The Cost of the Future: Residual Food Insecurity and Child Health

No previous textWe discussed Brazil's historic exit from the Hunger Map and the persistent challenges of residual food insecurity.[1]Although acute hunger has receded to levels below 2,5%, millions of Brazilians still face invisible barriers to accessing a balanced and nutritious diet. Among the main obstacles is the high cost of a healthy basic food basket: if the ideal diet requires R$ 432,00 per month per individual – an amount that drastically compromises the budget of families living on little more than that – survival forces choices.

According to a report by the FAO (Food and Agriculture Organization of the United Nations), when comparing these costs with disposable income, it is revealed that 31,9% of the global population does not have access to adequate meals. In Brazil, this percentage reaches 23,7% of the population, equivalent to 50,2 million people (FAO, 2025).

Therefore, to avoid an empty stomach, nutrition is neglected, making room for cheap and ultra-processed foods or reducing the amount of healthy foods that are purchased, which deteriorates the quality of diets.

In both cases, food insecurity once again surrounds the domestic environment, further vulnerabilizing poor families, women, children, and the rural population, thus exacerbating structural inequalities (Pact Against Hunger, 2025). The implications of these unavoidable choices overburden public health and the SUS (Brazilian Unified Health System) budget, affecting young children with priority and cruelty. When affected by nutritional states below the desired level, they carry irreversible marks on their cognitive and physical development. Caloric quantity is met, but with calories that do not nourish. This is the social cost – or at least part of it – of residual food insecurity.

The paradox of malnutrition: undernutrition and obesity side by side.

According to the World Atlas of Obesity, the likelihood of developing a chronic non-communicable disease (NCD) is increased by a number of risk factors such as smoking, sedentary lifestyle, Inadequate diet and excess body weightTogether, these factors account for more than half of premature deaths from NCDs, approximately 10,7 million in 2021. Of this total, 1,6 million (15%) were attributed to high body mass index (BMI). Even more serious: high BMI is responsible for 55% of premature deaths from type II diabetes (World Obesity Federation, 2025).

Following the Atlas criteria, a BMI between 25 and 30 kg/m² is classified as overweight, and a BMI above 30 kg/m² as obesity. Furthermore, a BMI of 35 kg/m² is the common threshold for referral to clinical interventions in current guidelines.

Research conducted by the World Obesity Federation shows that high-income countries, according to the World Bank classification, tend to maintain a high prevalence of obesity (high BMI) over the past few years (since 2010). This is not yet the case for low- and lower-middle-income countries, where the trend is towards an increase in the recent period and in projections up to 2030.

Graph 1 validates this result by illustrating the temporal evolution of obesity worldwide, in Latin America and the Caribbean (LAC), and in Brazil. It is undeniable that the challenge of residual obesity shows an upward trend that does not diminish over time, even in countries that, like Brazil, celebrated their exit from the Hunger Map. I venture to say that the problem has become a structural regularity of contemporary economies, going far beyond caloric deficiency. Projections from the FAO and other international institutions indicate the continuation of this trend if more rigorous state interventions are not implemented. Furthermore, the percentages for Latin America and the Caribbean and for Brazil are significantly above the global average.

Graphic 1Prevalence of obesity in adults (%)

According to data from Vigitel (Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey), an annual survey by the Ministry of Health, the prevalence of obesity in the Brazilian adult population reaches 25,8%, being slightly higher among women (26,8% versus 24,7% among men) (BRAZIL. Ministry of Health. Secretariat of Health and Environment Surveillance, 2026). This pattern of gender disparity is repeated globally and remains consistent over time (World Obesity Federation, 2025).

When we narrow our focus to early childhood – children up to 4 years old – the scenario is grim. Globally, overweight levels maintained a stable trend until experiencing a growing inflection point from 2020 onwards (Graph 2). Latin America and the Caribbean have maintained the upward curve observed in adults since the beginning of the historical series. Brazil, however, has exceeded the regional average since 2008: in 2024, FAO estimates indicate that 10,9% of our children in this age group will be overweight, equivalent to 1,4 million individuals. Just as mild and moderate food insecurity precede acute hunger, overweight acts as the stage preceding critical nutritional conditions, such as obesity and its consequent risks of exposure to NCDs.

At the other extreme of malnutrition, the Abrinq Foundation points out that 3,8% of children under 5 years of age suffered from chronic malnutrition (in terms of weight for age) in 2023, with a higher incidence in the North (4,7%) and Northeast (4,1%) regions. When the indicator observed is the height-for-age ratio – which reflects growth deficit – the rate jumps to an alarming 11,8%. In the same period, 5% of children were already obese (Abrinq Foundation, 2025).

Graphic 2Percentage of children under 5 years old who are overweight.

