RESUMO Analisar a trajetória da atuação de nutricionistas na Atenção Primária à Saúde no Sistema Único de Saúde. Realizou-se revisão narrativa integrando artigos científicos a partir da constituição do Sistema Único de Saúde, em 1988, nas bases de dados: Scientific Electronic Library Online, National Library of Medicine, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus e Web of Science. Organizou-se o material em três eixos: panorama histórico da inserção; formação; dimensionamento da força de trabalho. Analisaram-se 65 estudos publicados entre 2002 e 2025. Na primeira década de implementação do Sistema Único de Saúde, a atuação de nutricionistas foi limitada, expandindo-se com a inserção nos Núcleos de Apoio à Saúde da Família. As edições 1999 e 2012 da Política Nacional de Alimentação e Nutrição engendraram o protagonismo desses profissionais na construção de estratégias interdisciplinares de cuidado. Há esforços para alinhar a formação e a educação permanente de nutricionistas aos modelos de atenção do Sistema Único de Saúde e às necessidades de saúde das populações. Evidenciaram-se experiências formativas exitosas na integração universidade-serviços, apesar de lacunas curriculares em Saúde Coletiva. O insuficiente quantitativo de nutricionistas e a precariedade das condições de trabalho, relacionados ao subfinanciamento do Sistema Único de Saúde, restringem a efetivação das ações na Atenção Primária à Saúde. A atuação de nutricionistas na Atenção Primária à Saúde avançou, com o aprimoramento das políticas públicas, incluindo a dimensão interdisciplinar do trabalho. Entretanto, persistem desafios relativos à formação, à inserção e ao cotidiano de trabalho, que restringem o fortalecimento das práticas de alimentação e nutrição no Sistema Único de Saúde.
ABSTRACT This paper aims to assess the evidence of food systems approaches in higher education Nutrition programs, identify knowledge gaps, and to present a case study from Brazil. We conducted a scoping review following systematic protocols and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. To present practical evidence, we conducted a qualitative, cross-sectional, descriptive study with a national scope in Brazil, using a case study approach and an online crowdsourced mapping. The review identified 23 articles highlighting the need for systematic curriculum changes. Studies are recent and conducted in high-income countries, with a greater focus on curricula than on actual concrete practices. Integrative programs and practical applications in public health, healthcare, and food service with a systemic approach are proposed solutions. Qualitative data suggest incorporating garden-based learning, addressing food systems in internships, and promoting debates on food biodiversity and local producers. The case study identified 15 experiences, primarily extension actions. The results of the case study, based on Brazilian experiences, highlighted key debates on topics such as food security and sovereignty, food systems and sustainability, biodiversity, and planetary health. The methodologies involved integrated practices between disciplines — which are commonly configured in isolation — garden-based learning, and integrated research and extension projects with community participation. We emphasize that transdisciplinary approaches in Nutrition curricula are fundamental, as professionals must be aware of the complexities of the contemporary world, which include the development of sustainable and resilient food systems. This requires a more holistic vision of Nutrition, integrating environmental, social, and economic dimensions to address current and future challenges. Involving faculty and students in these changes is essential for implementing systemic practices.
ABSTRACT To examine the trajectory of nutritionists’ practice in Primary Health Care within the Brazilian Unified Health System. We conducted a narrative review, integrating scientific articles since the establishment of Unified Health System in 1988. The search was performed in the following databases: Scientific Electronic Library Online, National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Scopus, and Web of Science. The material was organized into three thematic axes: historical overview of integration, professional training, and workforce sizing. Sixty-five studies published between 2002 and 2025 were analyzed. The role of nutritionists was limited during the first decade of Unified Health System implementation, expanding significantly with the establishment of the Family Health Support Centers. The 1999 and 2012 editions of the National Food and Nutrition Policy positioned nutritionists as key players in the development of interdisciplinary care strategies. We observed some efforts to align the training of nutritionists and continuing health education with Unified Health System care models and the health needs of the population. Successful training experiences were identified in university-service integration, despite curricular gaps in Collective Health. The insufficient number of nutritionists and working conditions hinder the implementation of actions in Primary Health Care. The work of nutritionists in Primary Health Care has advanced with improved public policies, including the interdisciplinary dimension. However, challenges remain regarding training, integration, and daily practices, which limit the strengthening of food and nutrition practices in the Unified Health System.
