ArticlePLoS medicine2019
The association between heat exposure and hospitalization for undernutrition in Brazil during 2000-2015: A nationwide case-crossover study.
Article in PLoS medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Impact of extreme weather events on food security among older people: a systematic review.Aging clinical and experimental research · 2025Pooled it
- Non-pharmaceutical interventions for COVID-19 reduced the incidence of infectious diseases: a controlled interrupted time-series study.Infectious diseases of poverty · 2023Pooled it
- Effect of heat stress in the first 1000 days of life on fetal and infant growth: a secondary analysis of the ENID randomised controlled trial.The Lancet. Planetary health · 2024Trial
- Ambient temperature and deaths from homicide in Brazil from 2010-2019: a nationwide space-time-stratified case-crossover study.American journal of epidemiology · 2025Article
- Article
- Extreme heat and hospital admissions in older adults: A small-area analysis in the Greater Boston metropolitan area.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- In-hospital mortality of heat-related disease associated with wet bulb globe temperature: a Japanese nationwide inpatient data analysis.International journal of biometeorology · 2025Article
- Potential causal links of long-term PMSustainable cities and society · 2025Article
- Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study.Environment international · 2024Article
- Temperature-related mortality in China from specific injury.Nature communications · 2023Article
- Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi'an, China.Frontiers in public health · 2023Article
- Article
- Interactive effects of cold spell and air pollution on outpatient visits for anxiety in three subtropical Chinese cities.The Science of the total environment · 2022Article
- Association between ambient temperature and hospitalization for renal diseases in Brazil during 2000-2015: A nationwide case-crossover study.Lancet regional health. Americas · 2022Article
- Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study.BMJ (Clinical research ed.) · 2021Article
- Short-term exposures to atmospheric evergreen, deciduous, grass, and ragweed aeroallergens and the risk of suicide in Ohio, 2007-2015: Exploring disparities by age, gender, and education level.Environmental research · 2021Article
- Surrounding Greenness and Biological Aging Based on DNA Methylation: A Twin and Family Study in Australia.Environmental health perspectives · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobal warming is predicted to indirectly result in more undernutrition by threatening crop production. Whether temperature rise could affect undernutrition directly is unknown. We aim to quantify the relationship between short-term heat exposure and risk of hospitalization due to undernutrition in Brazil. METHODS AND
findingsWe collected hospitalization and weather data for the hot season (the 4 adjacent hottest months for each city) from 1,814 Brazilian cities during 1 January 2000-31 December 2015. We used a time-stratified case-crossover design to quantify the association between heat exposure and hospitalization due to undernutrition. Region-specific odds ratios (ORs) were used to calculate the attributable fractions (AFs). A total of 238,320 hospitalizations for undernutrition were recorded during the 2000-2015 hot seasons. Every 1°C increase in daily mean temperature was associated with a 2.5% (OR 1.025, 95% CI 1.020-1.030, p < 0.001) increase in hospitalizations for undernutrition across lag 0-7 days. The association was greatest for individuals aged ≥80 years (OR 1.046, 95% CI 1.034-1.059, p < 0.001), 0-4 years (OR 1.039, 95% CI 1.024-1.055, p < 0.001), and 5-19 years (OR 1.042, 95% CI 1.015-1.069, p = 0.002). Assuming a causal relationship, we estimate that 15.6% of undernutrition hospitalizations could be attributed to heat exposure during the study period. The AF grew from 14.1% to 17.5% with a 1.1°C increase in mean temperature from 2000 to 2015. The main limitations of this study are misclassification of different types of undernutrition, lack of individual temperature exposure data, and being unable to adjust for relative humidity.
conclusionsOur study suggests that global warming might directly increase undernutrition morbidity, by a route other than by threatening food security. This short-term effect is increasingly important with global warming. Global strategies addressing the syndemic of climate change and undernutrition should focus not only on food systems, but also on the prevention of heat exposure.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.