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Fidelis Baniwa EDJ, Putira Sacuena ER, Della Noce RR, Quaresma VB, Alencar TH, Lemes RB, Araújo AC, Cayres-Vallinoto IMV, Guerreiro JF. Fourteen-year trends in overweight, general obesity, and abdominal obesity in Amazonian indigenous peoples. BMC Public Health 2024; 24:1210. [PMID: 38693512 PMCID: PMC11064236 DOI: 10.1186/s12889-024-18689-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/23/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021. METHODS A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5 kg/m2; normal weight, ≥ 18.5 and < 25 kg/m2); overweight, ≥ 25 and < 30 kg/m2, and obesity, ≥ 30 kg/m2. A waist circumference (WC) < 90 cm in men and < 80 cm in women was considered normal. RESULTS The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages. CONCLUSION Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.
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Affiliation(s)
| | | | - Rosilene Reis Della Noce
- Faculty of Nutrition, Institute of Health Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Vanessa Barroso Quaresma
- Special Indigenous Health District of Altamira, Special Secretary of Indigenous Health, Altamira, PA, Brazil
| | - Teodora Honorato Alencar
- Special Indigenous Health District of Altamira, Special Secretary of Indigenous Health, Altamira, PA, Brazil
| | - Renan Barbosa Lemes
- Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, SP, Brazil
| | - Antônia Cherlly Araújo
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | | | - João Farias Guerreiro
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil.
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Chai L. Interplay between actual and perceived weight on mental health among Canadian Indigenous post-secondary students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592936 DOI: 10.1080/07448481.2024.2338419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Research increasingly focuses on the mental health implications of both actual and perceived weight, particularly among post-secondary students. Considering their unique socio-cultural context and the frequent oversight in research, this study examines these implications specifically among Canadian Indigenous post-secondary students. Recent evidence indicates that students with normal weight may also experience increased mental health risks due to negative weight perceptions. Therefore, this study explores the independent and combined effects of actual and perceived weight on the mental health of this group. PARTICIPANTS AND METHODS This study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations peoples living off-reserve, Métis, and Inuit. The focus was on Canadian Indigenous post-secondary students aged 19-34 years (n = 1,518). Logistic regression models, stratified by sex, were employed to analyze the data. RESULTS Perceptions of being overweight were linked to a higher risk of mood and anxiety disorders, poor self-rated mental health, and suicidal ideation among female students. This pattern was less evident among male students. Notably, female students who were overweight and perceived themselves as such were more likely to report poor mental health across all four indicators examined. In contrast, male students exhibited a less clear pattern. Diverging from recent studies, the findings indicated less robust mental health disparities among students with normal weight who perceived themselves as overweight, potentially due to the insufficient cell size of this category among Indigenous post-secondary students. CONCLUSIONS The study highlights the complex interplay between actual and perceived weight and its impact on mental health, particularly among female Indigenous post-secondary students.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
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Guarnido-Rueda A, Amate-Fortes I, Oliver-Márquez FJ, Martínez-Navarro D. Income or educational attainment: which is more effective in the fight against overweight? Evidence from Spain and Andalusia. J Biosoc Sci 2024; 56:270-291. [PMID: 38044837 DOI: 10.1017/s0021932023000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual's overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease.
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Affiliation(s)
- Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Francisco J Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
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Patriota P, Ko Maung K, Marques-Vidal P. Reported recommendations to address cardiovascular risk factors differ by socio-economic status in Brazil. Results from the Brazilian National Health Survey 2019. Prev Med Rep 2023; 36:102527. [PMID: 38116250 PMCID: PMC10728434 DOI: 10.1016/j.pmedr.2023.102527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/17/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023] Open
Abstract
Background Management of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient's socio-economic status has not been recently assessed in the Brazilian population. Aims To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population. Methods Survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant's educational level and income (in multiples of the basic salary per capita) was collected. Results Of the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes. Conclusion Better-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.
