The Faculty of Medicine of the University of Lisbon starts a new Degree from the beginning of September.

After the creation of the PhD in Metabolic Diseases and Food Behaviour in 2008, and in 2012 the Master’s Degree in Clinical Nutrition was created, 2018/19 promises to be the academic year that starts with the Nutritional Sciences study programme.

At a time when the subject of nutrition is becoming increasingly important in society, the Faculty of Medicine saw the creation of an integrated project and in articulation with its various training levels (Bachelor, Master and Doctorate) as vital and always with a possible opening for scientific research within this area.

Being matter highlighted in the various faculties, the Nutrition needed, however, to go beyond a theme or discipline. Catarina Sousa Guerreiro, had and she has a key role in the creation of this new Degree. This was the reason that led us to talk to her.

“Alfacinha” born and raised (in Lisbon), she adores her neighbourhood, Arco de Cego and says that she thinks about the organisation of her family so that they can travel by car as little as possible. In her roots, she has everything that could explain her humble and discreet personality, from whom she received the upbringing that true values never self-promote. Daughter and granddaughter of doctors, her father António Sousa Guerreiro specialises in Internal Medicine and is a healthy competitor of hers, since he is a Professor at the Universidade Nova de Lisboa, the University where Catarina even gave some classes related to Nutrition. Her mother, now retired, worked as coordinator of the planning office of the Rectory at the Universidade Nova de Lisboa. Her father and mother gave her directions that, without being aware of it, would become joined to her own.

On hearing her recall her origins, one realises that the deep sense of family may have been inherited from her maternal grandparents, who raised 10 children. For the large family that joined Sunday’s lunch at Grandma’s house on US Avenue, the tradition of having Sunday lunches or Christmas dinner remained.

Catarina graduated in Dietetics and Nutrition from the School of Health Technology in Lisbon, when she finished the study programme she felt she needed to continue learning. She went to do a Masters where she met Professors Helena Cortez Pinto, Ermelinda Camilo and Marília Cravo; it was the latter that would prove to be very important in her life, even to this day. Gastroenterologist Professor Marília Cravo challenged Catarina to go to practice with her in the IPO and study the relationship between genes, food and disease development. In fact, Nutrigenetics is spoken about, and in what form this interaction can be a risk factor in a neoplastic context (uncontrolled proliferation of cells, which can be benign or malignant). The Clinical Nutrition Masters at the Faculty of Medicine was successfully completed, as well as the internship where she applied her research. It was at that time (2005) that ESTeSL invited her to become a professor, while at the same time she was following a similar path at the Faculty of Medicine, as a guest assistant.

Getting her PhD was for Catarina a very natural and logical process, following what she determined to be her professional life. Nutrigenetics remained the focus, and whereas she had first researched colorectal cancer, she now looked at the causes of inflammatory bowel disease, Crohn’s disease.

She always described everything she had achieved with extreme simplicity, as if anyone could do it. She mimicked what she had learned in colorectal disease and conveyed questions about the influences of Nutrigenetics in her new field of study. At that time, she lived with the Gastroenterology patients at IPO and Santa Maria, a hospital she had also inherited when her maternal grandfather Coriolano Albino Ferreira, then administrator of the HSM (1956 and 1961), came from Coimbra to live with his family in the huge grey building. “My mother says she remembers playing around the Hospital corridors and gardens. In fact, the room where my mother and my aunt and uncle slept is now one of the wards. It’s funny, isn’t it? Little did I know that I would walk the very same places too.”

With the curriculum and personality conditions reunited, Catarina had everything to coordinate the new study programme in Nutritional Sciences. “I remember it as if it were today… on vacation in the month of July, there were several phone calls with Dr. Luís Pereira (Executive Director) so that we could have the proposal of our completed study programme processed on October 6, 2016. The truth is that the Faculty has some doctors who are close to the area of nutrition, but creating a proposal from scratch was not easy at all. But it was created and delivered on time. The fact is that everything went well and was very well classified in the A3ES Agency (Agency for Assessment and Accreditation of Higher Education) and the Portuguese Nutritionists’ Association also gave a positive opinion of our proposal.

Everything was ready to move forward with the new degree in 2017, Catarina Sousa Guerreiro and Joana Sousa, both Professors, took the two places to advance the study programme’s preparation. “Having Professor Joana (Sousa) by my side is excellent because we complement each other very well. She will offer vital support, I say, I think I would not dare to come without her.”

It was April 2017 and they were expecting to have everything ready to open in September of that year. Due to budget constraints and giving focus to other areas, such as physics, considered as primordial, by governmental decisions, it was decided not to open the vacancies for the study programme. The Universities were thus without space to be able to answer the demand of the new study programmes.

As a year later nothing changed in the opening of new vacancies, in a harmonious management between Director Fausto J. Pinto and the Dean of the University of Lisbon, António Cruz Serra, the internships were reorganised, considering that for the Degree in Nutritional Sciences thirty places of such a longed-for study programme would be designated.

