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The frequency of overweight among the population overall surpasses by eight times the weight deficit of women and by fifteen times the weight deficit of the male population.  Considering a universe formed by 95.5 million persons aged 20 and over, 3.8 million (4.0%) are underweight and a total 38.8 millions (40.6%), overweight, among whom 10.5 million are considered obese. This pattern is almost thoroughly repeated in most population groups analyzed in the country. These results are part of the second stage of IBGE’s Consumer Expenditure Survey 2002-2003, whose chapters on dietary intake and nutritional status have been produced in partnership with the Ministry of Health.

 

POF 2002-2003 shows that the Brazilian adult population overall is not exposed to malnutrition risks, since the 4% rate is compatible with international patterns, that is, with an expected proportion of naturally thin persons. Rates between 3% and 5% are found in all populations not exposed to nutritional deficiencies. Thus, only when the weight deficit exceeds 5%  are these populations said to be in risk of malnutrition. 

 

Exposure of the adult population to malnutrition is low, in some special cases

 

The analysis of the nutritional status according to POF 2002-2003 encompassed several population strata. The risk of malnutrition was considered low, when observed, corresponding to deficit proportions between 5 and 10%. International classifications consider that rates between 5% and 10% mean low exposure to malnutrition; between 10% and 20%, medium exposure; between 20% and 30%, high exposure and above 30%, extremely high exposure.

 

In the Brazilian case, the prevalence of weight deficit is equivalent or above 5% for men aged 74 and over (8.9%) and for women under 30 (12.2% between 20 and 24 years of age, and 7.3% between 25 and 29 years of age). Among adult men, in general, the weight deficit is always lower than 5% in all the Major Regions, ranging from 2% in the South to 3.5% in the Northeast, and slightly higher in the rural area, though never surpassing 5%. Among the female population, rates range between 3.7% in the South to 6.2% in the Northeast and Central West. In the rural area, they reach 3.6% in the South and 5.1% in the North Region. In the rural areas of the Northeast Region, the prevalence of the weight deficit reached 7.2% of the adult women, in the Southeast, 6.2% and in the Central West, 6.3%, indicating, in these three cases, low exposure to malnutrition.

 

The weight deficit decreases among men and women as income increases. In the male population, it is 4.5% when income per capita is equal to below ¼ of a minimum wage, and 1.3% for incomes above 5 minimum wages per capita.  Among women, the deficit is close to 5% when income is below two minimum wages per capita and 8.5% when income per capita is below ¼ of a minimum wage.

 

Overweight and obesity differ among men and women and rural and urban areas

In 2003, the excess of weight affected 41.1% of men and 40% of women, and obesity reached 8.9% of the men and 13.1% of the adult women in the country. Thus, obese persons represented 20% of the total overweight men and one third of the overweight women in the country.  

The excess of weight also tends to increase with age, at a higher rate among men, and more slowly, but in a more prolonged way, among women. It is observed that at the age of 55, for men, and 65, for women, weight tends to decrease. Between 20 and 44 years of age, the excess of weight is more frequent among men, and the opposite is true concerning older ages.

Among men, overweight is visible at two distinct levels: about 34% in the North and Northeast and between 44 and 46% in the other Major Regions. Similar behavior is observed in urban areas. In rural areas, the excess of weight appears at lower proportions, being 21% in the Northeast, reaching 40% in the South, and between 28 and 34% in the other rural areas.

 

 

In the case of women, this difference between rural and urban areas is not as significant, but the occurrence of overweight is always higher in rural areas. The exception is the Northeast, where the percetage is higher in urban (39.4% versus 36.8%). Among obese men, the proportions are much lower in the rural Brazil (5.1%) than in the urban one (9.7%). In the female population, there is a smaller difference (13.2% in the urban and 12.7% in the rural area).  Considering obese persons in general, the highest percentage was that of women living in the rural area of the South Region (18.6%), whereas the lowest percentage was that of men in the rural Northeast (3.2%).

In higher classes of income, more than half of men are overweight

In 2003, rates of 20% and 26% of overweight are found in the male population living in families with monthly income of up to half a minimum weight per capita.  Both overweight and obesity increase with income in the male population, and 56.2% of the men in higher income ranges, above five minimum wages, are overweight.  Among women, the increase of obesity percentages occurs up to a range of income per capita of two minimum wages, and falls beyond that figure. Overweight (42%) and obesity (14$) are highest among women who live in families with income ranges of 1 to 2 minimum wages per capita.

