Indicators of complementary feeding and social vulnerability in the Brazilian Amazon

Abstract

OBJECTIVE: To analyze Complementary Feeding Quality Indicators according to socioeconomic characteristics in Cruzeiro do Sul, Acre, Western Brazilian Amazon. METHODS: 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. RESULTS: 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). CONCLUSION: 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.