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A woman walks next to a relative as she pulls her cart filled with groceries from a feira livre market in the Mooca neighbourhood of Sao Paulo January 26, 2013. Brazil's official inflation rose to above the centre of its target estimate due to food pressures, local media reported. (Nacho Doce/REUTERS)

A woman walks next to a relative as she pulls her cart filled with groceries from a feira livre market in the Mooca neighbourhood of Sao Paulo January 26, 2013. Brazil's official inflation rose to above the centre of its target estimate due to food pressures, local media reported.

(Nacho Doce/REUTERS)

Brazil takes an unambiguous new approach to fighting fat Add to ...

Brazil, like Canada, is getting fatter by the year.

Obesity has reached such epic proportions that Brazil’s new soccer stadiums include more than double the number of extra-wide seats required by World Cup authorities to accommodate both people with disabilities and heavyweight fans. On Brazil’s famous beaches, adipose folds have multiplied as fast as the pizza joints and Burger Kings that were virtually non-existent two decades ago.

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Nevertheless, Brazil has a plan to reverse obesity – and it’s winning raves from North America’s toughest nutrition critics, including author Michael Pollan, food-industry watchdog Marion Nestle and Canadian bariatric expert Yoni Freedhoff.

Unlike food guides in Canada and the United States, it does not include arranging food groups in pie or pyramid shapes, adding up recommended servings listed in grams, or colour-coding nutrient groups that correspond to sectors of the agricultural industry – dairy, meat and grain. Nor does it require people to measure servings of pasta by the half-cup, or carve up steak into helpings the size of a deck of cards.

Instead, Brazil’s proposed guide (in public consultation until May) emphasizes meals, not nutrients. It urges people to be critical of food-industry advertising, and introduces healthy eating as a lifestyle choice that involves learning how to cook from scratch and taking the time to sit down and eat with others.

The concept is so simple, experts say, that it just might work.

Pollan (known for the phrases, “Eat food. Not too much. Mostly plants.”) called the new dietary guidelines “radical” in a recent tweet. The highly influential Nestle, who blogs at FoodPolitics.com, praised Brazil for its “sensible, unambiguous” approach.

And Freedhoff, Canada’s own healthy-eating guru, described Brazil’s food guide, released in February, as “refreshingly free of industry bias” and “exactly what we need to be doing as a society.”

How people eat is as important as what they eat, said Jean-Claude Moubarac, a Montreal-based postdoctoral scholar of public health and nutrition who spent two years as a member of the University of Sao Paulo team responsible to the Brazilian ministry of health for developing the new guidelines.

Research has shown that when people sit down at mealtimes with friends and family, “they tend to eat less” than when they’re eating alone or on the run, Moubarac explained.

Brazil’s new food guide contains no information on calories or how to limit serving sizes to reduce body mass index. Instead, it tells Brazilians what to leave off the dinner plate. The guide recommends that people limit or avoid ready-to-eat products such as snack foods, candy, sweetened beverages, instant soups and microwaveable meals.

The warning to be wary of food-industry advertising is a world’s first for government-issued dietary guidelines, Moubarac said. Compared with U.S. and Canadian guidelines, which don’t address the impact of the food industry on dietary habits, “It’s a huge thing that a ministry of health is saying, ‘be critical of commercial advertising,’” he said.

Canada’s Food Guide has not succeeded in shrinking waistlines in this country, where 18 per cent are now obese – a rate that has tripled since 1985.

Canada’s guidelines are based on recommended daily intake of specific nutrients derived from food groups. But the guidelines are not as evidence-based as they seem, according to Freedhoff, director of the Bariatric Medical Institute in Ottawa. For the most part, “RDIs are theoretical,” he said.

The nutrient-based approach has enabled the food industry to market products such as sugary cereals and oversalted soups as part of a healthy diet, based on added minerals or protein advertised on the box, Freedhoff explained. “This focus on nutrients has steered people towards nonsensical patterns,” he said.