 

In 30 years, less weight deficit and more overweight and obesity, mainly among men

In Brazil, the percentage of weight deficit has declined throughout the years, both among men and women. Between the 1970’s and 1980’s, this deficit fell 50%, showing slight reduction from 1989 on. Thirty years ago, 16% (7.6 million) of the adult population was overweight.

 

 

 

In the middle of the 1970’s, the problem of exposure to malnutrition in the female population was more serious in the North, Northeast and Central West Regions, with rates of 11% and 14%, representing moderate exposure. In 2003, there was low exposure to malnutrition in the female population of the North, Northeast, Southeast and Central West.  The excess of weight and obesity increased continuous and intensively in the male population.  In 1974, the problem of obesity was practically inexistent in the male population.  In 2003, there was confirmed low exposure to malnutrition in the female population of the North, Northeast and Central West.

Overweight and obesity increased continuous and significantly in the male population. In 1974, this problem was virtually inexistent among them. The percentage of overweight men doubled (from 18.6% to 41%) and the number of obese ones was three times bigger (from 2.8 para 8.8%). Up to 1989, the percentages of overweight and obesity, among men, were significantly smaller than those observed among women. In 2003, these percentages reached virtually the same levels.  On the other hand, overweight and obesity among women increased from 1974 to 1989 and remained stable between 1989 and 2003. Except for the Northeast, where this increased remained, the Major Regions recorded stability or decline of the rates.

On the other hand, overweight and obesity among women increased from 1974 to 1989 and remained stable between 1989 and 2003. Except for the Northeast, where this increase remained, all Major Regions recorded stability or decline of rates.

 

In the last 30 years, the evolution of the population’s nutritional status has been affected by income

Among men, the occurrence of overweight increases significantly with the income, whereas among women, the ratio between overweight and income percentages is lower, and the excess of weight is more common in intermediate income ranges.

In general, the the evolution pattern of the population's anthropometric and nutritional profile is repeated in all income ranges. Whereas, in the middle of the 1970’s, obesity was relatively rare among women in the income range of up to ¼ of a minimum wage (2.7%) and among men who earned up to one minimum wage per capita (0.5% among those who earned up to ¼; 1.4% among those who earned up to half a minimum wage and 2.3% among those who earned up to one minimum wage), from 1988 to 2003, the increase of weight excess and obesity among women was limited to the first two income ranges (up to ¼ and from ¼ to ½ a minimum wage per capita).  The exposure of women to malnutrition, in the first two income ranges, had moderate reach in the 1970’s, of 16.0% and 13.1%.

 

Dietary intake of Brazilian families has  high amount of sugar and little of fruit and vegetables

The 2^nd phase of POF 2002-2003 results shows that, in general, Brazilian families have a high intake of sugar, especially that contained in soft drinks, but eat small amounts of fruits and vegetables. In terms of amount of calories consumed, the daily per capita average in Brazil (1811.18 kcal) was below the average of energetic need estimated by FAO for Brazil (2300 kcal).  This diet corresponds to household availability of foods acquired by Brazilian families and not exactly to the real household intake, since the survey does not cover food away from home. Besides, it is known that part of the food acquired is not consumed by families. It is important to mention that monetary and non-monetary acquisitions are considered. The amount of average calories per capita on a day in urban areas is 1700 kcal, and in rural areas, 2400 kcal.  

 

Brazilian diet has adequate amount of proteins 

It is observed that the percentage of calories from carbohydrates (59.6%), proteins (12.8%) and lipids (27.6%) ingested are in accordance with nutritional patterns recommended by the World Health Organization (WHO) - between 55% and 75% of carbohydrates; between 10% and 15% of proteins and between 15% and 30% of lipids. In carbohydrates, the unbalance is associated to the amount of sugar (sucrose) ingested: 13.7%, but the recommended amount is 10%.  Among proteins, those of animal origin, with a high biological value, present consumption figures above 50%.

 

Household income determines availability of food in housing units

 

The results presented show that the income ranges of households determine the acquisition of most food products in the country.

Meats, milk and derivatives, fruits, vegetables and legumes, alcoholic beverages, condiments and ready-to-eat meals are food produts whose participation in the diet of families tends to increase in a uniform way, according to the range of family income. The opposite includes beans and roots and tubers. The participation of cereals and derivatives in the diet of families is relatively constant up to the level of two-minimum wages per capita of income. 

Some food products stand out in relation to income, for example, rice, whose consumption falls as the incomes of households increase. The opposite takes place among bread and cookies, whose participation in the diet tents to increase with the increase of income. 

