Eating in the Amazon: Nutritional Status of the Riverine Populations and Possible Nudge Interventions.

The Amazon is the largest tropical forest in the world and a source of healthy food, such as fruits and fish. Surprisingly, the Amazonian riverine population present an increased prevalence (as high as 58%) of non-communicable diseases, such as hypertension and insulin resistance, even higher than that described for the urban population of the Amazon. Therefore, this work aimed to analyze the nutritional status and associated risk of the riverine population. Body mass index, waist circumference (WC), waist-to-hip ratio, and neck circumference (NC) were evaluated, and risk analysis was assayed. Furthermore, data about occupation and the prevalence of consumers of the different groups of food were analyzed. All anthropometric parameters revealed high proportions of individuals at risk, WC and NC being the factors that had more high-risk women and men, respectively. Our data confirmed the characteristic profile of the riverine communities with a high number of fish consumers, but also observed different patterns probably associated to a phenomenon of nutrition transition. Based on our data, some nudge interventions that take into account the principles of behavior analysis are discussed and proposed for these populations, aiming to improve the nutritional status and avoid the long-term consequences of the results showed by this work.

O estilo de vida da população ribeirinha: as repercussões para a saúde e para o cuidado de Enfermagem / The lifestyle of the riverine population: the repercussions for health and for Nursing care

O presente estudo tem como objeto: a relação entre o estilo de vida da população ribeirinha de Macaé e a saúde. Para tanto, foram traçados os seguintes objetivos (geral): discutir o significado do estilo de vida da população ribeirinha com a saúde; (específicos): caracterizar o estilo de vida da população ribeirinha a partir do significado atribuído; relacionar o significado atribuído pela população ribeirinha ao estilo de vida e à saúde; propor teoria substantiva que elucide o universo de significados da vivência da população ribeirinha no tocante ao estilo de vida e à saúde. Como referencial teórico foi utilizado o Interacionismo Simbólico dada importância ao significado do fenômeno na investigação. A abordagem metodológica escolhida compreende a pesquisa qualitativa sob a orientação das premissas da Teoria Fundamentada nos Dados (TFD). Foi realizada uma pesquisa de campo cujo cenário compreendeu os distritos da região serrana do município de Macaé. São eles: Sana, Córrego do Ouro, Frade, Glicério e Bicuda Grande. Os participantes da pesquisa compreenderam a população ribeirinha adulta e idosa dos respectivos distritos. Os dados foram colhidos por meio de um roteiro de entrevista semiestruturado, um formulário e observação assistemática. Os dados foram analisados considerando os procedimentos próprios da TFD: codificação aberta, codificação axial e integração para posterior elaboração da categoria central, cerne do estudo. Emergiram diferentes categorias, articulando os comportamentos e os modos de ser junto ao rio, com marcas de agravos reais e/ou potenciais que acometem a população, bem como no que tange a significação à luz das pessoas sobre a discussão que envolve a saúde sustentável.

The present study has as its object: the relationship between the lifestyle of Macaé's riverside population and the health. In order to do so, the following objectives (general) were drawn: to discuss the meaning of the lifestyle of the riverside population with health; (specific): characterize the lifestyle of the riverside population based on the meaning attributed; relate the meaning attributed by the riverside population to lifestyle and health; propose substantive theory that elucidates the universe of meanings of the experience of the riverside population with regard to lifestyle and health. As a theoretical reference was used Symbolic Interactionism, given the importance the meaning of the phenomenon in the investigation. The methodological approach chosen comprises qualitative research under the guidance of the premises Grounded Theory (GT). A field survey was carried out whose scenario comprised the districts of the mountain region of the municipality of Macaé. The are Sana, Córrego do Ouro, Frade, Glicério and Bicuda Grande. The participants of the survey comprised the adult and elderly riverine population of the respective districts. The data were collected through a semi-structured interview script, a form and unsystematic observation. Data were analyzed considering the GT procedures: open coding, axial coding and integration for further elaboration of the central category, at the heart of the study. Different categories emerged, articulating the behaviors and the ways of being along the river, with marks of real and/or potential harms that affect the population, as well as with regard to the meaning in the light of the people about the discussion that involves sustainable health.