Added vitamins or not, heavily processed foods are loaded with excess sugar, fat and salt, which work against the biological mechanisms that let us know when we’ve eaten enough, studies have shown. Meals made from scratch are more likely to trigger feelings of satiety, Freedhoff said. “It is very challenging to consume very large quantities from fresh foods – you’re full.”

Cooking a healthy meal can be as simple as frying an egg, tossing a salad or making a sandwich, he added.

The trouble is that a growing number of people – Canadians and Brazilians – have either gotten out of the habit of making their own food, or never learned in the first place.

In Brazil, many grow up with a team of maids or grandmas who spend hours in the kitchen peeling and chopping meat and vegetables for almoco, the midday meal. A typical almoco consists of a dozen plates of food laid out on the table for the family to enjoy on a two-hour break from work or school.

But Brazil’s booming economy has resulted in longer working hours – which cut into almoco time – as well as job opportunities that lure workers far from home.

Young Brazilians who didn’t learn to cook from their parents are easily seduced by the convenience of fast food, Moubarac said. Focus groups conducted by the researchers who created Brazil’s new guidelines identified university students as the group most likely to say they did not like, or know how, to cook.

And now, many in Brazil have disposable income for the first time, thanks to economic and social reforms that pulled 20 million Brazilians out of poverty between 2003 and 2009. This means new freezers and microwaves to store and reheat food, and money for fast food.

Transnational food companies have seized the market opportunity, including McDonald’s (which has nearly 700 restaurants in Brazil), KFC and Burger King, which was acquired in 2010 by a Brazilian-owned global investment firm.

For lower-income Brazilians, eating a Big Mac holds far more social cachet than cooking rice and beans from the corner market. “It’s a way to climb the social hierarchy,” Moubarac said.

Escalating obesity has been the result. Nearly half of Brazilians are overweight – a proportion that has more than doubled since 1990. More than 15 per cent are obese, and in a decade or so, Brazil is predicted to reach the current U.S. obesity level of 35 per cent.

Moubarac acknowledged that dietary guidelines alone can’t counteract international market forces and major socioeconomic shifts that have added to Brazil’s girth. The new food guide is the first step in a larger plan that will include community-based programs designed to help lower-income families learn about healthy portion sizes and how to cook homemade meals with moderate amounts of sugar, fat and salt, he said.

He added that Brazilians who lack the time or inclination to cook can still make healthy choices by frequenting Brazil’s ubiquitous “por quilo” (by the kilogram) buffet-style restaurants, which offer a wide variety of freshly prepared meat and vegetarian dishes sold by weight.

Canada should borrow pages from Brazil’s new book, Freedhoff said.

Instead of focusing on abstract nutrition concepts, health authorities should support and encourage Canadians to cook simple, healthy, everyday meals.

Initiatives could include reintroducing home-economics classes for boys and girls in primary school and offering after-school programs that help parents learn how to cook, Freedhoff said.

In the meantime, he said, Brazil is a trailblazer: “These are guidelines that countries around the world should encourage their citizens to adopt.”

10 key points in Brazil’s proposed guidelines

The authors of Brazil’s proposed dietary guidelines boiled down the 87-page document into 10 basic steps:

1. Prepare meals using fresh and staple foods.

2. Use oils, fats, sugar and salt in moderation.

3. Limit consumption of ready-to-eat food and drink products.

4. Eat at regular mealtimes and pay attention to your food instead of multitasking. Find a comfortable place to eat. Avoid all-you-can-eat buffets and noisy, stressful environments.

5. Eat with others whenever possible.

6. Buy food in shops and markets that offer a variety of fresh foods. Avoid those that sell mainly ready-to-eat products.

7. Develop, practise, share and enjoy your skills in food preparation and cooking.

8. Decide as a family to share cooking responsibilities and dedicate enough time for healthy meals.

9. When you eat out, choose restaurants that serve freshly made dishes. Avoid fast-food chains.

10. Be critical of food-industry advertising.

Source: Guia Alimentar Para a Populacao Brasileira (2014)

Follow on Twitter: @AdrianaBarton

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