The nutritionist is the professional who understands the relationship between man and food, considering man as a social and biological being and all the physical-chemical processes of the nature of food. Thus, their field of study is the result of historical issues together with biological, social and psychological aspects, whether at an individual or population level [1].

Their work can occur in all fields in which food and nutrition are fundamental to the promotion, maintenance, recovery of health and prevention of diseases. Therefore, they are qualified to work in the areas of Nutrition in Collective Food, Clinical Nutrition, Nutrition in Sports and Physical Exercise, Nutrition in Public Health, Nutrition in the Production Chain, in Industry and Food Trade and Nutrition in Academic Teaching, Research and University Extension Programs [2].

The recognition of the nutritionist profession was sanctioned in 1967, by Law No. 5.276/67 and, from the 1970s onwards, the expansion of programs began in the Brazilian regions [3]. In the North region, the emergence of the first Bachelor of Nutrition Science degree dates back to 1973, offered by the Universidade Federal do Pará (UFPA, Federal University of Pará) [4]. Currently, the Bachelor of Nutrition Science degree is offered in 68 public higher education institutions, three of which are located in the North region, namely: UFPA, Universidade Federal do Amazonas (UFAM, Federal University of Amazonas) and Universidade Federal do Acre (Ufac, Federal University of Acre); in the latter two, the programs began in 2006 and 2009, respectively [5].

In Amazonas, the municipality of Coari received the Instituto de Saúde e Biotecnologia (ISB, Institute of Health and Biotechnology), one of the five Academic Units of UFAM created out of the capital city, which at the time offered six undergraduate programs, including Nutrition, which to this day is the first and only public program for training nutritionists in the state. One of the objectives of the ISB’s Bachelor of Nutrition Science degree is to fill the shortage of qualified professionals in small cities and aims to train generalist nutritionists, with a humanistic and critical vision, capable of working in all areas related to food and nutrition [6].

In a context of increasing supply of this degree in the private sectors and mainly in the distance modality, which questions the quality of learning in the scope of training professionals in the health area [7], it becomes essential to seek to understand the limitations and potential of the training process in nutrition [1].

The analysis of training processes as a strategy to understand their impact on professional life is seen as an opportunity to provide visibility to the institution’s results, both for the academic community and for society in general. Therefore, monitoring alumni is an important tool to provide information on the quality of education offered, as well as the profile of the trained professionals and their performance [8].

Considering that in the North region, three public institutions, and more specifically, in the state of Amazonas, only one, offer a Bachelor of Nutrition Science degree, and that no follow-up studies have been conducted on alumni, it is important to investigate the profile of these professionals in order to foster discussions about the training process, understand the challenges of the market, and defend and strengthen the program and the category. In this context, the objective of this study was to describe the profile of the Bachelor of Nutrition Science alumni at UFAM, who graduated between 2010 and 2020.

This is a descriptive, cross-sectional study with a quantitative approach, in which a random convenience sample was used. A survey of information regarding the professional and socioeconomic profile of the Bachelor of Nutrition Science alumni at UFAM, who graduated between 2010 and 2020, was performed, in which a total of 184 nutritionists were given to society.

This study was conducted online through the application of a questionnaire adapted from the handbook of Conselho Federal de Nutrição (CFN, Federal Council of Nutrition) on professional insertion of nutritionists in Brazil [9], which had objective questions regarding sociodemographic characterization, participation in institutional programs during the program, completion of another degree, aspects of postgraduate studies and professional performance, such as how long it took to be inserted in the job market after graduation, area in which the professional has worked and/or works, location and sphere of professional activity.

The data collection questionnaire was made available through a link posted on the official social media channel of the Bachelor of Nutrition Science from ISB and UFAM, from March to July 2022. Furthermore, in order to improve the reach of the research, the email addresses and telephone numbers of the alumni were requested through an official letter addressed to the coordination of the Bachelor of Nutrition Science at UFAM. The data obtained in the study were tabulated using Microsoft Office Excel® software and presented in numbers and proportions.

All ethical aspects addressed in Resolution 466/12 were considered [10]. The research was conducted with approval from the Research Ethics Committee of UFAM (CAAE 56253922.9.0000.5020).

