It is unlikely that anyone, today, does not know at least one person with diabetes, hypertension or obesity – if that someone is not, himself, affected by one of these conditions. This is true for Brazil, but it is also true in places like Mexico, the United States and the United Kingdom.
This fact, however, is seen with some normality by most of us. Having three diabetic relatives sounds much more banal than having three relatives with Covid-19, although both diagnoses have their risks. The sense of a pandemic is most noticeable in the field of infectious diseases, which can be transmitted from person to person. When the disease is chronic and non-communicable, the high prevalence can be overlooked.
Not for epidemiologists, of course. In the early 2000s, the growing number of people with chronic diseases intrigued doctor Carlos Monteiro, a professor at the Faculty of Public Health at the University of São Paulo. The advance of the silent pandemics of diabetes and hypertension did not match the data on food purchases: at the time, Brazilians reduced the purchase of items such as sugar, salt and soy oil.
Other items, however, began to gain space in supermarket carts. In general, they were ready-to-eat foods, such as stuffed cookies, instant noodles, and frozen lasagna. “People were no longer cooking. They exchanged home-cooked meals for options that already arrived ready-made or semi-ready”, says Monteiro. “This was related to the increased prevalence of chronic diseases, and my hypothesis was that the problem was in the food processing industry.”
The scientist’s insight led him to create, in 2009, a classification of foods, which he named Nova. It defines four food groups: in natura or minimally processed foods (such as fruits, vegetables, meats and grains), culinary ingredients (oil, sugar), processed foods (products that mix the first two categories, such as strawberry jam, which combines fruit and sugar) and ultra-processed foods. These are defined as industrial formulations that use part of food in natura (corn starch, vegetable fat) and which, in general, rely on dyes, sweeteners and flavorings to taste and smell something.
The launch of Nova made nutritional epidemiology look at ultra-processed products. Since then, scientific articles on the subject have popped up in all regions of the planet. In common, the studies point to associations between the consumption of these foods and a greater chance of having negative health outcomes, such as the development of obesity, diabetes, cancer and even depression.
From science to the field of public policies, Nova promoted the second edition of the Food Guide for the Brazilian Population, launched in 2014 with an innovative character. In short, the message of the document is that healthy eating is simpler than you might think: no fancy diets or specific nutrient deprivations, just focus on real food. Today, the guideline guides some public nutrition food policies, such as the National School Feeding Program, which gained a ceiling for the purchase of ultra-processed foods and a minimum amount for food purchases. in natura. The recommendation also guided food guides from other countries, such as Uruguay, Canada, France and Israel. It’s a way to fight a persistent and sneaky pandemic of chronic diseases around the world.
In addition to these pathologies, the Nova classification should clarify the understanding of another Brazilian public health challenge: food insecurity. “A lot has been said about hunger, which, of course, is a critical issue. But it is also necessary to look at other levels of insecurity”, says Monteiro. He explains that the path to hunger starts with mild food insecurity, when there is a qualitative reduction in food. That is, for reasons of physical and/or financial access, ultra-processed products begin to replace the in natura or minimally processed in the diet. Once again, it is up to science to monitor the diet of Brazilians and mitigate the advance of malnutrition in Brazil.
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Murilo Bomfim is a journalist.
This article was written for the #scienceinelections campaign, which celebrates Science Month. In July, the texts of the Ciência Fundamental blog will reflect on the role of science in the reconstruction of Brazil and its relationship with other topics of public interest. Today’s is about science and health.
