If today we recognize Emílio Peres' genius in having managed to connect nutritional knowledge with knowledge of food and in having inspired us to know how to best transmit this connection to citizens, it is equally true that Francisco Gonçalves Ferreira is responsible for a large part of the nutritional knowledge upon which the foundations of Nutritional Sciences in Portugal are based. He is also responsible for a (completely innovative) way of thinking about how to organize ourselves collectively to improve the diet of the Portuguese people, as well as some of the most important documents in the field of nutrition. A genius, an exceptional man, and also one of the people linked to the founding of FCNAUP (Faculty of Nutrition and Food Sciences of the University of Porto) whom all nutritionists should know better.
The beginning of nutrition research in Portugal
Francisco António Gonçalves Ferreira was born in Aguiar da Beira on November 24, 1912, precisely at a time when Nutritional Sciences were beginning their meteoric development. In the year he was born, 1912, Kazimierz Funk , a Polish scientist working in England, published an article entitled "Vitamins" where this concept was presented for the first time. Funk, who at the time was studying amino acids and their "organic bases," fed pigeons a diet of polished rice and discovered that, in a short time, the birds lost weight and became ill. As the birds consumed sufficient protein and energy, he deduced that the problem might not be a deficiency of protein or amino acids, but most likely a deficiency in the consumption of some substance present in the rice husk. Thus, Funk began to argue that certain diseases could be avoided if we ensured that certain chemical substances were present in our diet. He called these substances "vitamins," where "vita" meant vitality and "amines" meant a chemical compound containing nitrogen. Interestingly, in English, the "e" in "vitamine" was dropped in the 1920s, becoming simply "vitamin," when it was discovered that amines, or organic chemical compounds derived from ammonia, were not always present in the chemical composition of vitamins.
It is in this environment, from the early days of Nutritional Sciences worldwide, that Francisco Gonçalves Ferreira entered and graduated in Medicine from the Faculty of Medicine of the University of Coimbra in 1936. To complete his studies, he gave private tutoring (his mother died midway through the course, and his father stopped helping him after that). In 1936, he began a brilliant period of research and publication in the field of nutrition that lasted almost half a century. For more than 50 years, Francisco Gonçalves Ferreira worked at an extraordinary, almost frenetic pace. Organized, solitary, and extremely methodical, he never married nor had children, and in 1942 he published his undergraduate dissertation entitled "Ascorbic Acid in Foods Consumed in Coimbra." This marked the beginning of his research into the nutritional composition of foods, but always with a very concrete focus on regional and national food realities, a pursuit that never left him. Two years later, in 1944, he published "Vitamin B1 and Nutrition," and in the same year, "Vitamins, Chemistry, Metabolism, Deficiencies," a colossal 338-page manual on the subject. Also in the same year, he published his doctoral thesis entitled "Water-Soluble Vitamins and Nutrition: A Contribution to the Study of the Diet of the Portuguese." In his thesis, we already find an interest in studying foods, but framing their nutritional composition within the context of intake and the needs of the population within a public health framework. This vision, innovative at the time, would later give rise to such important works as the food composition table or the first national food survey.
Let us imagine the productive and technical capacity of this man of science in Portugal during the 1940s, where laboratory resources were tremendously scarce and where scientific culture in this area practically did not exist. Alongside this enormous scientific productivity, which would extend for more than half a century, we must highlight the seminal work "Human Nutrition," with 1291 pages, where everything is described and explored in depth. From an extraordinary dictionary on food and nutrition, covering the composition and metabolism of the main nutrients, public health, hospital diets, the history of food, epidemiology, legislation, and food policy. Published in November 1983 by the Calouste Gulbenkian Foundation, this is perhaps the most important book in the history of Portuguese nutrition. Francisco Gonçalves Ferreira is also a man deeply inclined to debate public policies and endowed with enormous social ethics. This contribution to citizenship and social justice began very early in his life.
The citizen with a sense of public service and health policies
In 1946, during the Estado Novo regime, he published "Scientific and Social Problems of Food" in the Biblioteca Cosmos (number 50) under the direction of Bento de Jesus Caraça. In this first book, he enumerated, far ahead of his time, the social factors that determined major social problems and the "policy of scientific food." Later, in the 1970s, he returned to this theme, reflecting on, writing about, and designing a proposal for a nutritional and food policy that was extraordinarily well-conceived and very advanced for its time. When, in 1974, at the joint WHO/FAO Conference in Rome, Nordic experts first proposed the need to implement food and nutrition policies to prevent chronic diseases associated with inadequate food consumption, a structured body of thought on the subject already existed in Portugal. In 1978, Francisco Gonçalves Ferreira published "Food and Nutrition Policy in Portugal," where he definitively presented a food and nutrition strategy for Portugal. Later, between 1979 and 1981, he published other documents of this kind. Although still lacking epidemiological information and based on strong intuition, these texts already contained some of the assumptions of a modern strategy for the area. Unfortunately, this strategy would only be partially realized in 2012 with the creation of the National Program for the Promotion of Healthy Eating (PNPAS) by the Directorate-General of Health.
