Consumo de alimentos procesados y ultraprocesados y factores asociados en niños entre 13 y 35 meses de edad

Batalha, Mônica Araujo; França, Ana Karina Teixeira da Cunha; Conceição, Sueli Ismael Oliveira da; Santos, Alcione Miranda dos; Silva, Francelena de Sousa; Padilha, Luana Lopes; Silva, Antônio Augusto Moura da

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ARTICLE • Cad. Saúde Pública 33 (11) • Nov 2017 • https://doi.org/10.1590/0102-311X00152016 copiar

Consumo de alimentos procesados y ultraprocesados y factores asociados en niños entre 13 y 35 meses de edad

Autoría SCIMAGO INSTITUTIONS RANKINGS

Resumen:

El objetivo de este estudio fue evaluar el consumo de alimentos procesados y ultraprocesados por parte de niños entre 13 y 35 meses de edad y sus factores asociados. Estudiamos a 1.185 niños de la cohorte BRISA en São Luís, Maranhão, Brasil. El consumo alimentario fue investigado con un recordatorio de 24 horas, y los porcentajes de ingesta diaria de calorías y nutrientes fueron estimados por grupos de alimentos, de acuerdo con la clasificación “NOVA”. Optamos por categorizar a los niños pertenecientes al tercil superior de la distribución como de consumo elevado de productos alimenticios procesados y ultraprocesados. Se utilizó un modelo de regresión Poisson de estimativa robusta de variancia con modelaje jerárquico para calcular las razones de prevalencia (RPs) de las variables asociadas al consumo elevado de productos alimenticios procesados y ultraprocesados. La ingesta calórica media era 1.226Kcal/día. Tras los ajustes, hubo una proporción mayor de consumo elevado de productos alimenticios procesados y ultraprocesados entre niños, cuyas madres contaban con menos de 12 años de escuela y entre niños con más de 16 meses de edad. Las madres con baja escolaridad y niños por encima de 16 meses deben ser objetivo de intervenciones para reducir el consumo de esos productos alimenticios y prevenir desenlaces de salud adversos en la adolescencia y edad adulta.

Palabras-clave:
Alimentos Industrializados; Consumo de Alimentos; Niño; Factores Socioeconómicos

Variables	n *	% **
Maternal
Age (years)
< 20	234	21.4
≥ 20 to 34	849	70.1
≥ 35	102	8.5
Education (years of school)
≤ 8	139	16.0
9-11	272	23.8
≥12	756	60.2
Marital status
Married	251	20.8
Consensual union	708	59.9
Without a partner	226	19.3
Remunerated activity
No	783	67.3
Yes	402	32.7
Parity
Primiparous	581	47.8
Multiparous	604	52.2
Alcohol consumption
No	919	77.9
Yes	252	22.1
Smoking
No	1128	95.9
Yes	44	4.1
Body mass index
Underweight	101	8.4
Normal weight	621	54.2
Overweight/Obese	442	37.4
Family
Socioeconomic class ***
A/B	221	20.3
C	696	53.7
D/E	268	26.0
Number of people residing in the house
1-3	595	48.5
4-5	368	31.6
> 5	222	19.9
Beneficiary of the Bolsa Família program (cash transfer)
No	822	68.6
Yes	362	31.4
Registered with the Family Health Strategy
No	935	78.5
Yes	248	21.5
Child
Gender
Female	578	48.8
Male	607	51.2
Age (months)
13 to ≤16	563	46.5
> 16 to ≤ 20	249	21.5
> 20 to 35	373	32.0
Child birthweight (g)
≤ 2,500	187	9.5
> 2,500 to 3,999	930	84.0
≥ 4,000	68	6.5
Introduction of solid and semi-solid foods (months)
≥ 6	977	82.1
< 6	208	17.9