Objective This study investigated the effects of a structured 12-week yoga program combined with individualized medical nutrition therapy on body composition, emotional expression, and healthy lifestyle behaviors in overweight and mildly obese women. Methods This is a quantitative intervention study. A total of 79 Turkish women aged 20-45 years with a body mass index between 25-34.9 kg/m(2 )were enrolled. Participants attended yoga sessions twice weekly and received personalized dietary counseling. Anthropometric data were collected, and two validated instruments-the Emotional Expressivity Scale and the Healthy Lifestyle Behaviors Scale II-were administered at baseline and after 12 weeks. Data were analyzed quantitatively using paired t-tests and correlation analysis. Results Statistically significant improvements were observed in body weight, body mass index, waist circumference, fat percentage, and emotional expression scores (p<0.05). Healthy lifestyle behaviors also improved across all subscales. Conclusion The integration of yoga and individualized nutrition counseling appears to be an effective and holistic approach to promoting emotional well-being and improving body composition among overweight and mildly obese adult women.
ABSTRACT Objective This study aimed to evaluate how weight stigma is addressed in national and international clinical guidelines for the treatment of obesity. Methods A systematic review with qualitative synthesis was conducted, analyzing recommendations from clinical guidelines published between 2000 and 2022. Both national and international documents were included, with the goal of identifying the presence, emphasis, and treatment given to the topic of weight stigma. The search yielded 713 publications, of which only 26 met the inclusion criteria established for this study. Results The findings revealed that most of the analyzed guidelines do not meaningfully address weight stigma in their recommendations. Despite the importance of this issue for improving the quality of care for individuals with obesity, it remains underexplored, highlighting persistent gaps in the ethical and humanized approach to treatment. Conclusion The results underscore the urgent need to incorporate the discussion of weight stigma into clinical guidelines for obesity. Such incorporation is essential to foster an epistemological shift in how obesity is understood and managed in clinical contexts. This transformation requires coordinated efforts at multiple levels – individual, community, and systemic – and entails a reconfiguration of societal relations with fat bodies, as well as a redefinition of the very notion of healthcare.
ABSTRACT We conducted a bibliographic analysis of qualitative dissertations and theses produced in Brazilian Nutrition postgraduate programs from 2019 to 2024. The systematic search was performed in the Brazilian Digital Library of Theses and Dissertations and the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel databases. A total of 44 dissertations and 13 theses were included, defended between 2019 and October 2024, in 13 of the 30 postgraduate programs linked to the Coordination for the Improvement of Higher Education Personnel Nutrition assessment field. The five most frequent central themes were cooking, obesity, food and nutritional security, breastfeeding, and school meals. The semi-structured interview was the most frequent data collection procedure, predominating the content analysis proposed by Bardin. Minayo appeared as the primary theoretical reference in the definitions of qualitative research. In the set of dissertations and theses analyzed, we observed an attempt to construct an identity pattern to form a scientific habitus aimed at sharing the same paradigms among members of the scientific community in qualitative research in Nutrition.
Objective The COVID-19 has resulted in a global pandemic, and markers for disease prognosis have been studied, such as the Prognostic Nutritional Index. This study aimed to evaluate the associations of the index with disease severity, comorbidities, laboratory test results, and clinical outcomes. Methods This retrospective, cross-sectional study was conducted with patients with a positive SARS-CoV RNA result from 2020 to 2022. Measures were Prognostic Nutritional Index, disease severity, comorbidities, laboratory tests, and clinical outcome. Prognostic Nutritional Index was calculated using the equation: serum albumin [g/d L] x 10 + total lymphocyte count [per mm3 x 0,005). Participants were categorized into severe malnutrition (PNI <35), mild malnutrition (PNI 35-38), and no malnutrition (>38). Results The sample (53% male) had a mean age of 56.77 +/- 17.42 years. Among those classified as Prognostic Nutritional Index 2, only 23.4% were discharged from the hospital, which was associated with higher mortality (p<0.01). PNI classification was associated with disease severity (p=0.01), and the highest proportion of critically ill patients was found in the PNI 2 group (60%). PNI 2 also evidenced significantly lower levels of hemoglobin, hematocrit, lymphocytes, and albumin (all with p<0.01). In the multivariate analysis, Prognostic Nutritional Index 1 and Prognostic Nutritional Index 2 groups had a higher risk of mortality (OR: 2.54; 95% CI: 1.73-3.72) and cardiomyopathies (OR: 1.92; 95% CI: 1.00-3.69). Conclusion The results suggest that Prognostic Nutritional Index may be a relevant marker for risk stratification in COVID-19 patients, with Prognostic Nutritional Index levels 1 and 2 proportionally associated with greater disease severity and mortality.