A total of 66 of the 184 alumni (35.8%) of the Bachelor of Nutrition Science at UFAM participated in the survey. Of these, 97.0% are from Amazonas and the majority (83.4%) are from towns outside of the capital city. They self-identified as brown (89.4%) and came from public elementary schools (95.5%). Furthermore, it is noted that local selection processes were predominant in enabling these graduates to enter the University (Table 1).

As for the responses about the undergraduate process, it is noted in the same Table 1 that a significant proportion (84.8%) participated, during their undergraduate studies, in the activities of the Programa Atividade Curricular de Extensão (PACE, Curricular Extension Activity Program), and almost half (47.0%) in the Programa Institucional de Bolsas de Iniciação Científica (PIBIC, Institutional Scientific Initiation Scholarship Program). A small proportion (6.1%) reported being enrolled in another undergraduate program at the time of data collection.

Regarding lato sensu postgraduate studies, most graduates had completed (62.1%) some type of specialization or were currently studying for one (16.7%). As for stricto sensu postgraduate studies, 5 people (7.6%) were studying, and of these, only 1 was pursuing a doctorate (Table 2). The reasons that led these alumni to pursue postgraduate studies were mainly professional development (40.9%) and technical-scientific improvement (37.9%). In the same table, the areas of Clinical Nutrition (47.4%) and Public Health (26.3%) were the most chosen for postgraduate studies.

Questions directed at professional activity showed that 69.7% were working in the area, and of those who were not working, 12.1% had never practiced the profession since graduation (Table 3). In general, alumni were able to enter the job market within one year (56%), the predominant areas of activity were Clinical Nutrition (32.9%), Collective Feeding (21.7%) and Public Health (18.6%) and the majority (72.4%) were working in towns of the state of Amazonas.

Among the alumni, 50% reported receiving between 2 to 4 minimum monthly salaries and 31.4% less than 2 minimum monthly salaries. The working hours of 62.0% were 30 to 40 hours per week. Regarding the level of satisfaction, 34.8% declared it to be reasonably satisfied, another 31.8% were satisfied, and 16.7% were not very satisfied. Regarding those who were not working (N = 20, 30.3%), when asked about the main reason for not practicing the profession, 18.5% claimed low salaries and 14.8% attributed it to qualifications in another area (Table 3).

The targeting of actions aimed at the establishment of higher education hubs in smaller cities, through the search for expanding the number of university seats, reducing dropouts and filling vacant seats, arising from the Programa de Apoio a Planos de Reestruturação e Expansão das Universidades Federais (REUNI, Support Program for Restructuring and Expansion Plans of Federal Universities) – (Decree No. 6.096/2007) [11] had its effects on Higher Education within the scope of the Bachelor of Nutrition Science at UFAM, given the profile of the graduates, coming from various municipalities in the hinterland and that in their majority have carried out their professional activities in these locations.

The establishment of university hubs in smaller cities provides access to Higher Education and causes a phenomenon of integration in inland cities, since it contributes to the development of the region, strengthening the economy [12]. Furthermore, considering the profile of the North region, confirmed by the self-declared race of the alumni, it allows the inclusion of groups marginalized in society due to the historical process experienced, such as blacks and browns [13].

Corroborating this aspect, there is also a predominance of students from public schools demonstrating the democratization of education. Among students who attend public schools, there is a feeling of gratitude for belonging to the collective, and they tend to make an effort to overcome the gaps arising from basic education [14].

There are several mechanisms to enter the gates of public universities, with Sistema de Seleção Unificada (SISU, Unified Selection System) which uses the score from the Exame Nacional do Ensino Médio (ENEM, High School National Exam) being the main tool. However, most nutritionists who graduated from UFAM entered through the Processo Seletivo Contínuo (PSC, Continuous Selection Process), which is a selection process specific to the university, to which 40% of the seats offered are allocated, and which consists of an exam in the three years of high school, in a serial and continuous manner [15]. In view of this, the importance of encouraging entry into higher education from the first years of high school is emphasized in a joint action by the state and administrators.

