Pediatric Health at the Crossroads of Climate Change, Food Insecurity, and Malnutrition

Climate change (CC) poses a major global threat to the health of current and future generations, disproportionately affecting pediatric populations. Investigating the links between CC and pediatric diseases is crucial to inform research and prevention strategies aimed at breaking the transgenerational cycle of social inequalities. This narrative review explores the complex interactions between early-life exposures to CC, food insecurity, and malnutrition, and their impact on infectious and noncommunicable diseases (NCDs) in pediatric populations. Data reveal a concerning global scenario: half of the world's children live in areas highly vulnerable to CC; malaria, enteric, and lower respiratory-tract infections account for ∼60% of the global communicable disease burden and related deaths in children and adolescents; over 2.1 billion people under-20 suffer from NCDs; almost 865 million children under-15 experience moderate-to-severe food insecurity; and millions of children under-5 face stunting (150.2), wasting (42.8), or obesity (35.5). The greatest burdens fall on low- and middle-income countries and the most disadvantaged households. Although the causal pathways and mechanisms linking CC to health outcomes have not been fully elucidated, epidemiological evidence shows that exposure from conception through adolescence increases risks of acute and chronic diseases, potentially altering lifelong health trajectories. This is plausibly driven by climate-induced disruptions in eco-agrofood systems, which compromise nutrition security and worsen malnutrition. Food systems are both vulnerable to and significant contributor to CC, and poor dietary patterns further amplify disease burdens. Addressing these intertwined challenges requires a holistic approach promoting healthy, sustainable, and equitable diets from infancy through adolescence, and employing an integrated "glocal" strategy taking into account both global and local contexts. Cross-sector collaboration and targeted pediatric research are paramount to enhance understanding of causal pathways and develop effective interventions to safeguard child health and well-being within a planetary health framework.