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Affiliation(s)
- Pollyanna Patriota
- Pôle Santé Vallée de Joux – Joux Valley Health Center, Le Sentier, Switzerland
| | - Ko Ko Maung
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Kramer CK, Leitão CB, Viana LV. The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry. Lancet 2022; 400:2074-2083. [PMID: 36502845 DOI: 10.1016/s0140-6736(22)00625-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Indigenous Brazilian peoples have faced an unparalleled increase in the rate of cardiovascular diseases following rapid nutritional transition to more urban diets. We aimed to conduct a systematic review and meta-analysis to evaluate the association between urbanisation (including data from Amazon rainforest deforestation) and cardiometabolic risk factors and outcomes. METHODS In this systematic review and meta-analysis, we searched Pubmed, Embase, Web of Science, and Scopus for articles published in any language between the year 1950 and March 10, 2022. Studies conducted in Indigenous Brazilian adults that evaluated metabolic health were included. Data for deforestation was obtained by the Amazon Deforestation Monitoring Project. Cardiovascular mortality was obtained from the Brazilian Health registry. Two independent reviewers evaluated studies for risk of bias, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The main outcomes assessed were the prevalence of obesity and related cardiometabolic risk factors among Indigenous Brazilian peoples and its association with urbanisation. Summary data were extracted from published reports for the meta-analyses. We calculated pooled estimates of the prevalence of each cardiometabolic outcome by using a random-effects model (DerSimonian-Laird method). This study is registered with the International Prospective Register of Systematic Reviews, CRD42021285480. FINDINGS 46 studies were identified, including a total of 20 574 adults from at least 33 Indigenous Brazilian ethnicities. Meta-analyses of the prevalence of obesity showed that there were higher rates of obesity (midwest region: 23% [95% CI 17-29]; and south region 23% [13-34]) and hypertension (south region: 30% [10-50]) in Indigenous peoples living in urban regions of Brazil, while the lowest rates of obesity (11% [95% CI 8-15]) and hypertension (1% [1-2]) were observed in those in the less urbanised (north) regions of Brazil. The prevalence of obesity was 3·5 times higher in participants living in urbanised Indigenous territories (28%) than in those living in lands with >80% native Amazon rainforest (8%). In meta-analyses that evaluated blood pressure level, there was no incremental change in blood pressure with ageing in Indigenous peoples who lived according to traditional lifestyle, in contrast to those living in urbanised regions. For Indigenous men with traditional lifestyles, systolic blood pressure changed from 109·8 mm Hg to 104·4 mm Hg between the youngest (<30 years) and the oldest (>60 years) age groups, and diastolic blood pressure changed from 69·8 mm Hg to 66·1 mm Hg. For Indigenous women with traditional lifestyles, systolic blood pressure was 100·0 mm Hg for the youngest age group with no changes for older age groups, and diastolic blood pressure was 62 mm Hg for the youngest age group with no changes for older age groups. For Indigenous men with urbanised lifestyles, systolic blood pressure changed from 117·3 mm Hg to 124·9 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 72·7 mm Hg to 76·4 mm Hg. For Indigenous women with urbanised lifestyles, systolic blood pressure changed from 110·0 mm Hg to 116·0 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 68·3 mm Hg to 74·0 mm Hg. For the years 1997 and 2019, the cardiovascular mortality rate in individuals living in the southeast region (the most urbanised) was 2·5 times greater than that observed in the north. Conversely, the incremental rise in cardiovascular mortality in the past two decades among Indigenous Brazilians living in the north or northeast (2·7 times increase) stands in stark contrast to the stable rates in those living in already urbanised regions. INTERPRETATION The macrosocial changes of Indigenous peoples' traditional ways of living consequent to urbanisation are associated with an increased prevalence of adverse cardiometabolic outcomes. These data highlight the urgent need for environmental policies to ensure the conservation of the natural ecosystem within Indigenous territories, as well as the development of socio-health policies to improve the cardiovascular health of Indigenous Brazilians peoples living in urban areas. FUNDING None.
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Affiliation(s)
- Caroline K Kramer
- Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
| | - Cristiane B Leitão
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana V Viana
- Serviço de Nutrologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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A’uwẽ (Xavante) views of food security in a context of monetarization of an indigenous economy in Central Brazil. PLoS One 2022; 17:e0264525. [PMID: 35213660 PMCID: PMC8880766 DOI: 10.1371/journal.pone.0264525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/13/2022] [Indexed: 11/24/2022] Open
Abstract
Following boom-and-bust economic cycles provoked by Brazilian governmental attempts to integrate Indigenous peoples into national society, it is approximately since the beginning of the 2000s that Brazilian Indigenous peoples came to be viewed officially as “poor” and victims of “hunger.” Consequently, the national indigenist agency and other State entities started to conceive and implement diverse initiatives that ultimately injected money and resources into Indigenous communities. In 2019 we undertook an ethnographic study in three A’uwẽ (Xavante) communities in the Pimentel Barbosa Indigenous Reserve, Central Brazil, with the objective of analyzing how people understand and pursue food security. We propose that in the studied communities the complex network of A’uwẽ food reciprocity is a fundamental strategy for mitigating hunger and acute lack of food. We show that among the A’uwẽ, the hybrid economy that developed since the 1970s has proved resilient to dramatic transformations and uncertainty in the availability and characteristics of external government inputs.
