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Nurturing Care Systems Underlying Early Childhood Food Insecurity in Brazil: A Causal Loop Diagram Approach.

Gabriela Buccini1, Krystyna A Stave2, Katherine Marçal3

  • 1Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Nevada, USA.

Maternal & Child Nutrition
|November 29, 2025
PubMed
Summary

Protecting Brazilian children from food insecurity requires innovative approaches. Applying the Nurturing Care Framework (NCF) and systems thinking identified food quality, positive parenting, and daycare as key leverage points to reduce childhood food insecurity.

Keywords:
causal loop diagramearly childhood developmentfood insecuritysystem thinking

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Area of Science:

  • Public Health
  • Nutrition Science
  • Systems Science

Background:

  • Early childhood food insecurity negatively impacts health and nutrition outcomes.
  • Brazilian households with children face high rates of food insecurity, with interventions limited by funding, coordination, and the COVID-19 pandemic.
  • Innovative strategies are needed to protect children from food insecurity in Brazil.

Purpose of the Study:

  • To explore the application of the Nurturing Care Framework (NCF) and systems thinking tools to identify pathways for reducing early childhood food insecurity in Brazil.
  • To analyze a causal loop diagram (CLD) to assess NCF integration within the Brazilian food insecurity system and identify leverage points for intervention.

Main Methods:

  • A participatory group model-building approach was used to develop a qualitative causal loop diagram (CLD).
  • Twelve Brazilian experts from diverse sectors contributed their knowledge to the CLD, which included 28 variables across NCF components.
  • The CLD was analyzed to understand system dynamics, feedback loops, pivotal variables, and potential intervention points.

Main Results:

  • The analysis revealed how food insecurity affects young children through direct and indirect links within the system.
  • Two reinforcing feedback loops, 'Financial Hardships' and 'Emotional Distress Spiral,' were identified as contributing to childhood food insecurity.
  • Food quality was identified as the pivotal variable most closely linked to early childhood food insecurity, with positive parenting and daycare participation showing direct intervention potential.

Conclusions:

  • The Nurturing Care Framework (NCF) and systems thinking provide a valuable lens for understanding and addressing early childhood food insecurity in Brazil.
  • Interventions focusing on improving food quality, promoting positive parenting, and expanding daycare access are crucial leverage points.
  • Enhancing access to nurturing care through policy is essential for building system resilience against disruptions like the COVID-19 pandemic.