Objective To evaluate salt intake and its relationship with blood pressure among adults living in the Aracruz indigenous reserve, Espirito Santo. Methods This cross-sectional study included 37% of the eligible population. Recruitmentwas conducted by invitations from researchers, indigenous leaders, and health agents. Fasting blood and urine samples were collected. Blood pressure was measured via oscillometry, whereas salt intake was estimated by the Na/creatinine ratio in urine using the Tanaka equation. The associations between salt intake and systolic and diastolic blood pressure were determined by multivariate linear analysis. The study was approved by the Research Ethics Committee (No. 22563019600005056). Results Of the 1,084 participants who were initially recruited, 36 were excluded from the analysis because of missing urinary data, and 248 were excluded because they were on antihypertensive medications. Thus, the final analysis included the data of 800 individuals (55.4% women; age = 37.9 +/- 13.4 years). In this sample, the average salt intake was estimated at 10.0g/day and was higher among men (10.4g/day) than among women (9.7g/day; p<0.01). Multivariable analysis indicated that age, body mass index and salt intake explained 24% of the variability in systolic blood pressure in the population, with age being the predominant factor. An increase of 0.11mmHg in the diastolic blood pressure was observed forthe intake of each additional gram of salt. Conclusion High salt intake in the indigenous population of Aracruz, although modestly affecting systolic blood pressure, contributes significantly to the development of hypertension.
Objective To compare two diagnostic criteria for metabolic syndrome in adolescents and to assess associations with subclinical atherosclerosis. Methods A cross-sectional study with a quantitative approach was carried out with 512 adolescents from public schools aged between 15 and 19 years in a municipality in northeast Brazil. The diagnostic criteria used forthe metabolic syndrome were the International Diabetes Federation and the National Cholesterol Education Program, Adult Treatment Panel III, adapted by COOK. Subclinical atherosclerosis was assessed through carotid intima-media complex thickness by ultrasound imaging. Results The diagnostic criteria for metabolic syndrome The National Cholesterol Education Program-Adult Treatment Panel III, adapted by COOK, identified a higher prevalence of young people with metabolic syndrome, 2.9%, was associated with subclinical atherosclerosis (p=0.02), had an of its components (elevated systemic blood pressure) associated with subclinical atherosclerosis (p=0.030), presented a higher percentage of positive predictive value (PPV=15%), compared to the International Diabetes Federation criteria. The concordance index between the two diagnostic criteria for metabolic syndrome was low (kappa of 0.28, p<0.001). Conclusion In adolescents, the criterion of the National Cholesterol Education Program-Adult Treatment Panel III adapted by COOK, was the criterion presented better evaluations and was the only one that was associated with the presence of subclinical atherosclerosis when compared to the criteria of the International Diabetes Federation.
Objective To develop a nutritional screening questionnaire aimed at outpatient care for adults and elderly individuals with a confirmed diagnosis of cancer. Methods The tool was developed based on the NRS-2002, ASG-PPP (short form), and Nutriscore questionnaires, with the latter being specifically directed at this patient group, although not yetvalidated for use in Brazil. Additionally, questions regarding caregiver presence and income were included. The questionnaire is targeted at adults and elderly individuals with a cancer diagnosis confirmed by histopathological examination, who are either undergoing treatment or about to begin treatment in an outpatient setting. Results The questionnaire consists of nine questions, each scored based on the identified nutritional risk. The final scoring was determined using fictitious data, also considering the criterion of age independence. Conclusion Thistool was designed foroutpatient oncology patients, with the aim of providing greaterspecificity, safety, and optimization in the identification of nutritional risk. It is recommended that the tool be applied in real-world settings so that it can be adjusted to better meet the needs of this patient group.