It is vital to emphasize that, just as AI fragments itself heterogeneously within the same household, the nutritional conditions of family members also diverge. How many times have we witnessed accounts of parents who go without food to ensure their children have a meal? Or of an older sibling who forgoes their plate so that the younger one doesn't go hungry? These extreme strategies comprise the range of forced choices that, from Amartya Sen's (2010) perspective, deepen the vulnerability of those who already suffer economic deprivation. By compromising cognitive development and school learning, residual AI exacts its highest price: the curtailment of these citizens' future "abilities" and opportunities.

Chart 3 presents a picture of the consequences of these less-than-desirable nutritional states for our young children, affected by growth delays, based on FAO estimates. The data reveal a worrying inflection point from 2020 onwards, with a more intense increase in the number of children impaired in their physical development. However, in both Latin America and the Caribbean and in Brazil, the estimated values ​​are below the global averages. Even so, in 2024, Brazil had approximately 8,9% of its children in this situation – almost one in ten. This may seem small in percentage terms, but this rate represented about... 1,2 million lives at the start of a future that can – and should – be promising. That's no small feat.

Graphic 3Percentage of children under 5 years old with stunted growth.

This is the paradox of malnutrition: obesity on one side and undernutrition on the other. Brazil has become a reference in Latin America and the Caribbean by reducing hunger indicators and leaving the Hunger Map on two occasions during the observed period. However, the country still struggles with the nutritional conditions of a significant portion of the population, for whom eutrophy (a healthy nutritional state) is far from being achieved.

Worse still, the nation's future, represented by children already showing the effects of malnutrition, is at risk. This is a scenario that imposes a high social cost today and will exact a very high price from everyone in the future, distancing the country from achieving target 2.1 of the Sustainable Development Goals (SDG 2): eradicate hunger and ensure access for all to safe and healthy food. In short, If we don't invest in these 1,2 million children today, the state will pay the price tomorrow in public health., as we will see later.

The scenario also portrays what the Pact Against Hunger calls the "food contradiction": while hunger and food insecurity (FI) persist, malnutrition is advancing, expressed by the increase in obesity and the consumption of ultra-processed foods (Pact Against Hunger, 2026; Swinburn et al., 2019). 

Graph 4, compiled with data from the Desiderata Institute (2024), details the nutritional status of children up to 4 years of age in percentage values ​​for the sex-race binomial.[2]It is noted that, regardless of declared race, there is a higher incidence of boys in non-eutrophic conditions, with overweight and obesity predominating. In this context, between 30% and 40% of our children in each sex-race group suffer from malnutrition.

In the group of Black children, for example, 7,72% of girls are overweight, compared to 8,2% of boys. Obesity (including the severe form) affects 5,89% of Black girls and 7,07% of Black boys. On the other hand, just over 3% in both groups suffer from underweight, and just under 3% from severe underweight.

Overall, based on the consulted database, approximately 6% of children in this age group suffer from obesity, 7,97% are overweight, 2,96% are underweight, and 2,33% are severely underweight. These general patterns tend to be replicated in other age groups.

Graphic 4Nutritional status of Brazilian children up to 4 years of age by self-reported sex and race (2024)

Eating behavior and the consumption ecosystem

According to research by the Pact Against Hunger (2026), several factors lead to inadequate nutrition. Besides income, other characteristics of the food ecosystem promote the consumption of cheap items or those with low nutritional value. Among these are the reconciliation of food preferences and the time required to prepare healthy meals, which generates an "invisible cost" of effort. Structural factors such as working hours, the challenges of urban mobility, the social division of care, and the type of work also influence this dynamic.

Table 1 summarizes the percentage of children who consume certain food groups, according to data from the Desiderata Institute. It is noted that, starting at 6 months of age, the consumption of ultra-processed foods emerges and intensifies in subsequent age groups. This data is consistent with the research of the Pact Against Hunger, which points to these products as a convenient alternative to optimize time and meet the demands of daily life, which become even more intense in the presence of children and other dependents at home, often requiring the sacrifice of nutritional quality in favor of practicality.

Thus, even knowing that they are not the best nutritional choice, Brazilians opt for these items because of their convenience. When there are income constraints, the choice is reinforced by the lower cost, reducing pressure on the family budget. In addition, the consumption of these foods emerges as a moment of relief or escape from routine, stimulated by marketing and the expansion of delivery services.

Table 1Dietary consumption patterns among children and young people aged 6 months to 19 years.

For lower-income families, the likelihood of entering a new cycle of poverty increases: a malnourished child performs worse at school, resulting in lower professional qualifications and, consequently, lower income in the future. Therefore, while acute hunger is an immediate humanitarian emergency, residual AI acts as a generational poverty trap.