Another important finding of this study was the fact that only 01 nutritionist who graduated from UFAM declared himself Indigenous, even though the state of Amazonas is the state with the largest number of indigenous people in Brazil, according to the 2022 census [16]. Indigenous people tend to be socially vulnerable and have few opportunities [13]. Given this, there is a need to strengthen policies and actions that aim to include this social group in higher education.

One of the most challenging aspects of the Amazon region is its geography. The Amazonas region has a vast territorial dimension and access to most of the municipalities in the hinterland of the state is almost exclusively by river. This results in low coverage of the health system in municipalities that are difficult to access [17]. Therefore, the establishment of university hubs in smaller cities of public education is essential to provide training for professionals born in the hinterland, who are capable and motivated to work in their own town or others, still in the hinterland of the state. These professionals can alleviate the difficulty in accessing specialized care by decentralizing care from the capital, especially in the areas of Clinical Nutrition and Public Health.

Furthermore, a high rate of participation in institutional programs was observed, which enhances the student’s career, providing the experience of conducting scientific research and university extension programs, contributing to the integration of the University with society, the establishment of bonds and socialization, in addition to the student’s experience with the particularities of reality into practice and the awakening of their role as agents for the promotion of healthy environments and spaces for health promotion [18].

Within one year after academic graduation, most graduates entered the job market. This process of transition from university to the job market is challenging, given that the new society demands many more skills than just a diploma to guarantee employment. Career planning therefore becomes a good option as a tool to guide and prepare students for the market [19].

According to the CFN (2019), the areas of Collective Food, Clinical Nutrition and Collective Health are responsible for employing approximately 80% of the country’s nutritionists (30.8%, 30.4% and 17.7%, respectively) [9], corroborating the profile of graduates. In the present study, the proportion of graduates working in Nutrition and Collective Health was very close to that working in Collective Food, differing from that observed in national and local studies and in relation to nutritionists registered in the Cadastro Nacional de Estabelecimentos de Saúde (CNES, National Registry of Health Facilities), in which the North region had the lowest number [20], evidencing the local culture of positions of trust in replacement of public examinations, which influences the length of time spent in positions and the degree of satisfaction with professional performance.

In this sense, Delgado and his collaborators reflect on the challenges of thinking about a linear relationship between graduation and professional performance and highlight the importance of considering socioeconomic contexts, individual interests and public management in this scenario [8].

Although this is an unprecedented study with information on the profile of alumni of a Bachelor of Nutrition Science in the North region, and more specifically in the State of Amazonas, the limitation of this study is the low participation of alumni, only 35.8% in relation to the total population. Studies with low participation emphasize the difficulty in finding professionals, given the outdated contact information [21-23]. This result highlights the importance of universities constantly updating the registry of graduated students and of having this contact and proximity since graduation, with a view to enabling monitoring and outcomes regarding these professionals.

Overall, the social return that the university provides to the population can be noted, since Amazonas is geographically the largest state in the country and presents challenges proportional to its vastness. The rivers are the “roads”, the main form of interaction between cities and, despite the beauty of appreciating this abundance, it is a true odyssey to explore it. It takes days of travel to cross the same state, making health coverage, education, integration with the media, the economy and development difficult.

The presence of the university in the hinterland is a milestone and, therefore, this study, more than identifying the profile of alumni, is a way of highlighting the role of ISB/UFAM in social change within the scope of the challenges and potential of Amazonas. In addition to academic training, it is worth noting that there are obstacles that are specific to the nutritionist class that require constant discussion and attention.

The process of internalizing higher education in Amazonas has achieved satisfactory results, considering that almost all alumni of the Bachelor of Nutrition Science are from towns of the state and came from the public education system before graduation. Nutritionists continued to work as professionals in the hinterland, mainly in the areas of clinical nutrition, nutrition in collective feeding and nutrition and collective health, a scenario that highlights the role of the university in a remote access region such as the one where this study was conducted.

In this sense, it is worth highlighting that more research aimed at understanding individual aspects and the context of nutritionist training and its impact on professional performance is essential for understanding the potential and gaps of public investment in Brazilian education and its return to society.