Distinct patterns in terms of income are also seen in the group sugar and soft drinks. In the case of sugar, there is slight increase in families with income of up to one minimum wage per capita, and strong decline afterwards. In the highest range of income, for example, the consumption of sugar is 50% below that of the lowest range. Considering soft drinks, there is significant and continuous increase in higher ranges of income, in such a way that their participation in the diet is five times bigger in higher income ranges.

Families with highest incomes eat more fat and less carbohydrate

 

In relation to macronutrients, the results show that families who earn more tend to consumer a bigger amount of fat and a smaller amount of carbohydrates. In the case of carbohydrates, the percentage recommended by the WHO (55%) is not reached by households with income above five minimum wages, and even more serious is the fact that about one-fifth (11%) correspond to sugar.

 

Considering fats, the maximum limit of 30% of total calories is surpassed by households with income above two minimum wages per capita per month.  Saturated fats tend to increase even more significantly with income than other fats, and the maximum limit for this component of the diet (10% of total calories) is virtually reached by families earning between two and five minimum wages (9.7%) and certainly surpassed by those earning more than five minimum wages per capita (11.2% of total calories).  The maximum limit of 10% for the proportion of calories coming from sugar is surpassed in all income ranges, and the most critical situation corresponds to intermediate income ranges, in which the participation of this item reaches almost 15%. 

 

Although the level of proteins in the diet increases according to the income, the proportion of calories from proteins was adequate in all income ranges. Another highlight is that the fraction of proteins of animal origin (of higher biological value) consumed increases with income, changing between 45% in the lowest and 60% in the highest income range.

 

 

In 30 years, consumption of fat increases and that of carbohydrate decreases

 

In the case of carbohydrates (55.9%), the minimum contribution is very close to the recommended amount, and one fifth corresponds to sugar. The maximum limit of 30% of fat in total calories is surpassed (30.52%). The consumption of proteins increased in the period, but always in an adequate way.

 

 

 

 

Dietary intake is quite varied among the Major Regions

POF investigated the annual acquisition of food per capita by Brazilian families, the information of which were the basis for the analysis of the household diet and the nutritional status of the adult population.  In the first comparison (Table 1.1 of the publication), it was observed that, among the Major Regions, there are significant differences in the amounts of food obtained for consumption at home. In Brazil, a total 48 kg of cereals and oilseeds, on the average, is consumed, and the South is least consuming Major Region (39 kg). Central-West (57 kg) and Northeast (52 kg) recorded the highest results, followed by the Southeast (48kg) and the North (46 kg). Information presented herein refers to amounts in kg per cap ita of food acquired for consumption at home, either by means of monetary expenses (when food is paid cash, by check or credit card) or non-monetary expenses (food obtained through private production, taken from a business, exchanged, donated or the like).  

In relation to the group green vegetables and fruits, the South Region had the biggest amounts acquired 939 kg and 31 kg, respectively). The North Region (20 kg) recorded the lowest per capita acquisition of green vegetables, significantly below the national average (29kg) and the Southeast (32 kg), Central West (23 kg) and Northeast (22 kg). As for fruits, the smallest level of consumption was that of the Central West (17 kg), followed closely by the North (18 kg).

Eating habits vary according to the Major Region. In the North, for example, the acquisition of coconuts, chestnuts and nuts reaches almost 17kg and probably results from the consumption of acai (emulsion), a typical product in that Region. In the other regions, the annual per capita consumption does not surpass 0.6 kg, whereas the national average is 1.6 kg.

Another group which presents regional peculiarities is the segment of flour, starch and pasta, with average national consumption of 23 kg. The main acquisitions were found in the North (44 kg) and Northeast (31 kg), mainly due to cassava flour (34 kg and 15 kg, respectively). In the South, consumption reaches 28 kg, the main highlight being wheat flour (18 kg). The Southeast (14 kg) and the Central West (11 kg) recorded the smallest quantities. Bakery goods (20 kg) had a very homogeneous level of consumption in the Northeast (20 kg), in the Southeast (22 kg) and in the South (21 kg), and smallest levels in the North (16 kg) and Central West (14 kg).

 

North surpasses South in terms of beef intake

The highest level of beef acquisition was that of the South region (35 kg). However, when the type of meat consumed is considered, the highlight is the North Region, where consumption of prime (8.5 kg) and choice beef (10.4 kg) surpassed that of Southern states (6.2 kg and 9.9 kg, respectively). As well as meat, fish is often present in the households of the North Region (25 kg), sometimes surpassing the consumption in Brazil (5 kg) and in the Northeast (5 kg), Southeast (2.2 kg), South (1.8 kg) and Central West (1.4 kg) Regions.

