Dietary Habits and Nutritional Status in Ecuatorian Children Aged 1–11 Years: A Systematic Review Highlighting the Dual Burden of Malnutrition

Abstract

Background: Background: Childhood dietary habits are critical determinants of physical growth, cognitive development, and long-term health. In Ecuador, malnutrition remains a major public health concern, with both undernutrition and overweight/obesity affecting children—especially in rural and indigenous populations. Methods: This systematic review followed PRISMA 2020 guidelines (PROSPERO ID: CRD420251080987). Searches were conducted in SciELO, Dialnet, and ScienceDirect (accessed August 2025) using Boolean operators to identify quantitative studies in Spanish or English published between 2018 and 2025 that assessed dietary habits and nutritional status in Ecuadorian children aged 1–11 years. Seventeen studies, including approximately 12,000 children, were included. Results: Prevalence of chronic undernutrition ranged from 15% to 35%, while overweight and obesity reached 20–30%. Undernutrition was higher among rural and indigenous children, whereas overweight predominated in urban and higher-income settings. Common dietary patterns included high consumption of ultra-processed foods and sugar-sweetened beverages, and insufficient intake of fruits, vegetables, and quality proteins. Maternal education, socioeconomic level, and school food environments were key determinants. Conclusions: Both malnutrition and overweight persist among Ecuadorian children, reflecting a nutrition transition influenced by socioeconomic and environmental factors. Context-specific public health actions are urgently needed, including school-based nutrition education, regulation of food marketing, improved access to affordable healthy foods, and community-level engagement to promote sustainable dietary habits. The included studies were mostly cross-sectional and often used non-validated dietary assessment tools, which may influence the reported prevalence estimates.