Food groups	Kcal/day	Total energy intake (%)
Unprocessed or minimally processed foods and culinary preparations	910.1	74.2
Eggs	2.1	0.2
Coffee	4.1	0.3
Beans	9.0	0.7
Fish	19.7	1.6
Breast milk	20.5	1.7
Vegetables	22.2	1.8
Other cereals *	24.9	2.0
Roots and tubers	40.7	3.3
Poultry	54.5	4.4
Beef	66.8	5.6
Fruits and natural juices	87.4	7.1
Rice	91.0	7.4
Other foods and culinary preparations **	116.9	9.5
Cow’s milk	350.3	28.6
Processed foods	15.6	1.3
Salted meat	0.2	0.0
Cheese	0.2	0.0
Other ***	0.3	0.0
Bread	14.9	1.2
Ultra-processed foods	300.3	24.5
Reconstituted meat products (sausage, ham)	1.2	0.1
Fast food	2.6	0.2
Bakery products	8.2	0.7
Other ^#	9.2	0.7
Carbonated drinks and artificial fruit drinks	14.3	1.2
Dairy-sweetened beverages	15.9	1.3
Crackers and packaged snacks	17.9	1.5
Instant soups and noodles	23.1	1.9
Cookies (biscuits), pastries and cakes	28.7	2.3
Petit suisse cheese	45.2	3.7
Infant and child food products ^##	134.0	10.9
Total	1,226.0	100.0

	Total food consumption	Unprocessed or minimally processed foods	Processed and ultra-processed foods
Sodium (mg/day)
Absolute	1627.2	360.4	1266.8
%	100.0	22.2	77.8
Fiber (g/day)
Absolute	6.8	5.9	0.9
%	100.0	86.8	13.2
Contribution in total energy per group
Carbohydrate (%)	49.8	43.5	54.4
Protein (%)	19.5	28.2	13.1
Total fat (%)	30.8	28.3	32.5
Saturated fat (%)	10.3	9.3	10.9

Variables	Unadjusted			Adjusted
Variables	PR (95%CI)	p-value	PR (95%CI)	p-value
Level 1
Mother’s age (years)		0.07
< 20	1.66 (1.08-2.56)
20-34	1.54 (1.02-2.31)
≥ 35	1.00
Mother’s education (years of school)		< 0.01		0.03
≤ 8	1.37 (1.08-1.73)		1.31 (1.04-1.66)
9-11	1.25 (1.03-1.52)		1.22 (1.00-1.49)
> 12	1.00		11.00
Mother’s remunerated activity		0.12
No	1.00
Yes	0.87 (0.72-1.04)
Mother’s marital status		0.36
Married	1.00
Consensual union	1.17 (0.94-1.47)
Without a partner	1.09 (0.83-1.45)
Number of people residing in the house		0.05
1 to 3	0.79 (0.64-0.97)
4 to 5	0.79 (0.63-0.99)
> 5	1.00
Family socioeconomic class *		0.92
A/B	1.00
C	0.99 (0.79-1.24)
D/E	1.03 (0.80-1.34)
Child gender		0.98
Female	1.00
Male	1.00 (0.85-1.19)
Child’s age (in months)
13 to ≤ 16	1.00	< 0.01	1.00	< 0.01
> 16 to ≤ 20	1.42 (1.15-1.76)		1.37 (1.10-1.70)
> 20 to 35	1.32 (1.08-1.61)		1.30 (1.07-1.59)
Level 2
Registered with the Family Health Strategy
No	1.00	0.23
Yes	1.13 (0.92-1.37)
Beneficiary of the Bolsa Familia program (cash transfer)		0.83
No	1.00
Yes	0.98 (0.81-1.18)
Level 3
Parity		0.83
Primiparous	1.00
Multiparous	1.02 (0.86-1.21)
Maternal consumption of alcohol		0.09
No	1.00
Yes	1.21 (0.97-1.52)
Maternal smoking		0.43
No	1.00
Yes	1.18 (0.78-1.78)
Level 4
Child birthweight (g)		0.12
≤ 2,500	0.90 (0.70-1.16)
> 2,500 to < 4,000	1.00
≥ 4,000	1.31 (0.98-1.76)
Level 5
Introduction of solid and semi-solid foods (months)		0.07
≥ 6	1.00
< 6	1.21 (0.98-1.48)
Level 6
Mother’s body mass index		0.97
Underweight	1.03 (0.76-1.41)
Normal weight	1.00
Overweight/Obese	1.00 (0.84-1.20)

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[1] * Correspondence M. A. Batalha Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão. Av. Barão de Itapary 227, São Luís, MA 65020-070, Brasil. monicaabatalha@gmail.com