Table 1.

Description of the studies evaluating the influence of conditional cash transfer programs in Brazil on the nutritional status of the recipients.

Authors/ Program	Participants	Study design	Local and data	Outcome	Main conclusions	Methodological limitations
Plausibility study with internal control
Morris et al14 PBA	1,347 children under 7 included in the PBA and 483 excluded due to administrative errors (measurements taken); 472 children receiving and 158 excluded under 3 years old (reported measurements)	Cross-sectional study and retrospective cohort study	4 municipalities in the Northeast 2002	Z-sores for weight/age, difference in weight gain 6 months after staring to receive PBA	Children included had lower z-score for weight/age than those excluded.	Possible bias from the receipt of another benefit (School Grant) by the beneficiaries of the PBA.
					Each additional month in the PBA (total of 6 months) was associated with 31 g less weight gain after adjusting for socioeconomic characteristics.	Lack of a measure of weight and height prior to the start of the program. Sample of only four municipalities in the Northeast.
Plausibility study with external control
Paes-Sousa et al17 PBF	22.375 children under 5 years old from areas with low socioeconomic levels (included and not included in the PBF)	4 cross-sectional studies	419 municipalities in Brazil (4 Chamadas Nutricionais) 2005/2006	Z score for weight/age and height/age	Children included in the PBF showed 26% greater chance of having appropriate height/age and weight/age. Greater effect among children older than 35 months, after adjusting for socioeconomic characteristics.	Cross-sectional study has inherent limitations. Unable to determine the time of exposure to the program or the possible biases related to participation in programs other than the PBF.
						Some variables not assessed could explain residual confounding such as family income, food consumption and nutritional status before entry into the program.
Piperata et al20 PBF	469 individuals in 2002	2 cross-sectional and one longitudinal study	7 rural communities in 2 municipalities in Pará 2002 and 2009	Z score for weight/age and height/age in individuals aged under 18	Significant positive effect of PBF on the difference in height/age between the two studies for both sexes and for males, after adjusting for socioeconomic characteristics.	The doubt remained as to whether the effect came from the cash transfer itself or from another aspect of the PBF, such as the conditionalities.
	429 individuals in 2009
	Sub-sample of 204 individuals (longitudinal)
						Small sample size.
Oliveira et al15 PBF	443 children aged from 6 to 84 months (262 included and 184 not included), with per capita income < R$ 120.00	Cross-sectional study	One municipality in the Southeast 2007	Malnutrition (z-score for weight/age and height/age < -2)	There were no statistically significant differences between the prevalence of malnutrition among the groups for any anthropometric index, after adjusting for socioeconomic characteristics.	Inclusion of siblings of children selected to compose the study.
Oliveira et al16 PBF	443 children aged from 6 to 84 months registered to receive the PBF (184 not included and 262 included)	Cross-sectional study	One municipality in the Southeast 2007	Z-score for weight/age and height/age and BMI/age	There were no statistically significant differences between the nutritional status of children included in the PBF and the length of time receiving the benefit, without adjusting for other factors.	The prevalence rates cannot be extrapolated for all Brazilians. Cross-sectional analysis means it cannot be guaranteed that the results represent the effect of the program or whether they already existed before the PBF started.
Saldiva et al25 PBF	411 families and 164 children under 5 (included and not included in the PBF)	Cross-sectional study	One municipality in the Northeast 2005	Z-score for weight/height, weight/age and height/age	There were no statistically significant differences between the nutritional status of children and being included in the PBF, without adjusting for other factors.	No limitations indicated.
Paula et a18l PBF	115 children aged from 6 ato10 years old	Cross-sectional study	1 municipal school of a municipality in the Southeast 2009	Stunted (height/age index) and BMI/age	3.0% of stunted in children not in the de PBF and 0% in children included in the de PBF (p = 0.28).	Not possible to evaluate association between doing physical exercise and nutritional status.
					Increased risk of overweight or overweight of 27.6% in those not included and 16.2% in those included in the PBF (p = 0.16).	Minimum sample size not calculated. Small sample size. Study carried out in one municipal school in Belo Horizonte.
Studies of accuracy
Lima et al9 PBF	747 adults included in the PBF	Population based cross-sectional study	One municipality in the South 2006/2007	Excess weight (BMI > 25 kg/m2) risk of CVD (waist circumference).	Prevalence of 29.0% overweight and 27.1% obesity. Higher chance of being overweight in men, being over 40 and being single. 46.2% of adults at increased risk of CVD.	No limitations indicated.
Silva28 PBF	79,795 children aged 5 to 10 years old, receiving the PBF (DATASUS/ SISVAN records).	3 cross-sectional studies	State of Sergipe 2008 to 2010	Prevalence of overweight and obesity by sex, year of study and each health region.	Prevalence of overweight in girls went from 12.2% in 2008 to 13.2% in 2010 and obesity from 11.0% to 11.9%. In males, prevalence of overweight went from 12.4% to 13.2% and obesity form 11.0% to 15.1%. Higher prevalence in regions with lower HDI.	Use of secondary data meant not controlling for possible data input and recording errors, as well as possible underreporting.

PBA: Food grant program; PBF: Family grant program; CVD: Cardiovascular disease; HDI: Human Development Index.