El presente estudio tiene como objetivo: la relación entre el estilo de vida de la población ribereña de Macaé y la salud. Por lo tanto, se delinearon los siguientes objetivos (generales): discutir el significado del estilo de vida de la población ribereña con la salud; (específico): caracterizar el estilo de vida de la población ribereña a partir del significado dado; relacionar el significado atribuido por la población ribereña al estilo de vida y la salud; proponer una teoría sustantiva que aclare el universo de significados de la experiencia de la población ribereña en términos de estilo de vida y salud. Como marco teórico, se utilizó Interaccionismo Simbólico, dada importancia del significado del fenómeno en la investigación. El enfoque metodológico elegido comprende la investigación cualitativa bajo la guía de las premisas de Teoría Fundamentada (TF). Se realizó una investigación de campo cuyo escenario incluyó los distritos de la región montañosa del municipio de Macaé. Ellos son: Sana, Córrego do Ouro, Frade, Glicério y Bicuda Grande. Los participantes de la investigación comprendieron la población de adultos y ancianos de la ribera de los distritos respectivos. Los datos fueron recolectados a través de un guión de entrevista semiestructurada, un formulario y observación no sistemática. Los datos se analizaron considerando los propios procedimientos del TF: codificación abierta, codificación axial e integración para una mayor elaboración de la categoría central, el núcleo del estudio. Surgieron diferentes categorías, articulando los comportamientos y las formas de ser junto al río, con marcas de lesiones reales y / o potenciales que afectan a la población, así como con respecto al significado a la luz de las personas sobre la discusión que involucra la salud sostenible.

Ethnobotanical study of medicinal plants used by Ribeirinhos in the North Araguaia microregion, Mato Grosso, Brazil.

ETHNOPHARMACOLOGICAL IMPORTANCE: Currently, in many traditional communities, such as the riverine community in the North Araguaia microregion (Mato Grosso, Brazil), plant knowledge and use represent the main, if not the only, therapeutic resource for the maintenance of health and/or treatment of diseases. This study aimed to identify and document species of medicinal plants used by local experts from riverine communities in the North Araguaia microregion in Mato Grosso State, and to further chemical and pharmacological studies on species selected based on searches in the relevant literature. MATERIALS AND METHODS: This is a cross-sectional ethnobotanical study, with non-probabilistic sampling (n =60), that applied the snowball method to select local riverine experts who understand medicinal plant use. Socio-demographic, ethnobotanical and ethnopharmacological data (vernacular name, uses, geographical origin, habit, method of preparation and part used) on medicinal plants were collected during semi-structured interviews. The results were analyzed by descriptive and quantitative means: indices of use-report (UR) were used to select plant species with therapeutic potential. RESULTS: In total, 309 plant species belonging to 86 botanical families were cited; 73% were native to Brazil, and Fabaceae was the most representative family (11.3%). Arboreal was the predominant life form (37.2%). The leaf was the most used part (28.9%). Infusion was the most commonly reported method of preparation (31.3%). The plants reported in the survey were indicated for 18 of the 22 ICD-10 disease categories. The disease categories most commonly cited were the infectious and parasitic diseases (IPD, 718 UR), digestive system diseases (DSD, 565 UR) and respiratory system diseases (RSD, 504 UR), representing 16.6%, 13.1% and 11.7%, respectively of the total UR. Dysphania ambrosioides L. was the most sighted in the IPD category 50 UR. Copaifera langsdorffii Desf. (133), Lafoensia pacari A. St.-Hil. (131), and Cecropia pachystachya Trécul (126) were the species with the highest UR. Bidens pilosa L., Vernonia ferruginea Less, and L. pacari, respectively, were the most cited native plants used to treat such diseases. Of the 8 investigated native plants, C. langsdorffii, and Brosimum gaudichaudii are the most prominent: in addition to having been widely studied, in terms of phytochemical and pharmacological, these species have been marketed as pharmaceutical products, with associated patent deposits. CONCLUSIONS: Local riverine experts from the North Araguaia microregion use a wide variety of medicinal plants in self-care health, especially those species used to treat IPD. The therapeutic potential of some of these plants has been scientifically validated; however, there are other species whose pharmacological effects and safety remain to be properly investigated. Thus, the present study, aside from being a basis for future chemical, pharmacological and agronomic bioprospecting studies, may contribute to the development of the management, conservation and sustainable use of medicinal flora in the microregion studied.