Consumption of ultra-processed foods during the first year of life and associated factors in Cruzeiro do Sul, Brazil

Nogueira, Mariana Bossi; Mazzucchetti, Lalucha; Mosquera, Paola Soledad; Cardoso, Marly Augusto; Malta, Maíra Barreto

doi:10.1590/1413-81232022272.47072020

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FREE THEMES • Ciênc. saúde coletiva 27 (02) • Feb 2022 • https://doi.org/10.1590/1413-81232022272.47072020 copy

Consumption of ultra-processed foods during the first year of life and associated factors in Cruzeiro do Sul, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to assess the consumption of ultra-processed foods (UPFs) during the first year of life and associated factors. We analyzed data from the one-year follow-up of the MINA-Brazil birth cohort. Socioeconomic, demographic and obstetric data were collected in the baseline study and at one-year follow-up (n = 774). Dietary intake during the previous day was assessed using a food frequency questionnaire to determine UPF consumption. Multiple Poisson regression with robust variance was performed to estimate prevalence ratios (PR) and confidence intervals (95%CI) for factors associated with the consumption of ≥ 3 UPFs. Prevalence of UPF consumption and consumption of ≥ 3 UPFs was 87.5% and 40.5%, respectively. Consumption of ≥ 3 UPFs was associated with lower maternal education (≤ 9 years of schooling [PR: 2.02 95%CI 1.42; 2.87] and between 10-12 years of schooling [PR: 1.55, 95%CI 1, 11; 2.14]), below-average wealth index (PR: 1.26, 95%CI 1.04; 1.53), and having a teenage mother (PR:1.19, 95%CI 1.00; 1.49). Lack of dietary diversity was inversely associated with the outcome (RP: 0,65, IC95% 0,51; 0,81). The consumption of ≥ 3 UPFs was associated with lower wealth index, education and maternal age. Dietary diversity was associated with higher levels of UPF consumption.

Key words:
Child nutrition; Industrialized foods; Complementary foods; Cohort study

Variables	UPF consumption during the previous day
Variables	Total (n = 774)	Not consumed (n = 97)	1 to 2 UPFs (n = 364)	3 or more UPFs (n = 313)	p^e
Maternal age (n=774)					<0.001
< 19 years	16.0	6.2	13.2	22.4
19-35 years	73.4	75.3	75.3	70.6
≥ 35 years	10.6	18.6	11.5	7.0
Maternal education (n=761)				<0.001
0-4 years of schooling	7.2	6.2	5.1	10.1
5-8 years of schooling	13.0	12.4	9.8	16.9
9-11 years of schooling	51.7	45.4	50.0	55.5
≥ 12 years of schooling	28.1	36.1	35.1	17.5
Wealth index (n=762)				<0.001
Below-average	50.0	38.1	44.8	59.7
Above-average	50.0	61.9	55.2	40.3
Receives Bolsa Família (n=762)	36.9	32.0	33.6	42.2	0.041
Maternal skin color (n=762)					0.292
White	12.2	8.3	14.0	11.4
Black/Indigenous/Brown	87.8	91.8	86.0	88.6
Living with partner (n=762)	78.7	77.3	81.2	76.3	0.281
Mother head of household (n=762)	13.7	14.4	15.4	11.4	0.309
First pregnancy (n=762)	42.3	39.2	40.1	45.8	0.265
Number of antenatal appointments (n=770)				0.463
< 6 appointments	18.2	15.6	17.1	20.2
≥ 6 appointments	81.8	84.4	82.9	79.8
Pre-pregnancy nutritional status (n=757)					0.147
Normal weight	50.7	44.1	48.7	55.1
Underweight	4.2	2.2	3.6	5.5
Overweight	30.9	38.7	31.9	27.4
Obese	14.1	15.1	15.7	12.1
Child sex (n=774)					0.390
Female	52.2	46.4	51.9	54.3
Male	47.8	53.6	48.1	45.7
Birthweight (grams) (n=773)					0.153
Underweight (< 2,500 g)	6.3	12.4	5.2	5.8
Normal weight (2,500-3,999 g)	87.6	82.5	87.9	88.8
Macrosomic (≥ 4,000 g)	6.1	5.2	6.9	5.4
Breastfeeding on 1st day (n=774)	96.0	95.9	95.6	96.5	0.843
Use of feeding bottle^a (n=774)	62.7	69.1	62.6	60.7	0.330
Use of pacifiera (n=774)	22.0	30.9	20.6	20.8	0.074
Exclusive or predominant breastfeeding in first six months (n=628)	7.8	9.9	5.4	10.0	0.097
Breastfeeding at 12 months (n=774)	69.4	58.8	72.3	69.3	0.038
Short length-for-age^a,b (n=772)	2.2	2.1	1.4	3.2	0.271
Overweight^a,c (n=772)	6.6	7.2	8.3	4.5	0.127
Dietary diversity^a,d (n=774)	76.6	66.0	74.3	82.1	0.002

