Food patterns and food and nutritional (in)security in the Bolsa Família Program

Abstract: The Bolsa Família Program (PBF) has several effects on the population with social risks and vulnerabilities, mainly in relation to food, education, and health. The objective of this study was to identify dietary patterns of beneficiary families or not of PBF in São Paulo municipality, analyzing their association with levels of food insecurity (FI). The study included 150 families. Socioeconomic, demographic, anthropometric, and food consumption aspects were evaluated through validated questionnaires. The FI was evaluated by the Brazilian Food Insecurity Scale (BFIS). Food patterns were calculated using Cluster analysis. The association between FI and PBF with dietary patterns was tested using the Poisson regression model. Three dietary patterns were identified: restricted, healthy and traditional. The restricted pattern was associated with lower educational level, anemia history, moderate FI (MFI) or severe FI (SFI), and higher mean age. In the unadjusted and adjusted for age analysis, the families with MFI or SFI were respectively 55% and 57% more likely to adhere to a restricted pattern and 41% less likely to follow a healthy pattern. Having a healthy or traditional pattern was related to the origin of this population, revealing an important element within the SAN concept: food sovereignty.

摘要：巴西家庭补助金计划（Bolsa Família Program, PBF）对存在社会风险与脆弱性的群体具有多方面影响，主要涉及食品、教育与健康三大领域。本研究旨在明确圣保罗市参与及未参与PBF的家庭的膳食模式，并分析其与粮食不安全（Food Insecurity, FI）程度的关联。本研究共纳入150户家庭，通过经过信效度验证的问卷对研究对象的社会经济、人口统计学、人体测量学特征及食物摄入情况进行了评估。采用巴西粮食不安全量表（Brazilian Food Insecurity Scale, BFIS）评估研究对象的粮食不安全状况，通过聚类分析方法计算得到研究对象的膳食模式。采用泊松回归模型检验粮食不安全状况、PBF参与情况与膳食模式三者间的关联。研究共识别出三类膳食模式：受限型、健康型与传统型。受限型膳食模式与较低的受教育水平、贫血病史、中度粮食不安全（MFI）或重度粮食不安全（SFI）及更高的平均年龄显著相关。在未校正模型与年龄校正模型中，存在中度或重度粮食不安全的家庭遵循受限型膳食模式的几率分别高出55%与57%，而采用健康型膳食模式的几率则分别降低41%。研究对象采用健康型或传统型膳食模式与其人群来源相关，这一发现凸显了SAN理念中粮食主权这一关键要素。