.2	33	86.8	5	10.6	42	89.4	0.875

Variable	Total				p	1^st Macro				p	2^nd Macro				p	3^rd Macro				p
	<Nat. Ref.		>Nat. Ref.			<Nat. Ref.		>Nat. Ref.			<Nat. Ref.		>Nat. Ref.			<Nat. Ref.		>Nat. Ref.
	n	%^*	n	%		n	%	n	%		n	%	n	%		n	%	n	%
Presence of the Municipal Coordination of FN	1	08.3	32	23.0	0.465	0	00.0	9	22.0	0.569	1	100	11	22.9	0.245	0	0.0	12	24.0	0.325
Presence of a technical officer in FN actions	12	100	76	54.7	0.001	4	100	23	56.1	0.138	1	100	23	47.9	0.490	7	100.0	30	60	0.045
Articulation of the FN area with other municipal sectors	10	83.3	110	79.1	1.000	4	100	31	75.6	0.561	1	100	37	77.1	1.000	5	71.4	42	84.0	0.594
Development stages with intersectoral articulation
Action planning	8	80	94	85.5	0.645	4	100	27	87.1	1.000	0	0.0	33	89.2	0.132	4	80.0	34	81.0	1.000
Resource investment for action	2	20	50	45.5	0.184	1	25.0	12	38.7	1.000	0	0.0	18	48.6	1.000	1	20.0	20	47.6	0.362
Action execution	8	80	96	87.3	0.621	4	100	29	93.5	1.000	0	0.0	33	89.2	0.132	4	80.0	34	81.0	1.000
Evaluation and monitoring	6	60	73	66.4	0.734	4	100	23	74.2	0.553	0	0.0	25	67.6	0.342	2	40.0	25	59.5	0.638
Actions developed in an intersectoral manner
Food and nutrition education	9	90	104	94.5	0.465	4	100	30	96.8	0.886	0	0.0	35	94.6	0.079	5	100.0	39	92.9	0.708
Promotion of Adequate and Healthy Food	8	80	80	72.7	1.000	3	75.0	23	74.2	1.000	1	100	28	75.7	1.000	4	80.0	29	69.0	1.000
Control and prevention of malnutrition	8	80	84	76.4	1.000	4	100	23	74.2	0.553	0	0.0	27	73.0	0.289	4	80.0	34	81.0	1.000
Control and prevention of micronutrient deficiencies	6	60	74	67.3	0.730	2	50	23	74.2	0.561	1	100	23	62.2	1.000	3	60.0	28	66.7	1.000
Control and prevention of obesity/overweight	9	90	98	89.1	1.000	4	100	26	83.9	1.000	1	100	34	91.9	1.000	4	80.0	38	90.5	0.445
NCD control and prevention	7	70	85	77.3	0.697	4	100	23	74.2	0.553	1	100	29	78.4	1.000	2	40.0	33	78.6	0.097
Food and Nutrition Surveillance	9	90	80	72.7	0.450	4	100	22	71.0	0.553	1	100	27	73.0	1.000	4	80.0	37	73.8	1.000
Monitoring of families and users of the Bolsa Família Program	8	80	97	88.2	0.612	3	75.0	28	90.3	0.399	1	100	32	86.5	1.000	4	80.0	37	88.1	0.511
Variable	Total				p	1^st Macro				p	2^nd Macro				p	3^rd Macro				p
	<Nat. Ref.		>Nat. Ref.				<Nat. Ref.		>Nat. Ref.				<Nat. Ref.		>Nat. Ref.			<Nat. Ref.	>Nat. Ref.
	n	%^*	n	%		n	%	n	%		n	%	n	%		n	%	n	%
Food and nutrition actions in schools that joined the SHP	9	90	107	97.3	0.297	4	100	30	096.8	1.000	1	100	37	100.0	-	4	80.0	40	95.2	0.292
Sectors that articulate with the FN area
Agriculture/Agrarian Development	4	40	33	30.0	0.496	2	50	10	032.3	0.594	0	0.0	9	024.3	1.000	2	40	14	33.3	1.000
Social Assistance	10	100	96	87.3	0.604	4	100	29	093.5	1.000	1	100	32	086.5	1.000	5	100	35	83.3	1.000
Culture	3	30	17	15.5	0.368	2	50	4	012.9	0.128	0	0.0	4	010.8	1.000	1	20	9	21.4	1.000
Education	10	100	108	98.2	-	4	100	31	100.0	-	1	100	37	100.0	-	5	100	40	95.2	1.000
Private Initiative	0	0.0	12	10.9	0.596	0	0.0	4	012.9	1.000	0	0.0	3	008.1	1.000	0	0.0	5	11.9	1.000
Charitable or religious institutions	1	10	34	30.9	0.278	0	0.0	11	035.5	0.285	0	0.0	10	027.0	1.000	1	20	13	31.0	1.000
Environment	1	10	17	15.5	1.000	1	25.0	4	012.9	0.477	0	0.0	3	008.1	1.000	0	0.0	10	23.8	0.569
Public Ministry	2	20	27	24.5	1.000	2	50	11	035.5	0.618	0	0.0	8	021.6	1.000	0	0.0	8	19.0	0.571
NCDs	0	0.0	20	18.2	0.210	0	0.0	5	016.1	1.000	0	0.0	7	018.9	1.000	0	0.0	8	19.0	0.571
Food and nutrition security	5	50	60	54.5	1.000	3	75.0	17	054.8	0.619	0	0.0	19	051.4	1.000	2	40	24	57.1	0.644
Local legislative power	3	30	12	10.9	0.111	2	50	3	009.7	0.089	0	0.0	5	013.5	1.000	1	20	4	09.5	0.445

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[1] Correspondence to: DF CARVALHO. E-mail: <daniellefranklin6@gmail.com>.