Peer-reviewed article
Food Insecurity, Anemia and Vitamin A Deficiency in Brazilian Children Aged between 6 and 59 Months of Age: Brazilian National Survey on Child Nutrition (ENANI-2019).
Letícia Ramos da Silva, Paula Normando, Raquel Machado Schincaglia, Inês Rugani Ribeiro de Castro, Pedro Gomes Andrade et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This national survey of 6,020 Brazilian children aged 6–59 months examined links between food insecurity, anemia, and vitamin A deficiency. About 48% of households experienced some level of food insecurity, with 4.2% in severe food insecurity. Children in severely food-insecure households had significantly higher rates of anemia (15.5%) compared to food-secure households (6.4%), representing an 82% increased prevalence. Vitamin A deficiency was present in 3% of children overall, but no clear association with food insecurity was found.
Key points
- Mild, moderate, and severe food insecurity affected 37.7%, 6.2%, and 4.2% of households respectively
- Anemia prevalence was 7.1% overall, but rose to 15.5% in severely food-insecure households
- Children in severe food insecurity had 82% higher prevalence of anemia than food-secure children (PR: 1.82)
- Vitamin A deficiency affected 3% of children with no significant linear trend by food insecurity level
- Clear dose-response relationship observed: anemia prevalence increased progressively with worsening food insecurity status
Limitations
This is a cross-sectional survey, so causality cannot be established—food insecurity may be associated with anemia, but the direction of causation or confounding variables are not determined. The study cannot explain the mechanisms linking food insecurity to anemia or why vitamin A deficiency showed no clear association.
Abstract
BACKGROUND: Anemia and vitamin A deficiency (VAD) can be related to poverty and food insecurity (FI), which can increase risk of stunting and delayed child development. OBJECTIVES: This study aims to assess the association between FI and the occurrence of anemia and VAD in Brazilian children aged 6-59 months. METHODS: Data from 6020 children from the Brazilian National Survey on Child Nutrition (2019) were used. FI was assessed using the Brazilian Food Insecurity Scale, classifying households into food security (FS) and FI levels. The outcomes were anemia [hemoglobin <10.5 g/dL (6-23 months) and hemoglobin <11 g/dL (24-59 months)] and VAD (retinol corrected by C-reactive protein <0.7 μmol/L). FI frequencies, anemia, and VAD prevalences were calculated according to FI levels, 95% confidence intervals (CIs), and P-trend. The adjusted prevalence ratio (PR) was estimated using quasi-Poisson regression. RESULTS: The prevalence of mild, moderate, and severe FI was 37.7% (95% CI: 32.0%, 43.4%), 6.2% (95% CI: 4.8%, 7.6%), and 4.2% (95% CI: 3.1%, 5.3%), respectively. The prevalence of anemia was 7.1% (95% CI: 5.9%, 8.3%), and VAD was 3.0% (95% CI: 2.5%, 3.6%). A significant linear trend (P-trend < 0.001) was observed in the prevalence of anemia according to the degree of FI: severe (15.5%; 95% CI: 8.1%, 22.9%), moderate (10.0%; 95% CI: 5.4%, 14.6%), mild (6.6%; 95% CI: 4.9%, 8.3%), and FS (6.4%; 95% CI: 4.7%, 8.1%). Children living in households with severe FI had an 82% higher prevalence of anemia (PR: 1.82; 95% CI: 1.40, 4.17) than those living in FS. A significant linear trend (P-trend < 0.001) was observed in the prevalence of VAD according to the degree of FI: severe (3.3%; 95% CI: 0.0%, 6.7%), moderate (5.8%; 95% CI: 2.3%, 9.2%), FI (2.8%; 95% CI: 1.9%, 3.7%), and FS (2.9%; 95% CI: 2.1%, 3.7%). No association was observed between FI and VAD. CONCLUSIONS: Severe FI was associated with anemia among Brazilian children aged 6-59 months.