Variables	Consumption of 3 or more UPFs during the previous day (n = 774)
	Crude model			Model 1^a		Model 2^b
	PR (95% CI)	p	PR (95% CI)	p	PR (95% CI)	p
Maternal age
≥ 19 years	Ref.		Ref.		Ref.
<19 years	1.51 (1.26; 1.82)	<0.001	1.21 (0.98; 1.48)	0.073	1.28 (1.06; 1.55)	0.010
Maternal education
> 12 years	Ref.		Ref.		Ref.
10 - 12 years	1.74 (1.26; 2.40)	0.001	1.51 (1.07; 2.12)	0.020	1.58 (1.13; 2.20)	0.007
≤ 9 years	2.38 (1.73; 3.28)	<0.001	1.89 (1.31; 2.74)	<0.001	1.97 (1.38; 2.80)	<0.001
Wealth index
Above-average	Ref.		Ref.		Ref.
Below-average	1.48 (1.24; 1.77)	<0.001	1.20 (0.99; 1.46)	0.068	1.26 (1.04;1.53)	0.018
Bolsa Família
Not received	Ref.		Ref.
Received	1.25 (1.05; 1.49)	0.011	0.97 (0.81; 1.16)	0.743
Mother head of household
No	Ref.		Ref.
Yes	0.81 (0.61; 1.08)	0.150	0.84 (0.63; 1.11)	0.217
Mother in paid employment
Yes	Ref.		Ref.
No	1.49 (1.22; 1.84)	<0.001	1.11 (0.88; 1.39)	0.377
Living with partner
Yes	Ref.		Ref.
No	1.15 (0.95; 1.40)	0.164	1.07 (0.87; 1.31)	0.551
Pre-pregnancy nutritional status
Normal weight	Ref.		Ref.		Ref.
Underweight	1.21 (0.86; 1.70)	0.284	1.15 (0.81;1.63)	0.452	1.16 (0.82;1.65)	0.401
Overweight	0.82 (0.66; 1.00)	0.052	0.85 (0.70;1.05)	0.128	0.85 (0.69;1.04)	0.104
Obesity	0.79 (0.59; 1.04)	0.096	0.81 (0.61;1.07)	0.138	0.80 (0.60;1.06)	0.117
First pregnancy
Yes	Ref.		Ref.
No	0.87 (0.73; 1.03)	0.103	0.91 (0.74; 1.11)	0.357
Exclusive or predominant breastfeeding in first six months
Yes	Ref.		Ref.		Ref.
No	0.76 (0.57; 1.02)	0.064	0.78 (0.58;1.03)	0.082	0.78 (0.59;1.04)	0.095
Short length-for-age^c
No	Ref.		Ref.
Yes	1.47 (0.98; 2.21)	0.064	1.20 (0.74; 1.94)	0.457
Overweight^c
No	Ref.		Ref.
Yes	0.67 (0.42; 1.05)	0.078	0.73 (0.46; 1.16)	0.184
Dietary diversity^cd
Yes	Ref.		Ref.		Ref.
No	0.71 (0.56; 0.90)	0.005	0.65 (0.52;0.81)	<0.001	0.65 (0.51; 0.81)	<0.001

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[1] Collaborations

MB Nogueira: analysis and interpretation of data, preparation and revision of the manuscript. L Mazzucchetti: data analysis and critical review of the manuscript. PS Mosquera: data collection, interpretation and critical review of the manuscript. MA Cardoso: conception and design of the study, data collection and critical review of the manuscript. MB Malta: study planning, data collection, analysis and interpretation and critical review of the manuscript.