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

Abstract

Introduction: it is known that obesity is currently characterized as a public health pandemic, affecting children and the elderly in developed and developing countries. Given the complexity of factors involved in its etiology, effective public policies that consider the individual as a whole and the range of external factors that influence him/her are becoming increasingly necessary. The intersectoral approach to health, in turn, has been cited as a strategy for dealing with diseases with multifactorial causes. Objective: To describe the management profile and the forms of intersectoral articulation related to the area of food and nutrition carried out in Primary Health Care and its association with the prevalence of obesity in the three health macro-regions of the state of Paraíba. Methods: cross-sectional study conducted with health managers from 151 municipalities in the state of Paraíba, nested in a national population-based study. Data collection occurred through the application of semi-structured and self-applied questionnaires, made available remotely through the digital platform SurveyMonkey®. Variables related to the municipality, respondent managers, and intersectoral actions on food and nutrition were evaluated. A survey on the prevalence of obesity in adults was also carried out by municipality of Paraiba, based on data from the Food and Nutrition Surveillance System. The data were analyzed using SPSS (Statistical Package for the Social Sciences®) software, version 22.0. Initially, a descriptive analysis was performed using absolute and relative frequency for qualitative variables, and mean and standard deviation for quantitative variables. The normality distribution was assessed through the Kolmogorov-Smirnov test. Pearson's chi-square test and Fisher's exact test were used to test the association between categorical variables, when necessary. A 5% level of statistical significance was adopted. Results: All health macro-regions showed a prevalence of obesity in adults higher than the national reference for people over 18 years of age described in the National Health Plan 2020-2023. The presence of a technical manager for food and nutrition actions was associated with higher rates of obesity. The realization of food and nutrition education actions, and intersectoral practices related to the Food and Nutrition Security sector were associated with lower rates of obesity. Conclusion: the mere presence of a specific position for food and nutrition actions does not guarantee the effectiveness of the results, highlighting the importance of monitoring the actions developed to identify possible failures and, if necessary, make adjustments in the process. It is recommended the use of Food and Nutrition Education actions focused on prevention and health promotion, aiming at reducing the prevalence of obesity. It is necessary to carry out new studies focused on this theme, considering also epidemiological factors and those related to the obesogenic environment, not observed in this research.