Acting against obesity: a cross-cultural analysis of prevention models in Spain, Argentina and Brazil.

This article analyses and compares preventive models for obesity in Spain, Argentina and Brazil through an examination of the respective measures adopted to counter it in those countries. Based on a qualitative study of the main actions carried out since 2004, the aim is to delineate the conceptual framework and reflect on the reasons for their relative effectiveness. The results show that in contexts where prevalence has increased rapidly, sociocultural causes acquire greater explanatory power as opposed to biological and/or behavioral factors. These models premise worsening diets and sedentary lifestyles as being the main culprits, and assume that contemporary societies generate obesogenic and toxic environments. The international health bodies have developed specific strategies to control and prevent obesity based on this diagnosis, and these have been supported by member states such as Spain, Argentina and Brazil. Although the measures reflect certain particularities, they conform to a common pattern organized from platforms promoting so-called "healthy lifestyles" and articulated mainly around the twin axes of a balanced diet and regular physical exercise. The discussion suggests that the excessive emphasis on individual responsibility and the underplaying of the role of food as a complex practice, as well as changing structural factors and the differential distribution of this disease, might largely explain the limited impact of these strategies.

¿Comer como el discurso médico-nutricional manda? Discursos y prácticas sobre alimentación saludable en sectores medios de la ciudad de Buenos Aires, Argentina / ¿Eating as the medical-nutritional discourse orders? Discourses and practices on healthy eating habits among middle-class sectors in the City of Buenos Aires, Argentina

Resumen. Objetivos: describir y analizar los discursos sobre alimentación saludable y su relación con las prácticas declaradas de integrantes de hogares con hijos/as que pertenecen a los sectores medios y que residen en la Ciudad Autónoma de Buenos Aires. Métodos: se utilizó un enfoque cualitativo, un tipo de estudio exploratorio-descriptivo y la técnica de relevamiento de la información fue la entrevista semiestructurada. Se seleccionaron intencionalmente 12 hogares pertenecientes a sectores medios que residen en la Ciudad Autónoma de Buenos Aires, integrados por parejas con hijas/os de diferentes edades. El procesamiento y análisis de la información fue realizado mediante la estrategia de análisis temático cualitativo. Resultados: se evidencia un discurso homogéneo sobre lo que se considera alimentación saludable, en función de las recomendaciones alimentarias vigentes independientemente de la edad y de vivir o no con sus hijos/as. Así como, una diversidad de prácticas de compra, preparación y consumo de alimentos. Esta diversidad se explica por la presencia de otros criterios que compiten con la búsqueda de alimentación saludable. Aunque se reconoce el efecto preventivo de la alimentación en relación con los problemas de salud asociados a esta, como el sobrepeso y la obesidad, emergen como los más enunciados y las explicaciones se asocian con la responsabilidad individual. Dos son las consecuencias más visibles de la divulgación y penetración del discurso médico-nutricional: reenviar al ámbito individual las prácticas alimentarias y del cuidado del cuerpo y omitir el peso del contexto y la responsabilidad colectiva en la explicación de los problemas de salud asociados con la alimentación actual.

Abstract. Objectives: To describe and analyze the discourses on healthy eating habits and their relationship with declared practices that hold middle-class parents who live in the Autonomous City of Buenos Aires, Argentina. Methods: A qualitative research was conducted, a type of exploratory-descriptive study and data was gathered with semi-structured interviews. Twelve households were intentionally selected, consisting of couples who had children of different age. A thematic analysis strategy was carried out to systematize and analyze the transcriptions. Results: A homogeneous discourse on healthy eating was observed, which is aligned with expert recommendations regardless of the interviewee´s age, whether or not they live with their children, and also their varied food purchasing, preparation, and consumption practices. The diversity observed in these practices can be explained by other criteria which compete with their quest for healthy eating. Even if the benefits of healthy eating to prevent food-related illnesses are recognized, overweight and obesity seem to prevail as the main reasons to choose what to eat, and individual responsibility is articulated. Two are the consequences of the diffusion and incorporation of the medical and nutritional discourse: first, to consider eating practices and body care as issues related to the personal realm; and, second, to leave out the weight that the social context and collective responsibility exert in the explanation of health problems associated with current eating habits.