Currently Lisbon only has ESTeSL with a polytechnic training in the area of Nutrition and two private institutions that will fill the vast demand. There is a very strong point to highlight in this Faculty of Medicine project at the University of Lisbon. The project has a link to the Faculty of Human Motricity, where it seeks the part of physical exercise, and with the Faculty of Pharmacy, more focused on the toxicological analysis of food. It will primarily be taught at the Faculty of Medicine, at the new Reynaldo dos Santos Building; however, the possibility of dedicating concrete days of education at the other two faculties involved is not ruled out. “There will be days designated for the classes to occur at the Faculty of Pharmacy or Human Motricity. We will promote interaction between schools and teachers, but we will do everything to ensure the comfort of students.”

In addition to the journey of becoming a Professor, Catarina also carries out a clinical activity highly focused on the role of nutrition in intestinal diseases. She thinks that she is only involved in the projects as long as they are beneficial to her, but mainly, and only, if she feels that she can give something to enrich them. And although it seems that these steps were happening almost unintentionally, the facts prove that it would be unfair to believe that it was just so.

In 2011, when she finished her PhD, she sent her CV to the Champalimaud Foundation, as she was called in 2015. She has collaborated with them since then in Nutrition consultations, once a week, and intends to keep the tie.

Her daughter Julia, her firstborn, is now 6 years old. Then came João, now 4 years old and then Manuel who is one year old. From the hectic time she has already had, she knows that she needs energy management and with the new study programme she combines the Master’s in Clinical Nutrition with the subject in the Health Sciences study programme and the electives in Nutrition.

Nearly 39, Catarina Sousa Guerreiro shoulders the burden of coordinating a study programme at the Faculty where she has specialised very seriously.

How did we come to this decision of a new study programme, since in the past there had already been other qualifications?

Catarina S Guerreiro: In the past, the Faculty had a Study Programme in Dietetics and Nutrition created and thought through by very important people in the area of Nutrition, such as Professor Ermelinda Camilo, who tried to create a be very important in light of a European context and was well thought out… The point is that in Portugal things were different. Here events came to a boil, namely the creation of a professional association that now determines which study programmes give access to a profession. What happened in the past is that, despite being well thought out in the European context, the study programme did not meet some of the basic requirements nationally. The truth is that Professor Fausto Pinto took on this new project with great conviction and he is very persistent in what he wants and, as such, did everything to make this study programme possible. And he did it.

When we talked, he said, “We think we’re too young and then we’re not as young as that.” Do you feel this is a start that carries some weight?

Catarina S Guerreiro: We are in a Faculty with a very strong institutional weight, with a lot of history, and, of course, I often think that the role I’m going to take here will force me to take positions and take a place… of course, that always forces us to grow. I think that Nutrition is going to have to conquer its own space. But to date it’s important to say that we haven’t come across any obstacles. Zero. Even now we had a meeting for first-year professors to prepare the next academic year, mainly doctors, because the subjects in Nutrition essentially come from the 2nd year and we were afraid of what the first struggle would be like. All the professors have demonstrated a lot of interest and enthusiasm with the new degree. Then there is Management, which has shown a great deal of openness to everything we need and I can say the same about all parts of the administrative services. That is, there have been no difficulties, there is only awareness of responsibilities. In fact, the year we didn’t open was good for us. Of course, at the time we felt that we were “dying on the beach” when we received the news in July, but the fact was that it allowed us to consolidate institutional relations, consolidate research projects and set the goals where we want to go really well.

Do you have an idea of the profile of students you are going to receive?

Catarina S Guerreiro: I do. As I have been in the academic context of nutrition for many years, I think I know the changes in the public compared to 2002, the year when there was another undergraduate degree. Now the student who goes into Nutrition is different from that of old, because the overwhelming majority don’t come to this study programme with the future goal of going into Medicine later. Whereas the student used to put medicine in their first options and only later chose Nutrition, I now think that picture has changed. At this time, there are many more people who choose Nutrition and even want Nutrition. I think this will be related to the enormous prominence that nutrition has in our daily lives.

There is a concept of healthy living that this Director fights for vehemently and this is one of his banners, “For a Healthy University,” a programme where the Faculty of Medicine will play an important role.

Catarina S Guerreiro: When I earned my degree, I thought that at the time the normal way was to leave university and go to work in a hospital< we thought we would always deal with disease. I never wanted to go into Medicine, I never intended to become a doctor. But in my generation we greatly aspired to work in the clinical area. And the big change is that those who are looking for Nutrition today don't think so: some will think only of the clinic, but others already think about nutrition applied to sports, to food marketing, that is, nutrition as a promoter of well-being. Now it is also true that this connection to well-being is increasingly associated with fashion trends. And we here in this new project cannot be the "elderly of the Restelo:" we will have to be able to follow the evolution of the behaviours and attitudes related to nutrition, but we will have to be serious and credible in the approaches to these new trends. There is a tendency on the part of the media to take Nutritional issues to its more media-based, often tempting side. As an academy, we have to know how to follow the trends while knowing full well what the pillars of our performance are. [su_spacer size="10"] Is the balance between modernity and tradition well defined in this starting point?

