Indicators of complementary feeding and social vulnerability in the Brazilian Amazon

To analyze Complementary Feeding Quality Indicators according to socioeconomic characteristics in Cruzeiro do Sul, Acre, Western Brazilian Amazon.

This is a cross-sectional analysis nested within the MINA - Brazil birth cohort (n = 971), using data from the 1-year (n = 774) and 2-year (n = 854) follow-up visits. Dietary intake was assessed using a 24-hour recall to construct the Complementary Feeding Quality Indicators, adapted from World Health Organization recommendations: minimum dietary diversity, meat and/or egg consumption, ultra-processed food consumption, and zero fruit and vegetable consumption . Socioeconomic, neonatal, and morbidity variables were analyzed according to a hierarchical conceptual model (distal, intermediate, and proximal levels). Prevalence ratios (PR) were estimated using Poisson regression with robust variance and multiple adjustment; variables were selected based on theoretical assumptions or an association with p < 0.10 at each level.

Regarding meat and egg consumption, 79.0% of 1-year-old children and 89.9% of 2-year-old children consumed at least one food item from this group the previous day. High frequencies of ultra-processed food consumption were observed in the first (89.1%) and second (94.6%) years of life. The minimum dietary diversity indicator in the first year was less frequent among children from families with lower wealth indices (lowest tertile: PR = 0.74; 95%CI 0.63-0.86) and whose mothers were not engaged in paid work (PR = 0.87; 95%CI 0.80-0.95). Zero fruits and vegetables consumption was more prevalent among children from families with lower wealth indices (lowest tertilel: PR = 4.89; 95%CI 2.90-8.24).

The results highlight the influence of socioeconomic factors on children's dietary patterns, reinforcing the importance of intersectoral strategies to promote food and nutritional security.