Objective This study aimed to develop the Scale of the Tendency Towards the Flexitarian Diet (STFLEX) to measure the leaning towards the flexitarian diet. Methods The researchers created a 31-draft scale. Two items with lower content validity ratios were excluded from the scale. A 29-item draft was submitted through an online survey for data collection. Healthy adult volunteers attended from different Internet websites in T & uuml;rkiye. Scale items measuring individuals' predisposition to follow aflexitarian diet. The itemswere evaluated with contentvalidity following the Lawshe method. Confirmatory factoranalyseswere conducted totestconstructvalidity. The Cronbach's alpha coefficient was calculated for reliability. Results Based on the validation analyses, no item was excluded from the item whole. Because of the factor analysis, the scale was divided into four subdimensions (economic reasons, macro-environment, environmental sustainability, and meat consumption). The developed STFLEX showed good compliance statistics, as established with the confirmatory factor analysis fit indices (chi 2/df = 1.593, CFI = 0.967, TLI = 0.960, NFI = 0.916, RMSEA = 0.053), and high reliability (Cronbach's alpha = 0.958). Conclusion The STFLEX is a reliable and valid tool for measuring the tendency toward the flexitarian diet, and it can be used in studies.
Objective To identify the prevalence and factors associated with excess weight in healthcare workers at a hospital complex in southern Brazil. Methods This is a cross-sectional study with secondary data from the local Occupational Medicine sector. Anthropometric, demographic, socioeconomic, lifestyle and occupational information were investigated. Multivariate analysis was performed using Poisson regression, with their respective prevalence ratios and significance level p<0.05. Results Three thousand one hundred and ninety-eight workers were included, 2,398 women (75.0%) with a mean age of 34.7 +/- 9.69 years. The prevalence of excess weight was 64.2%, which was significantly higher among men than among women (67.5% vs 63.1%, respectively). Excess weight was associated with lower education, lack of physical activity, being a healthcare professional and working less than 5 years at the institution. Work schedule, work shift and weekly workload are not associated with being overweight. Conclusion A high prevalence of excess weightwas identified among healthcare professionals and associated factors included demographic, socioeconomic, lifestyle and occupational characteristics.
Objective To evaluate the association between dietary intake and the prevalence of cardiovascular diseases in the Brazilian adult population in 2019. Methods This is a cross-sectional study in the Brazilian adult population, with data from the 2019 National Health Survey. Food intake was investigated through the adequate frequency of food groups intake that are markers of healthy intake (fruits and vegetables, beans and fish) and the frequency of regular consumption of markers of unhealthy intake (soft drinks, artificial juices and sweets) and estimated in consumption proportion (%). The association between food intake and prevalence of cardiovascular diseases prevalence was obtained by Poisson regression with robust variance, using Stata (R) software. Results Among individuals who had cardiovascular diseases, 62% had adequate fruit and vegetables intake, with a prevalence of cardiovascular diseases 13% lower than those who did not have adequate intake. The prevalence of cardiovascular diseases was higher in those with adequate fish intake and lower in those with regular soft drinks intake, artificial juices and sweets. In women aged 20 to 39 years the prevalence of cardiovascular diseases was higher in those with regular artificial juices intake. In women aged 40 to 59 years the prevalence of cardiovascular diseases was lower in those with regular sweets intake. Conclusion These results provide information about Brazilian's population health and contribute to guide actions to promote healthy food intake, which should be based on encouraging increased consumption offish, fruits and vegetables, and reducing consumption of sweets and artificial drinks.
Objective The objective of this article is to presentthe results of conducting an evaluability study for nutritional attention in Primary Health Care with a focus on the analysis of implantation. Methods The stages of the evaluability study were developed based on documentary analysis, literature review and consensus techniques with experts as methodological strategies for the construction of the evaluation model. From the literature review and documentary analysis the object modeling was carried outthrough theTheoretical Model and Logical Model. Itwas structured the Matrix of Analysis and Judgment composed of the dimensions, subdimensions, indicators and the respective measures. The evaluative model was submitted to consensus among experts using the Delphi Method. Each item of the matrix was considered validated when it reached 95% agreement. Results Nutritional attention in Primary Health Care is understood as part of the care process and has municipal management as responsible for providing organizational conditions for its implementation. The Analysis and Judgment Matrix for the analysis of nutritional care in Primary Health Care is subdivided into 2 dimensions Management and Assistance, with 3 subdimensions each, with 17 indicators and 33 measures. Conclusion Nutritional care in Primary Health Care was considered evaluable, based on the principles of comprehensive health care. The evaluation model proposed for future studies was considered adequate for analyzing the implementation of the intervention.
