Food Poverty and Early Childhood Development Across Food Insecurity Levels in Brazil

This cross-sectional study investigated associations between food insecurity, food poverty, and early childhood development (ECD) among Brazilian children under 5 years of age, and explored whether the association between food poverty and ECD varied across food insecurity levels. Data were drawn from 14,062 participants from the Brazilian National Survey on Child Nutrition. ECD was assessed using milestone scores from the Survey of Well-Being of Young Children-Brazilian Version (SWYC-BR). Exposures included food insecurity levels (secure, mild, or moderate/severe) and food poverty (lack of minimum dietary diversity). Crude and adjusted linear regression models estimated associations and 95% confidence intervals (CIs), with stratified and interaction analyses by food insecurity levels. The mean SWYC-BR score was 14.14; 46.2% of children experienced moderate food poverty, 16.0% severe food poverty, 38.0% mild food insecurity, and 10.2% moderate or severe food insecurity. Mild food insecurity (adjusted β = -0.41; 95% CI: -0.74, - 0.09) and severe food poverty (adjusted β = -0.91; 95% CI: -1.37, - 0.44) were associated with lower SWYC-BR scores. In stratified analyses, children from food-secure (fully adjusted β = -0.87; 95% CI: -1.50, - 0.24) and mildly food-insecure (fully adjusted β = -1.17; 95% CI: -1.93, - 0.41) households experiencing severe food poverty had lower SWYC-BR scores. Findings indicate that food poverty is associated with ECD in Brazil and this association varies across food insecurity levels, underscoring the need for public health policies that address both nutritional quality and household food security among vulnerable populations.