Evidence map›Paper›PMID 40617462›Full record

ArticleJournal of the Academy of Nutrition and Dietetics2026

Poor Water Quality and Food Insecurity in Ecuador: Disparities in Exposure and Associations With Young Child Feeding Practices.

Joshua D Miller, María Belén Ocampo Ordóñez, Ivonne Headley, Heather Wasser, Amanda L Thompson

Abstract read
In one paragraph

Article in Journal of the Academy of Nutrition and Dietetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Water and nutrition in a rapidly changing world: Introduction to the special issue.Journal of the Academy of Nutrition and Dietetics · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Joshua D MillerDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: josh.miller@unc.edu.
María Belén Ocampo OrdóñezEscuela de Salud Pública y Nutrición, Universidad San Francisco de Quito, Quito, Ecuador.
Ivonne HeadleyDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Heather WasserDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Amanda L ThompsonDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Funding

Differential impacts of water insecurity on diet and body composition throughout the life courseF31HD113400 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MILLER, JOSHUA D · 2023 to 2024
$81k
NICHD NIH HHS F31 HD113400
6 · The paper itself

Abstract

backgroundReliable access to adequate food and safe drinking water is essential for child health and development, but food insecurity and water quality issues are common globally. Understanding how these factors are associated with child feeding practices is critical for identifying strategies to mitigate their potential negative influences.

objectiveTo estimate exposure to poor water quality and food insecurity among young children in Ecuador and examine their associations with child-feeding practices.

designSecondary analysis of a cross-sectional, nationally representative survey of households with children aged 0 to 23 months, conducted from July 2022 to July 2023 by the Ecuadorian National Institute of Statistics and Censuses. PARTICIPANTS/

settingHouseholds in Ecuador with children younger than 2 years (N = 6985).

main outcome measuresExclusive breastfeeding to age 6 months (maternal recall), commercial milk formula use (reported consumption in the prior 24 hours), and meeting minimum dietary diversity (reported consumption of ≥5 of 8 World Health Organization-designated food groups). Key exposures were drinking water risk (Escherichia coli concentration measured at the point of use) and food insecurity (assessed using a subset of items from the Latin American and Caribbean Food Security Scale). STATISTICAL ANALYSES PERFORMED: Poisson regressions adjusting for confounders and design effects estimated the relative prevalence of each outcome across key exposures, by child age (0 to 5 months, 6 to 11 months, and 12 to 23 months).

resultsNationally, 25.3% of households with young children had high-to-very-high drinking water risk, and 37.9% of children experienced moderate-to-severe food insecurity. Households with very high-risk drinking water had a higher prevalence of exclusive breastfeeding and a lower prevalence of commercial milk formula use compared with those with low-risk drinking water. Greater food insecurity was associated with lower exclusive breastfeeding, less commercial milk formula use, and fewer children meeting minimum dietary diversity.

conclusionsIntegrated policies and programs addressing water safety and food insecurity have the potential to improve child nutritional well-being.

Indexed as

Drinking WaterFeeding BehaviorFood InsecurityFood SupplyWater QualityAdultBreast FeedingCross-Sectional StudiesDietEcuadorFamily CharacteristicsFemaleHumansInfantInfant FormulaInfant, NewbornDrinking WaterCommercial milk formulaDietary diversityExclusive breastfeedingFood insecurityWater quality

Identifiers

PMID40617462
PMCPMC12286298

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Registered trials

None linked

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.