Objective This study aimed to examine the impact of digital nudge models and emotional eating behaviors on online food choices among university students. Methods This cross-sectional study was conducted on 356 students (87.1% female). Data were collected via an online questionnaire, including the Barratt Impulsivity Scale, Twenty-item Toronto Alexithymia Scale, and the Emotional Eater Questionnaire. Fourdigital nudge categorieswere used (default, highlighting, social influence, and warning) to assess their influence on food choice. Additionally, body weight and height were taken with the participants' declaration. Data were analyzed using IBM degrees SPSS degrees 24.0. Results The most frequently selected food category was hamburgers (n=282), with the warning nudge in the dessert category being the most effective (43.3%), followed by the social influence nudge (31.3%). There was no significant correlation between impulsivity, emotional eating, and digital nudge effectiveness (p>0.05). However, gender differences were noted, with females responding more to social influence nudges. There was a moderate positive correlation between Emotional Eater Questionnaire and body mass index and Twenty-item Toronto Alexithymia Scale (r=0.315, p<0.001, r=0.347, p<0.001, respectively). Furthermore, the Barratt Impulsivity Scale showed a weak positive correlation with Twenty-item Toronto Alexithymia Scale (r=0.127, p<0.05). Conclusion Digital nudges influenced food choices; however, psychological factors such as impulsivity and emotional eating did not significantly affect their effectiveness. Future research could explore the role of psychological traits in digital nudging for healthier food choices.
Objective To investigate the association between protein-rich food consumption and the risk of developing dynapenia and sarcopenia overfive years. Methods This longitudinal study used data from older adults (>= 60 years old) in S & atilde;o Paulo, collected in 2010 and 2015 as part of the Health, Well-being, and Aging Study. A total of 519 participants were analyzed, and the classification of dynapenia and sarcopenia was based on handgrip strength and the muscle mass index, respectively. The frequency of protein-rich food consumption was categorized and analyzed regarding the incidence of dynapenia and sarcopenia using binary logistic regression models, considering odds ratio and 95% confidence intervals. Results The incidence of dynapenia and sarcopenia was, respectively, 22% and 1.1% among participants. Analysis showed that individuals with daily consumption of meat and legumes had the lowest risk of developing these conditions. Daily meat consumption alone also reduced the risk. Conclusion Frequent consumption of meat and legumes is associated with a lower risk of developing dynapenia and sarcopenia in older adults. Combining these foods rich in animal and plant proteins offers significant benefits for muscle health.
Objective A sustainable meal menu is important as it addresses various environmental and social concerns associated with food production and consumption. This study aims to compare the nutritional, environmental, and diet quality of omnivorous and vegetarian menus concerning sustainable nutrition. Methods One-month meal data was obtained from a university's website. The dietary quality of the menus was determined by Healthy Eating Index-2015. The meals' macro and micronutrients, and antioxidant capacities were analyzed with the BeBiS programme. Carbon, water and ecological footprint calculations were made using the food quantities obtained from the recipes of the menus. Results Omnivorous menus were higher in energy, in total protein, essential amino acids, total fat, saturated fat, cholesterol, n-6, vitamin E, riboflavin, niacin, B6, B12, iron, phosphorus, and zinc. Vegetarian menus were higher in fiber. There was no significant difference between the two menus regarding total Healthy Eating Index-2015 scores. The carbon, water and ecological footprint of omnivorous menus is significantly higher than the footprint of vegetarian menus. Conclusion When omnivorous and vegetarian menus were compared according to environmental, and diet quality vegetarian menus were more sustainable. Although both menus are not different in terms of HEI-2015, the amount of protein is lower in vegetarian menus. By diversifying with quality protein sources like legumes, eggs, pseudocereals, or oilseeds, professional-prepared vegetarian menus are required. In orderto reduce the carbon, water and ecological footprints of omnivorous menus, reducing animal-based foods, including more plant-based foods and ensuring diversity, as in vegetarian menus, will contribute to sustainable nutrition.