Dairy products (milk and its derivatives) also recorded significant differences. Significantly above the national average (50 kg), the South is the main consuming Major Region (71 kg), followed by the Southeast (60 kg) and Central West (57 kg).  In the North (24 kg) and in the Northeast (29 kg), consumption does not reach half of the amount of other regions.  A highlight in this group is the type of milk consumed: in the South and Southeast there is prevalence of pasteurized milk (41 kg and 40 kg, respectively), whereas in the North and Northeast, the highlights is fresh cow's milk (15 kg and 17 kg, respectively).

The group of sugar, sweets and confectionary items, with average acquisition of 24 kg in Brazil, and of salt and condiments (6 kg) and oils and fats (10 kg) presented little difference in the amounts consumed in each Major Region.

On the other hand, beverages and infusions recorded major regional differences: 55 kg in the Southeast; 53 kg in the South; 35 kg in the Northeast and in the Central West and 25 kg in the North.  In Brazil, the average annual household consumption per capita is 45 kg, and the group alcoholic drinks corresponds to 6 kg, and the subgroup non-alcoholic beverages, to 36 kg.   In the five Brazilian Major Regions this relationship is similar. The habit of acquiring alcoholic drinks for consumption at home is less present in the North and Northeast (on the average, 2 kg per capita) and less significant in the South (9 kg).

Also in comparison among the Major Regions, it is observed that the consumption of prepared food is most common in the South (4 kg) and in the Southeast (3 kg). The lowest amount was observed in the Northeast, where annual consumption does not reach 1 kg, followed by the Central West (1.6 kg) and the North (1.7 kg).  

 

In higher ranges of income, there is less intake of cereals and legumes and of flour, starch and pasta

By income ranges, POF 2002-2003 showed that, the bigger the income, the smaller the per capita intake of cereals and oilseeds and flour, starch and pasta (Table 2.1 of the publication). In the case of cereals and legumes, the acquisition of families with income of up to R$ 400 is 52 kg per capita a year, whereas in income ranges above R$ 3000, the amount is R$ 38 kg.  It is interesting to observe that, up to R$ 1600 of income, the amount consumed was close to 50 kg.  From this figure on, the amount acquired decreases.

In the case of flour, starch and pasta, the amount decreases with the increase of the income range, changing from 29 kg to 16 kg in the year. That is mainly due to the cassava flour, the consumption of which falls from 14kg to 2 kg in families with higher income. On the other hand, there is growing consumption of flour and pasta (both about 5 kg) and little change among income ranges.

 

Families with higher income acquire more alcoholic beverages

Beverages and infusions, dairy products, green vegetables and fruits are highlights of groups whose amounts increase with income.  In families who earn up to R$ 400, the consumption of alcoholic beverages is 1 kg, whereas in the income range above R$ 3000, the intake is 15 kg. The same is true concerning non-alcoholic beverages, the acquisition of which grows with income, changing from 12 kg to 72 kg. A favorite beverage in the country, coffee is an exception in the group, since it presents amounts that range between 2.5 kg to 2.9 kg in all the income ranges.

As for dairy products, with acquisition ranging from 27 kg to 75 kg, the highlight is milk: 24 kg in families with lower income and 59 kg among those who earn more than R$ 3000. It is observed that pasteurized milk (9kg to 50 kg) follows this trend, however, the same does not occur to fresh cow's milk, the acquisition of which is 15 kg in lower ranges of income, and reaches figures between 17 and 20 kg when income near R$ 1000 and fall again, reaching 9 kg in families with higher incomes.  Cheese and cream cheese (from 0.4 kg to 6 kg per capita in the year) also present increase of consumption as income increases.  In relation to green vegetables, the amounts range from 16 kg to 42 kg, according to the income range, and in the case of fruits, from 11 kg to 46 kg.  In general, the items which form these two groups follow the same trend.  

The amounts consumed of bakery goods 9from 12 kg to 29 kg), meat (from 17 kg to 32 kg) and poultry and eggs (from 12 kg to 16 kg) also increase with income, but at a lower rate.  The two main components of bakery goods, bread (from 8 kg to 21 kg) and cookies (from 4 kg to 6 kg) present amounts which increase with income.  In the subgroup cookies, crackers have per capita acquisition amounts very similar to those of income ranges (about 2 kg).

In meats, the increase of acquisition of prime beef (from 2 kg to 11 kg) is directly proportional to the change of income.  The acquisition of choice meat change little in relation to income differences, and families who earn between R$ 1600 and R$ 3000 consume higher amounts.

