[Impact of the worker food program in Brazil].

Objective: The worker food program of the Brazilian Ministry of Labor and Employment attempts to ensure adequate nourishment for low-income workers. This study evaluates the nutritional impact of the program, which currently serves approximately 10 million workers.

Methods: This retrospective dynamic cohort study was carried out with 8,454 workers living in the state of Bahia, Brazil. Health-related data from January 1996 through April 2000 were obtained from computerized medical records from an organization that provides health surveillance services to a large number of companies in the state. The analysis utilized demographic data and nutritional data (weight and also preobesity, that is, a body mass index of 25.00-29.99). Additional information was obtained from the companies through telephone interviews.

Results: Being covered by the food program was positively associated with weight gain (age- and sex-adjusted incidence-density ratio = 2.21; 95% confidence interval: 1.78-2.75). No statistically significant association was found between the program and preobesity. The risk of weight gain was higher (P < 0.05) among workers who, at baseline, were of normal weight (body mass index of 18.50-24.99), were preobese, or were from a low socioeconomic background.

Conclusions: These results suggest that the worker food program has an unintended negative impact on the nutritional status of workers from a low socioeconomic background. The program's approach, which is limited to dietary recommendations concerning the caloric content of meals, should be revised to better promote the health of the workers participating in the program.