Objective Lifestyle modifications stimulate external influences on diet, which can impact food choices, thus improving the practice of mindful eating. Mindful eating can help identify behaviors related to eating and assist in the recovery of more nutritionally adequate dietary patterns. This cross-sectional study aimed to analyze the relationship between external environmental influences on the consumption of ultra-processed foods and the food choices of individuals with type 2 diabetes mellitus. Methods Adult and elderly patients with type 2 diabetes mellitus and HbA1Cwere included. Dietary intake was assessed using a 24-hour recall and categorized according to the NOVA Food Classification. The Mindful Eating Questionnaire and its domains were used to identify external influences. Anthropometric data such as weight, body mass index, and waist circumference were analyzed. Results The sample consisted of 325 individuals, 60% of whom were female, with a mean age of 60.85 +/- 9.3 years; 58.8% were married and 49.2% were white. Regarding nutritional status, the body mass index was 30.3 +/- 4.6 kg/m(2 )and the waist circumference was 103.1 +/- 11.7 cm. The NOVA Food Classification identified a higher score in the consumption of unprocessed and minimally processed foods at 64.4% (53.4-73.5) and a lower score in the processed culinary ingredients group at 1.8% (0-5.3). There was a statistically significant positive correlation between the external domain of the Mindful Eating Questionnaire and body mass index (r=0.124; p<0.01), weight (r=0.119; p<0.01), and waist circumference (r=0.151; p<0.01); as well as a significant negative association in the consumption of minimally processed foods however, these correlations were weak. Conclusion Our study found a correlation between the consumption of unprocessed or minimally processed foods and the external domain of the Mindful Eating Questionnaire. Additionally, the findings show that the greater the external influences on eating, the higher the values of weight, body mass index, and waist circumference.
Objective Identify factors associated with excess weight in adolescents during the COVID-19 pandemic. Methods Cross-sectional study with 302 students from an integrated high school/technical education unit. A digital questionnaire was used with questions about time spent on screens, amount of sleep hours (Mini Sleep Questionnaire), eating habits in front of a screen, food consumption, physical activity, socioeconomicvariables and obesity in parents. In orderto assess nutritional status, weight and height were used as informed by the respondents. Descriptive statistics and regression analyses were produced to identify factors associated with excess weight, defined as BMI Z-score >= 1.0. Results Excess weight was present in 28.5% of the students and obesity (BMI Z-score >= 2.0) in 8.9%. Four out of ten students reported eating their main meal in front of the screen every day of the week; 87.7% had poor sleep quality and 29.9% slept less than 7 hours/night. Only 29.8% performed the daily physical activity recommendation. Those in the 3rd tertile of total screen time tripled the chance of being overweight (OR=3.35, 95% CI=1.62-6.89) and eating meals in front of screens 5 or more days/week multiplied that chance by 3.25 (OR=3.25; 95% CI=1.63-6.49. Having the mother with low education was a protective factor for being overweight (OR=0.37; 95% CI=0.16-0.84). Conclusion Even during the pandemic period, students with more screen time and those who regularly ate meals in front of a screen were more likely to be overweight, confirming the negative role of these factors on adolescents' nutritional status.
ABSTRACT Objective To describe and review the role of nutritionists in three Brazilian Food Security facilities: popular-restaurants, food banks, and community kitchens. Methods This study comprises a review of the scientific literature combined with an assessment of regulations and technical documents addressing the role of nutritionists in Food Security facilities. Results A total of 29 studies were included in the sample after screening for the inclusion and exclusion criteria: 12 addressed popular-restaurants, 11 food banks, and 6 o community kitchens. The studies indicated that there was an insufficient number of nutritionists in the facilities when compared to the requirements set forth in to-day’s regulations, which ought to be reviewed and updated taking into account the current context. Furthermore, it was difficult to obtain accurate data on the number of nutritionists working in these facilities in Brazil. Conclusion In order to enhance the role of nutritionists in food and nutritional security, actions are required at all levels, including improving professional training, expanding job openings in the public food and nutrition programs, monitoring and inspection by legal councils and raising awareness and mobilizing the professional category to value and acknowledge the actual need of nutritionists and their duties in the food and nutritional security teams.
