1 Federal University of São Paulo (UNIFESP). Department of Pediatrics. Discipline of Nutrology. São Paulo, Brazil; 2 Boston University (BU). Department of Pediatrics. Children’s HealthWatch, Boston, United States of America; 3 State University of Campinas (UNICAMP). Faculty of Medical Sciences, Campinas, Brazil.
Introduction: Food Security is the right to regular and permanent access to nutritionally adequate food in sufficient quantity, without compromising access to other essential needs, based on food practices that promote health. Children living in moderate or severe food-insecure households are subjected to worse health conditions, becoming adults less capable to generate sufficient income, therefore remaining in poverty. Objective: The present study analyzed the association between food insecurity and biological variables among children under five years. Methodology: Using secondary data from the National Survey on Demography and Health of Women and Children(PNDS-2006), and food security information collected by the Brazilian Food Insecurity Scale(EBIA), the outcome variable food (in)security was dichotomized as food security or mild food insecurity(FS/MiFI) versus moderate or severe food insecurity(M/ SFI). Statistical analysis used Poisson regression with a hierarchical modeling approach and associations were presented as adjusted prevalence ratios(aPR) with confidence intervals(CI) of 95%. Results: Independently of geographic location(macro-region and urban-rural classification) and household variables(economic status, government financial aid, maternal education, marital status and number of children), having had at least one episode of diarrhea during the three months preceding the interview (aPR 1.2, 95%CI 1.1; 1.4), at least one hospitalization for pneumonia within the twelve months before the interview (aPR 1.7; 95%CI 1.3; 2.2), height-for-age < -1.5Z (aPR 1.1, 95%CI 1.0; 1.3), and having not eaten fruits and vegetables every day in the past seven days before interview (aPR 1.8, 95%CI 1.4; 2.5) were associated with children under-five living in moderately or severely food-insecure Brazilian households. Conclusion: There is a relationship between living in moderate or severe food insecurity and objective adverse child health outcomes. These relationships are shaped by the environment, and may represent an important factor in the transmission of socioeconomic inequality across generations, impacting negatively on the prosperity of future Brazilian citizens.