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Sombra NM, Gomes HLM, Sousa AM, Almeida GSD, Souza Filho ZAD, Toledo NDN. High blood pressure levels and cardiovascular risk among Munduruku indigenous people. Rev Lat Am Enfermagem 2021; 29:e3477. [PMID: 34495189 PMCID: PMC8432582 DOI: 10.1590/1518-8345.4970.3477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/11/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: to identify the risk factors associated with prehypertension and arterial
hypertension among Munduruku indigenous people in the Brazilian Amazon. Method: a cross-sectional study carried out with 459 Munduruku indigenous people
selected by means of stratified random sampling. Sociodemographic variables,
habits and lifestyles, anthropometric data, fasting glucose and lipid
profiles were evaluated. An automatic device calibrated and validated to
measure blood pressure was used. The analyses of the data collected were
carried out in the R software, version 3.5.1. For continuous variables, the
Kruskall-Wallis test was used; for the categorical ones, Fischer’s Exact.
The significance level was set at 5% and p-value≤0.05. Results: the prevalence of altered blood pressure levels was 10.2% for values
suggestive of hypertension and 4.1% for pre-hypertension. The risk of
prehypertension among indigenous people was associated with being male
(OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist
circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial
hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with
increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with
substantially increased waist circumference (OR=5.46; 95%
CI=1.78-16.75). Conclusion: among Munduruku indigenous people, men were more vulnerable to developing
hypertension; age and increased waist circumference proved to be strong
cardiovascular risk factors.
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Affiliation(s)
- Neuliane Melo Sombra
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, AM, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Hanna Lorena Moraes Gomes
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, AM, Brazil.,Scholarship holder at the Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM), Brazil
| | - António Manuel Sousa
- Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde, Manaus, AM, Brazil
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Leepile TT, Mokomo K, Bolaane MMM, Jones AD, Takada A, Black JL, Jovel E, Karakochuk CD. Anemia Prevalence and Anthropometric Status of Indigenous Women and Young Children in Rural Botswana: The San People. Nutrients 2021; 13:1105. [PMID: 33800575 PMCID: PMC8066262 DOI: 10.3390/nu13041105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.
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Affiliation(s)
- Tebogo T. Leepile
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | | | - Maitseo M. M. Bolaane
- San Research Centre, Botswana and the Department of History, University of Botswana, Gaborone, Botswana;
| | - Andrew D. Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA;
| | - Akira Takada
- Centre for African Area Studies, Kyoto University, Kyoto 606-8304, Japan;
| | - Jennifer L. Black
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
- Department of Food, Nutrition, and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- The Peter Wall Institute for Advanced Studies, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - Eduardo Jovel
- Integrated Studies in Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.T.L.); (J.L.B.); (E.J.)
| | - Crystal D. Karakochuk
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Food, Nutrition, and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Welch JR, Ferreira AA, Souza MCD, Coimbra CEA. Food Profiles of Indigenous Households in Brazil: Results of the First National Survey of Indigenous Peoples' Health and Nutrition. Ecol Food Nutr 2020; 60:4-24. [PMID: 33573410 DOI: 10.1080/03670244.2020.1781105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The objective of the present study was to characterize the food profiles in Indigenous households participating in the First National Survey of Indigenous People's Health and Nutrition in Brazil. Multiple correspondence analysis was used to estimate distances between regions and foods from three sources (local Indigenous production, purchased, and external donation), in addition to "not consumed." The combined distribution of the first two dimensions revealed three distinct profiles of food acquisition. Observed proximities between geopolitical regions and distinct modes of food acquisition speak to regional contrasts in food sovereignty among the Indigenous population that are closely linked to historical occupation and economic expansion in the country. Considering the concept of food sovereignty as involving rights to dietary autonomy, healthy diets, and resource management, our data suggest Brazil's North region is the closest of the four regions analyzed to these goals. Food sovereignty in the Northeast and South/Southeast regions is reduced due to greater monetarization and proximity to market economy resources. The advance of agribusiness in the Amazon has been a hallmark of the Brazilian government's current environmental policy, directly threatening the survival of Indigenous peoples living in that region.
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Affiliation(s)
- James R Welch
- Escola Nacional De Saúde Pública, Fundação Oswaldo Cruz , Rio De Janeiro, Brazil
| | - Aline Alves Ferreira
- Instituto De Nutrição Josué De Castro, Universidade Federal Do Rio De Janeiro , Rio De Janeiro, Brazil
| | | | - Carlos E A Coimbra
- Escola Nacional De Saúde Pública, Fundação Oswaldo Cruz , Rio De Janeiro, Brazil
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