Catarina S Guerreiro: I know that we are endowed with professors who will give us lots of answers. I’ll give you a concrete example: in the first year, we’ll have the Public Health department, where we will have highly experienced Professors who will help us, in light of scientific evidence, to demystify some of the myths and issues related to nutrition. What establishment is better for this great challenge than ours? We have academically excellent professors whose conduct is based on the best clinical practice. This is to tell you that I don’t know at the outset what the point of balance will be, but I am very sure of the foundations.

With a large family, this reminds me of the ritual they had at the table. A complete proponent of tradition, what does this tell us about your family table?

Catarina S Guerreiro: My grandparents promoted lunches a lot, living around the table, and even after losing them, we tried to maintain this ritual. Now on Sunday we have lunch at a restaurant that everyone can easily reach, each coming at the time they can and when they can. But then there’s always snack time at some aunt/uncle or cousin’s house. Cousins alone total 29, and at Christmas we are more than 80. And it is a Christmas dinner without much luxury, where the family spirit is what matters. Each person brings something because the most important thing is that we are all together.

And does it make sense to say “we are what we eat?”

Catarina S Guerreiro: I think so. It may sound like a catchphrase, but I really believe it. In addition, I work in an area that is very much linked to the gastrointestinal tract, and we are increasingly aware that what happens in our intestines and our (intestinal) microbiota seems to have an influence, even in the way we behave. Now, if I am healthily nourished, in a way that is appropriate to my body, then it can only translate into a better quality of life. In that regard, we will very much be what we eat.

Do you think that a great fundamentalism has been created in recent years about the body and the aesthetic part? Does the stereotype of the perfect woman influence a dietary decision?

Catarina S Guerreiro: The problem is that I think that today we are adding other stigmas on top of this. This is the basal one, that of a woman with a perfect body, which encourages a restrictive eating pattern. But on top of that, now the trend is to tamper with food selection, creating unbelievable diets. This new trend of restraint is dangerous, and do you know why? Because unlike what we should be doing, we aren’t personalising anything, but rather massifying exclusion. And this exclusion isn’t only to do with the ideal of a perfect body, which is even measurable, but is mainly to do with the other ideas that we can’t quantify, and that to do with any sort of well-being. But well-being can never arise at the expense of unbalanced diets of exclusion. And all of this has consequences, either momentary, or in the long term. What we need is a greatly varied dietary pattern. It may seem like another catchphrase, but how many of us unconsciously don’t tend to always buy the same kind of vegetables or even fruit or fish. Do you know what happens? Minerals, vitamins, or on the other hand additives or pesticides will always be the same, and our body is, in a very prolonged way, subject to the same range of compounds. If we vary what we eat, we do not take that risk. Then there’s another problem. We are no longer as moderate as we were in the past and, very importantly, we don’t do physical exercise adjusted to what we eat. Our perception of the doses we should consume is totally out of order. How many of us are not satisfied if the portion they serve us in a certain restaurant is not “nice”? We increase portions and move less and less. You have no idea how ten thousand steps a d ay might be useful in this equation. So I would even go further: we are the reflection of the balance between what we eat and what we move.

If you could remember a single flavour or smell of the grandfather’s Sunday tables, what flavours would come to mind?

Catarina S Guerreiro: (Does not hesitate to answer) Of very thin, fresh toast. The smell associated with this and the taste are very present because it was something that was always there. Always… (smiles and adds voice) And there it is. It’s still there…

Catarina Sousa Guerreiro is but a short time away from testing the success of everything she has been building for this study programme. Awaiting her is a first year with thirty students in a study programme that will last four years and will have a unique teaching group composed of three Reference Faculties (Medicine, Pharmacy and Human Motricity). It will be a study programme with a great deal of theory and practice, as well as practical cases of resolution. At the end of it all, and in the last year, there will be a semester for internship and for protocols, not only in hospitals, but in diverse areas that afford students a perspective of what they can come to be in the future.

In the near future, these potential nutritionists will be able to follow in the footsteps of Catarina and go for the clinical aspect (in a public or private context), or opt for sports centres, nurseries and schools, or other teaching and research centres, food and pharmaceutical companies, or catering companies and public or proven social or civil institutions.

September is almost here and promises to be full of news. It is up to us to wish good work to all and all the good luck to Catarina Sousa Guerreiro, because she deserves it unconditionally.

Joana Sousa

Editorial Team