In the area of more general health policies and the organization of health services, Francisco Gonçalves Ferreira initiated a revolution in public health. Among other measures, he contributed to a profound reformulation of the National Institute of Health Dr. Ricardo Jorge (INSA). Director of INSA from 1967, he transformed the Institute into an "effective instrument to support the decision-making of political actors and to inform the general population, developing technical and authoritative skills for the identification and evaluation of the country's needs in the entire field of Public Health, instead of only having responsibilities in the area of Hygiene, as had been the case until then." Amidst all this, he still found time to create and direct the Food and Nutrition Council (CAN) and the Nutrition Studies Center (CEN) from 1976 onwards. In other words, Francisco Gonçalves Ferreira transformed INSA into a modern public research institute.
Later, he made a decisive contribution to the embryo of the National Health Service, three years before April 25, 1974, when he published Decrees-Law No. 413/71 and 414/71, while serving as Secretary of State for Health and Assistance. With the publication of these laws, the services of the Ministry of Health and Assistance were reorganized through the “development of public health and social promotion activities, creating more favorable conditions for their implementation, through the integration of public services and the condemnation of private initiatives and institutions that must ensure the medical-social, sanitary and assistance coverage of the population.” Much of modern Portuguese public health and disease prevention is already present here.
Some milestones in Nutritional Sciences in Portugal
Along the way, all the most important documents in the history of national food in the 20th century will come into her hands. Among them, we can mention the "Table of the Composition of Portuguese Foods," which she compiled with her dedicated colleague Maria Ernestina da Silva Graça in 1961 and republished in 1985. This work, spanning years, nutritionally describes hundreds of Portuguese foods from hundreds of samples and would form the backbone of nutrition research in Portugal for many years.
In 1972, she published what would become a precursor to the National Food Survey, the "Notes on the availability and needs of food in mainland Portugal." In 1976, through the CEN (National Food and Nutrition Centre), she began preparing the large National Food Survey, which would conclude in 1980 and, for almost 40 years, would be the only one of its kind in Portugal. This completely innovative work aimed to assess food consumption, conduct clinical and anthropometric evaluations, and perform a biochemical evaluation of blood and urine from a representative sample of the national population. For this task, he developed brilliant work in the area of constructing methodologies for nutritional, clinical, and laboratory research. In between, and in 1977, he conducted studies on the costs of maintaining a healthy diet for Portuguese families, through the food consumption patterns of 100 urban families in Lisbon, which he published in the journal number 1, Volume I (pages 5-16) and number 3, Volume II (pages 3-24) of CEN, a remarkable work where his social awareness and desire to fight against social inequalities are highlighted.
Francisco Gonçalves Ferreira and the Porto School of Nutrition
Beyond these activities, Francisco Gonçalves Ferreira is intensely involved in teaching and pedagogy. He participates in the development of new medical training courses and also actively collaborates in the creation of the Nutrition Course at the University of Porto in the 1970s. In between, he develops sample food education sessions and actively participates in the creation of the first Food Wheel, which was later developed in subsequent versions by professors at FCNAUP (Faculty of Nutrition, Food and Nutrition of the University of Porto).
Passionate about Porto, where he worked for many years in the 1950s and 60s, Francisco Gonçalves Ferreira is intimately linked to the establishment of the Porto School of Nutrition and its nutrition course in the 1970s at the University of Porto. In the book "40 Years of the National Health Service," journalist Maria Elisa Domingues quotes the former Minister of Health, Correia de Campos, who called Gonçalves Ferreira "Impeccable and impossible." As my professor at the National School of Public Health, I would add the epithet "Perfectionist and ethically irreproachable." I remember, as his student, hearing him say countless times, after appreciating our work: "Here's a good idea, with potential, but to get there we still need to organize it better and give it more quality thinking time."
Thank you, Professor, from all of us.
Written by
Pedro Graça, Director of the Faculty of Nutrition and Food Sciences at the University of Porto