O papel da violência entre parceiros íntimos no consumo alimentar e no estado nutricional de crianças entre seis e trinta meses

Abstract

This thesis aimed to investigate the relationship between exposure to intimate partner violence (IPV) and two outcomes in children aged six to thirty months: overweight and the consumption of healthy eating markers. Data were drawn from the project “Variation in Food and Nutritional Insecurity, dietary intake and anthropometric measures, from 2005 to 2009/2010,” conducted in Campos Elísios, the 2nd District of Duque de Caxias, in the state of Rio de Janeiro, Brazil. The study adopted a cross-sectional population-based design, with three-stage cluster sampling (census tracts, households, and individuals), including households with children aged six to thirty months and women who had been in a romantic relationship in the twelve months prior to the interview. IPV − both physical and psychological, perpetrated against women and between couples − was assessed using the Revised Conflict Tactics Scale (CTS2), validated for the Brazilian context. Statistical analyses were conducted using Stata 17.0 software, employing multivariate logistic regression with sampling weights. The first article examined the association between IPV and childhood overweight, assessed through body mass index for age (BMI/A). Results indicated that 69.3% of women reported psychological violence and 26.9% reported physical violence; among couples, these rates were 79.6% and 36.8%, respectively. Children exposed to physical violence against their mothers had a higher likelihood of being overweight (OR: 1.10; 95% CI: 1.01–1.20), with an even greater risk when both forms of IPV were present (OR: 2.60; 95% CI: 1.34–5.03). Violence between couples was also significantly associated with increased probability of childhood overweight (OR: 1.10; 95%CI: 1.01–1.20 for psychological violence, and OR: 1.37; 95%CI: 1.16–1.61 for physical violence). The second article analyzed the relationship between IPV and the consumption of fruits, vegetables, beans, and breastfeeding. Dietary intake was measured using a 24-hour recall applied to the child’s primary caregiver. Exposure to violence against the mother was associated with a lower likelihood of the child consuming fruits and vegetables (OR: 0.75; 95% CI: 0.58–0.97), while physical violence between couples was linked to a reduced likelihood of breastfeeding for six months or longer (OR: 0.86; 95% CI: 0.78–0.94). No significant associations were found between IPV and bean consumption, nor between couple violence and fruit and vegetable intake. The findings of this thesis highlight that IPV, even when not directly targeted at children, may negatively affect nutritional status and dietary habits during early childhood—a phase marked by high dependence on caregivers. Living in violent family environments compromises caregiving practices, affects food intake, and contributes to health inequalities. The results underscore the importance of intersectoral public policies that integrate violence prevention, food and nutrition security promotion, and support for healthy child development. Expanding research on IPV across diverse social contexts can help strengthen preventive strategies and health promotion efforts from the earliest years of life