In the shower of colours (Na chuva de cores)
That rains down in the afternoon, (da tarde que explode,)
the lagoon is brilliant. (a lagoa brilha.)
The lagoon paints itself (A lagoa se pinta)
with every colour. (de todas as cores.)

In May the kitchen gardens from Maricá are full of couve (a type of kale). The traditional Brazilian culinary recommends that the leaves of couve be torn by hand. Recently, scientists discovered chemopreventives in the leaves that are activated by maceration (1). Once again folk wisdom, in this case of the value of shredding couve preferably by hand, has anticipated scientific evidence. Boiled couve is an invariable side dish served with our famous feijoada (2), originally invented by slaves, whose main ingredients are black beans, salt pork, and also bovine offal meats such as ears, feet, throat, and all the other parts that were usually discarded by the slave-owners. Today, it is enjoyed by all classes at weekends. Couve also gives the colour to the traditional originally Portuguese caldo verde (green broth).

References

1. Hecht SS. Chemoprevention of cancer by isothiocyanates, modifiers of
   carcinogen metabolism. J Nutr 1999; 129:768S-774S.
2. Freixa D, Chaves G. Gastronomia no Brasil e no Mundo. Rio de Janeiro: Senac, 2008.

Nutrition in cities
Warm words and hot dogs

The 5th World Urban Forum, organized by UN-Habitat, held between 24-26 March, was attended by me and another 13,717 participants from 150 countries. This time Brazil was the host. Its location was within old warehouses located in the Mauá Harbour, located in downtown Rio. The warehouses are being renovated as are many other abandoned sites, in anticipation of the 2016 Rio Olympics.

For the first time of the history of the Forum we got a session on nutrition in cities, organised by the UN System Standing Committee on Nutrition (SCN). This was thanks to the persistence of SCN steering committee member Florence Egal of the Food and Agriculture Organization of the United Nations in Rome, who for many years has been trying to convince UN-Habitat that nutrition is relevant to the urban environment, which you might think is obvious. But it took five events for UN-Habitat to get the message.

True, there are very many other urban issues struggling to be recognised. For instance, there are still more than 45 million people living in favelas (shantytowns and slums) in Brazil, in conditions characterised by lack of clean water, lack of adequate or any sanitation, overcrowding, and fragile housing. In Brazilian cities on average only one-third of children attend primary school (1). Such issues are so obvious and basic that they often are overlooked. We always need to go on reminding ourselves and others of what is fundamental.

Public-private dissonance

The SCN session addressed malnutrition in the urban setting. Much of the discussion was about the politics of nutrition. In discussion Florence Egal said that nutrition professionals are part of the problem, because conventionally we have narrowed nutrition to being merely a biological discipline, whereas like other aspects of public health it is fundamentally political. Treated as merely biological, nutrition seems boring and only marginally relevant outside such a narrow setting.

The opening speaker was Association founder member Denise Coitinho, who has now returned to WHO in Geneva from having been responsible for the UN World Food Programme’s REACH initiative in Rome. She addressed ‘the double burden of malnutrition and its urban dimension’ and suggested feasible and effective actions to address these problems, which include undernutrition and infection, and also obesity and chronic diseases, within the same community and even the same family. It’s interesting to see how the recommendations of the UN agencies are contradicted by those of industry. Thus on the one hand we have the UN strategy for infant and young child feeding which emphasises breastfeeding, whereas industry focuses on commercial weaning foods. Again like other aspects of public health, nutrition includes battles between the public interest and the private interest.

In further discussion Florence Egal said that she preferred to work within the agricultural sector in order to be closer to the basis of nutrition, including the ways foods are produced, the origin of what arrives in our plates; these also are dimensions of nutrition that go far beyond biochemistry.

Time to speak and act

Maybe the delegates to the Forum knew about the principles of good food. Whether they did or not, they didn’t get much chance to put these into practice. But I didn’t hear anybody apart from people in our group grumbling about the catering on offer. Do you want to know what people ate once they were inside the Forum arenas? Yes, there was one restaurant (for 13,000 plus people) to eat meals, but dozens of hot dog, ice-cream, pizza, and snacks stands.

Maybe it’s time to get militant. Can we imagine activists in front of soft drink factories and supermarkets – or inside the World Urban Forum – with placards proclaiming ‘stop harming children!’? After all, direct action has been and remains essential to tobacco control and environmental protection. Every day I am becoming more and more convinced that we need now to get out from behind our desks and to speak out, using the media, and in the streets. It’s time to turn consumers into citizens.