Therefore, the long-term social cost ends up being... the GDP that we stopped producing Because we are not investing in the quality of the food today. This is a price that everyone will pay.

And what about the SUS (Brazilian public healthcare system)?

Public spending on health is a central component of the nation's present and future social cost. According to Giannichi et al. (2024), if the current trend of population weight gain continues, The projected spending between 2021 and 2030 is 1,8 billion international dollars in direct costs for the SUS (Brazilian Public Health System). (treatments and hospitalizations) and $20,1 billion in indirect costs (loss of productivity, absenteeism and premature deaths).

On the other hand, the same study demonstrates the financial return on prevention: a 6,7% reduction in the prevalence of overweight by 2030 would save more than 74 million dollars in public funds.

The financial impact of early malnutrition casts a long shadow over the public budget. According to a study by the Desiderata Institute and Fiocruz, cited in a report by Radioagência Nacional, childhood and adolescent obesity could generate direct costs of R$ 3,84 billion for the SUS (Brazilian Public Health System) by 2060, with almost 95% of expenses concentrated on hospitalizations (RADIOAGÊNCIA NACIONAL, 2025). Furthermore, annual spending is expected to jump from the current R$ 83 million to R$ 115 million in the coming decades.

The State as a driver of health and protector of the future.

It is clear that subsidizing "real food" and combating residual AI is not an expense, but a strategy of fiscal responsibility and the survival of the Brazilian public health system (SUS). It is a preventive investment in public health.

Furthermore, income transfer and food security policies are strategic not only for keeping Brazil off the Hunger Map, but also for reducing the effects of residual food insecurity and the social cost of inadequate nutritional conditions.

Given the above, it is necessary to examine all forms of food insecurity – from mild to severe – and integrate policies that simultaneously combat hunger, obesity, and other forms of malnutrition. Brazil has built a positive trajectory in the fight against hunger, standing out regionally in reducing the prevalence of undernourishment (PoU) and influencing the results in South America. However, it is still necessary to address hunger and food insecurity in groups that remain invisible or unserved by current public policies.

In this scenario, the urgency to combat child and adolescent malnutrition is absolute. From a rational point of view, an economy does what it can with the resources and capabilities it possesses, and the seedbed of these capabilities is composed of our children. What will our future be as a nation if we do not combat malnutrition in childhood and adolescence? Are we willing to take the risk?

Finally, this is not about welfare, as many describe social policies involving income transfer and combating hunger. It is about guaranteeing the human right to adequate food for the entire population, as established by the Federal Constitution. Even though these policies are exemplary in the fight against hunger, obesity persists despite all efforts, proving that the State, while capable of producing positive effects on these indicators, needs to be even more insistent and strategic in the fight against this societal ill.

This text does not necessarily reflect the opinion of Unicamp.

References

BRAZIL. MINISTRY OF HEALTH. SECRETARIAT OF HEALTH AND ENVIRONMENTAL SURVEILLANCE. Non-Communicable Diseases and Conditions. Accessed on: May 13, 2026.

FAO. The State of Food Security and Nutrition in the World 2025The State of Food Security and Nutrition in the World 2025. Rome: FAO; IFAD; UNICEF; WFP; WHO;, 25 Jul.2025.

ABRINQ FOUNDATION. The landscape of childhood and adolescence in Brazil. [Sl: Sn].

GIANNICHI, B. et al. The projected economic burden of non-communicable diseases attributable to overweight in Brazil by 2030. Public Health, v. 230, p. 216–222, 1 May. 2024.

Pact Against Hunger. Technical Analysis SOFI 2025. [Sl: Sn]. Accessed on: May 13th. 2026.

Pact Against Hunger. Eating Behavior: Perceptions and Challenges of Healthy Eating. [Sl: Sn]. Accessed on: May 13th. 2026.

Overview of Childhood Obesity. Overview of Childhood Obesity. Rio de Janeiro: [Sn]. Accessed on: May 13th. 2026.

NATIONAL RADIO AGENCY. Obesity could generate costs of more than R$ 3 billion for the SUS (Brazilian Public Health System) by 2060. Radio report (Audio), 10 Oct. 2025.

SEN, Amartya. Development as freedom. 11. ed. [Sl]: Companhia das Letras, 2010.

SWINBURN, Boyd A. et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. The Lancet Lancet Publishing Group, 23 Feb. 2019.

World Obesity Federation. World Atlas of ObesityLondon: [Sn].

[1] Residual Food Insecurity (FI) is the persistence of poor nutritional quality and unequal access to healthy food in populations that, although no longer suffering from acute hunger (calorie deprivation), remain vulnerable to inadequate diets due to financial and structural barriers.

[2] It is important to point out that the general patterns illustrated are replicated in other age groups.

Cover photo: