Insegurança alimentar e anemia ferropriva: duas condições que comprometem o crescimento e desenvolvimento da criança

Abstract

Food insecurity and iron-deficiency anemia are distinct expressions of the same phenomenon, social and nutritional inequality that compromises child development. Considering the complexity of this issue, the present dissertation was developed in the format of scientific articles and comprises two complementary products. The first product consists of an integrative review article, published in Current Nutrition Reports, which aimed to analyze the repercussions of hunger and poverty, aggravated by food insecurity, on child development, as well as the main associated outcomes and possible mitigation strategies targeted at this age group. The literature search was conducted in January 2025 in the SciELO, PubMed, BVS, SCOPUS, and EMBASE databases, including studies published between 2010 and 2024 in Portuguese, Spanish, and English. The synthesis of the evidence indicates that food insecurity markedly affects children’s nutritional status and micronutrient availability and is associated with growth deficits, cognitive impairment, and socioemotional difficulties, in addition to the coexistence of the double burden of malnutrition, undernutrition and overweight, in contexts of social vulnerability. These findings provided the theoretical foundation for the empirical investigation presented in the second product of this dissertation. The second product consists of an original, quantitative, cross-sectional study linked to the project “Evaluation of the effectiveness of public food and nutrition security policy in southern Minas Gerais: a case study of the Municipal Food Bank.” The study aimed to estimate the prevalence of iron-deficiency anemia and household food insecurity among children living in households assisted by the Municipal Food Bank of Lavras (BMAL). A total of 80 families participated in the study, comprising 117 children. Sociodemographic, housing, and child health data were collected through interviews with the household head. Household food insecurity risk was assessed using the TRIA; nutritional status was evaluated using height-for-age and BMI-for-age indicators, with Z-scores calculated using the WHO Anthro software; and dietary practices were assessed using questionnaires adapted from the Food and Nutrition Surveillance System (SISVAN). Hemoglobin concentration was measured using capillary blood samples, analyzed on site with a portable hemoglobinometer (HemoCue®), adopting a cutoff point of 11 g/dL. Statistical analyses were performed using Stata® software (version 13.0), applying Pearson’s chi-square test and univariate and multivariate logistic regression models. A prevalence of anemia of 40% was observed among children under five years of age, and household food insecurity risk was identified in 70% of the assessed households. Family income, the quantity of food consumed after receiving the benefit provided by the BMAL, and the economic activity of the household head showed significant associations with household food insecurity risk. Among children older than two years, the consumption of sweets was associated with food insecurity risk, significantly increasing the likelihood of classification as at risk. Iron-deficiency anemia was associated with the consumption of processed meats and confectionery, with the intake of these foods identified as an independent determinant of the condition. These findings highlight the need to strengthen the implementation and coordination of intersectoral public policies already established in the municipality, in order to promote healthy eating and ensure food sovereignty among populations in situations of vulnerability.