Pediatric Health at the Crossroads of Climate Change, Food Insecurity, and Malnutrition

Climate change poses a major global threat to the health of current and future generations, disproportionately affecting pediatric populations. Investigating the links between climate change and pediatric diseases is crucial to inform research and prevention strategies aimed at breaking the transgenerational cycle of social inequalities. This narrative review explores the complex interactions between early-life exposures to climate change, food insecurity, and malnutrition, and their impact on infectious and non-communicable diseases (NCDs) in pediatric populations. Data reveal a concerning global scenario: half of the world’s children live in areas highly vulnerable to climate change; malaria, enteric, and lower respiratory-tract infections account for approximately 60% of the global communicable disease burden and related-deaths in children and adolescents; over 2.1 billion people under-20 suffer from NCDs; almost 865 million children under-15 experience moderate to severe food insecurity; and millions of children under-5 face stunting (150.2), wasting (42.8), or obesity (35.5). The greatest burdens fall on low- and middle-income countries and the most disadvantaged households. Although the causal pathways and mechanisms linking climate change to health outcomes have not been fully elucidated, epidemiological evidence shows that exposure from conception through adolescence increases risks of acute and chronic diseases, potentially altering lifelong health trajectories. This is plausibly driven by climate-induced disruptions in eco-agrofood systems, which compromise nutrition security and worsen malnutrition. Food systems are both vulnerable to and significant contributor to climate change, and poor dietary patterns further amplify disease burdens. Addressing these intertwined challenges requires a holistic approach promoting healthy, sustainable, and equitable diets from infancy through adolescence, and employing an integrated “glocal” strategy taking into account both global and local contexts. Cross-sector collaboration and targeted pediatric research are paramount to enhance understanding of causal pathways and develop effective interventions to safeguard child health and well-being within a planetary health framework. Statement of Significance This review critically examines how early life exposure to climate-related disruptions in eco-agrofood systems exacerbates the pediatric disease burdens. It also provides actionable insights to help guide research, policy, and actions tackling these interrelated challenges, focusing on the connection between climate change and the food environments, from a "glocal" perspective, ultimately protecting child health.