In the group poultry and eggs, the most relevant acquisition was that of chicken, which, being traded as slaughtered chicken, is more often acquired by families with income of up to R$ 3000. Cut pieces, such as chicken breast, present amounts acquired which grow with income (0.3 kg to 2.6 kg).  

Fish, on the other hand, had quite the opposite behavior, according to several income ranges, with amounts of amount 6 kg in lower income and about 4 kg in higher income ranges.  Fresh water fish are the main influence of this behavior of the group (about 3 kg in lower income ranges and smaller than 1 kg in the higher ones).

The group sugar, sweets and confectionary items presents small changes in relation to income: 22 kg and 25 kg in several ranges. The subgroup sugar, however, presents acquired quantities (from 21 kg to 16 kg) proportional to the increase of income: crystallized sugar range around 13 kg in families with income of up to R$ 1600, having fallen from there until it reached 8 kg in richer families. Per capita income of refined sugar is about 6 kg, whatever the income range. The consumption of the subgroup sweets and confectionary items increases with income: 1 kg per capita in lower income and close to 5 kg in higher incomes.                                                               

Another situation investigated by POF 2002-2003 refers to expenses with food away from home which, as observed in the chart below, increase consistently with income.

 

 

In rural areas, non-monetary acquisitions are more common

POF 2002-2003 also shows is the form of acquisition of the product is monetary (with money) or non-monetary (through donations, own-production, withdrawla from a business, exchange, etc.). So, it is possible to know if the product has been bought, donated, exchanged, etc.

In Brazil, the biggest percentages of non-monetary acquisitions were recorded by the following products:  coconuts and chestnuts (45%); fish (30%); eggs (28%); milk and cream (23%); green vegetables (14%) and fruits (13%); cereals and legumes (13%); poultry (10%) and flour, starch and pasta (10%).  In the urban Brazil, among the highlights presented, the amounts of non-monetary acquisitions if each item do not exceed 10% of the total amount per capita acquired.  In this case, with percentages around 8%, we can mention fish, eggs, milk and coconut and chestnuts.  in rural Brazil, non-monetary acquisition is naturally more common.  The highlights, in this case, are: coconuts and chestnuts (83%); milk (78%), mainly fresh cow’s milk (86%); eggs (73%0; fish (63%); fruits (56%); green vegetables (54%); poultry (44%); cereals and legumes (32%); meat (28%, except chicken and fish); and flour, starch and pasta (20%).

In the North, percentages of non-monetary consumption of cassava flour and fish are high

Among the Regions, the percentage of non-monetary acquisition of flour, starch and pasta reaches 27% in the North, and in the rural area of the Region, the percentage reaches 49%. These results are influenced by cassava flour, whose non-monetary acquisition is 30% in the Region and 53% in the rural area.   Another highlight in the North Region in terms of non-monetary are coconuts, chestnuts and nuts 951.1%), with participation of 85% in the rural area.   Acai (emulsion) accounts for these percentages. The North also recorded the biggest amount per capita of acquisition of fish for consumption at home (25kg), and 47% of the amount consumed came from non-monetary acquisition.  In the urban area of the region, the non-monetary parcel reaches 11% of the total, whereas in the rural area this participation was 76%. Other highlights are meats, whose non-monetary consumption corresponds to 15.3% in the region.  The highlight, in this case, is pork (58% of the total in the region) and other meats (except beef and pork) which, in the rural North, present a percentage of non-monetary acquisition of 92%.   

In the Northeast, the main products acquired and not related to payment by check and credit card or check are milk (33% total, 12% in the urban area and 67% in the rural one) and cereals and legumes (19% total, being 32% in the rural Northeast).   Considering milk specifically, the most significant non-monetary acquisition was that of cow’s milk:  46% total in the area, 17% in urban areas and 73% in the rural Northeast.  The Southeast, on the other hand, had the lowest percentages of non-monetary acquisition among those observed in the other areas.  

In general, Brazilians choose to pay cash for the products they consume  

Considering the forms of monetary acquisition by type (cash or by installments), it is observed that, in Brazil, foods and beverages for consumption at home were paid cash, reaching 98% in some groups.  The little significant percentage of monetary acquisition in installments remains in the five Major Regions of Brazil.

In the details of non-monetary acquisitions (donations, own production, withdrawal from one’s own business and other), donations and own production were the most common ones.  These two types together account for more than 75% of non-monetary acquisitions in the country, but the regional behavior is quite varied.

 

 

^{(*) In order to make compatible to variety of units of measure in the survey, and considering the weights and volumes informed, we have chosen to use the kilogram to express all amounts mentioned.}