Evolution of nutrition actions in primary health care along the 20-year history of the Brazilian National Food and Nutrition Policy

This study aimed to systematize food and nutrition actions developed in primary health care (PHC) from 1999 to 2019, identifying advances in this period and current perspectives. This is a qualitative study that analyzed documents published between 1999 and 2020, available in scientific databases and in the gray literature. In addition, a quantitative analysis was conducted using information .systems from the Brazilian Ministry of Health, such as the Food and Nutrition Surveillance System and the Health Information System for Primary Care, and microdata from the National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB). The actions and regulatory milestones identified were categorized as federal administration, food and nutrition surveillance, promotion of proper healthy food, nutritional care - multiple burdens of poor nutrition and training. The results showed food and nutrition actions followed the pace of the epidemiological scenario, considering the multiple burdens of poor nutrition. The first decade was more focused on handling issues involved in hunger, malnutrition and micronutrient deficiency and, in 2006, it started to emphasize prevention and care for people with obesity and other non-communicable chronic diseases and promote proper healthy food, developing actions in the period with a strong intersectoral character and understanding PHC as a priority field of action in the Brazilian Unified National Health System (SUS). The universalization of food and nutrition actions in PHC is still a current challenge.