Reference

1. UN-Habitat. State of the World’s Cities 2008/2009. Harmonious Cities. London: UN-Habitat, 2008.

The politics of nutrition
Parent and citizen power

Talking about consumers, I have also participated in the ALANA Institute’s 3rd international forum on children and their needs and rights, held in São Paulo. This focused on three themes: honouring childhood, childrens’ play, and reflections on consumption. My main interest was this third theme, and the responsibility of parents on behalf of their children.

Marcelo Furtado, executive director of Greenpeace in Brazil, told us how consumers acting as citizens have helped Greenpeace to change the whole chain of unsustainable ways of productions. He gave the example of food industries that used to buy ingredients such as sugar and soya from farms that were expanding through the Amazon forests. Greenpeace then threatened the manufacturers, saying that they would tell the consumers that the ingredients of their products come from deforested areas. This worked. They did the same with shoe manufacturers who bought leather from cattle raised in deforested areas.

As a result industry is now more sensitive to reducing harm to nature. But the same does not yet apply to harm to health. Why? One reason is that this is not yet on the agenda of politicians. The reason for that is partly the links between government at all levels and industry. But the main reason is that telling consumers that products are bad for their health still does not translate into changed behaviour – and industry knows this.

What is also missing, as I felt at the World Urban Forum, is direct action. Advocacy should not merely be aimed at consumers. It should be led by consumers acting as parents and citizens, not only by health professionals. Getting public health nutrition on politicians’ minds requires strong sustained social pressure. We also need to be aware that the manufacturers of processed foods and drinks are seeking and gaining partnerships and other association with people in government at all levels, from international agencies to small towns. For this reason health professionals, government executives and officers day by day have less scope to act. Politicians need to feel that if they act in ways that threaten public health – and that of children in particular – they will be denounced, exposed, and be more likely to be slung out of office.

 

The World Urban Forum made me think some more about life and health in big cities. One big issue is of course transportation. It’s practically impossible to live in any city in Brazil, a country whose railway system has mostly been ripped up for the benefit of car manufacturers, without constant use of motorised transport. This is the other side of the energy balance coin. Physical inactivity plus energy-dense diets means energy imbalance, overweight and obesity (1).

Car ownership has rocketed in lower-income countries. In Brazil in 1959, 14,000 cars were sold for private use. Fifty years later in 2009 the figure was 2,200,000 cars (2). This is why cities like Rio have become festooned with overpasses like snakes writhing over the urban landscape, creating filth, squalor and pollution, and even so the motorways are constantly jammed and gridlocked. Cities designed or redesigned for cars don’t even work for cars.

The state of traffic now adds environmental arguments to the social and economic reasons given by Alvin Toffler when he foresaw people doing everything from home, or as he has said, from their ‘electronic cottage’ (3). It is just crazy to spend three to four hours a day in traffic, which is not uncommon in Brazilian cities such as Rio de Janeiro and São Paulo. Our environment is screaming but we still are not listening.

Unlocking the grid

Times are beginning to change in some cities. Niterói is the city over the other side of Guanabara Bay, linked with Rio by a 13 kilometre bridge. A great change in the city has made the solitary drivers of private cars furious, and those who share the way to work and home very happy. Every hour on average, 2,500 cars and 300 buses go through the Avenida São Boaventura, a main street 6.5 kilometres long. In March the city authorities created an express lane for collective transport only. When I took the bus in my way from Rio, passing quickly through the traffic, I felt like teasing the drivers. I thought of hanging a poster from the bus window saying: ‘Leave your car at home pal, and get on board!’ This new system benefits half a million people and has generated over 200 new jobs. Cars need 30-40 minutes to get from one end of the Avenida to the other, and this time jumps to 2 hours on holidays. Collective transport – buses and vans – make it in 15 minutes.

Other active transport systems are being created. In 2008, Rio launched the programme Rio - the State of the Bicycle, coordinated by Mobilicidade. This makes bicycles available for use in the city. Rio being Rio, in December 2009 56 bicycles were stolen from the bike stations. After that the service was temporarily suspended and the system of locks strengthened. In March just three bikes were stolen. The bicycle company is asking advice from one of the thieves who was caught, on how to make their locks even more impregnable.