I graduated in medicine in the small city of Botucatu, in the state of São Paulo, Brazil. The school programme integrated clinical work, basic sciences, and preventive medicine with research. For three years during the course, I had a scholarship in neurophysiology. After finishing medical school I got a Master’s degree in neurophysiology at the University of São Paulo. The year was 1976 and political effervescence was great at universities. I joined a large organised movement against dictatorship, at a time when in workers’ neighborhoods childhood malnutrition was highly prevalent.
I could no longer reconcile studying sleep-wake cycles in hamsters with the upheaval of the political activities in my country during the period of military rule, so in 1978 I got into the School of Public Health at the University of São Paulo for one year’s training. Working with primary health care services I collected longitudinal data of growth of children, breastfeeding and infections. My attempts to analyse these data made me realise the complexity of nutritional science.
In 1982, I got a position at the University of Maringá, in the northern part of the state of Paraná. My first grant was to study rural families, mainly workers in the production of soybeans, and the nutritional status of their children. Maringá was already an example of the effects of monoculture food production. While still living in Maringá, I did my PhD in public health nutrition, once again at the University of São Paulo, studying dietary factors associated with iron deficiency anemia in children. Sophia C. Szarfarc, my advisor, introduced me to the analysis of bioavailabilityof iron in the diet.
The complexity of the associations between diet and health led me to plunge into the methods of nutritional data analysis, the core of my teaching and research projects in the last 20 years. Since 1994, I have worked in the department of epidemiology of the State University of Rio de Janeiro. Influenced by the Harvard School of Public Health’s development and use of food frequency questionnaires with the leadership of Walter Willett, I developed one that is now extensively used in Brazil. During three sabbatical periods,one at the National Institutes of Health in the US and two at the Harvard School of Public Health, my appreciation for methods of dietary measurement has been enhanced.
One development in this field is the comparison between studies based on household expenditure surveys and those based on estimates of total food consumption. Work continues in this area. The idea of combining both methods to assess consumption has gained support, and is incorporated in the latest national survey conducted by IBGE, the Brazilian Bureau of Census, which includes a module of individual consumption in the most recent household budget survey.
The studies that I have conducted or collaborated with, mainly in metropolitan areas of Brazil, show the complexity of the nutritional transition, with a clear coexistence of poverty and food insecurity with obesity, and the mix of Brazilian traditional dietary patterns with the ‘Western’ pattern.
In this journey from São Paulo, where I was born, to Rio de Janeiro, I have developed great pleasure in cooking for my family, which now includes a granddaughter. The pleasures of eating and cooking have added a special flavour to my public health nutrition activities, allowing me to have a better understanding of the importance of nutrition as a social as well as a biological science.