Ultra-processed foods: Consumption among children at day-care centers and their classification according to Traffic Light Labelling system

Consumption of ultra-processed foods and associated factors in six-year-old children

This article aims to estimate the prevalence and weekly frequency of ultra-processed food consumption in six-year-old children and associated factors in a municipality in southern Brazil. Cross-sectional study with 956 children. Data were collected through interviews with mothers in the households. The outcomes were the consumption of candies, chewing gum, lollipops and chocolates; stuffed cookies; artificial juices; and soft drinks using the Índice de Alimentação Escolar (School Feeding Index). The independent variables were gender, type of school, education and maternal occupation, breastfeeding, duration of exclusive breastfeeding and the use of bottle. Bivariate analysis was performed using the chi-square test and the multivariate analysis using Poisson regression. In the multivariate analysis, the weekly prevalence of stuffed cookies consumption was 14% higher in students from public schools and 8% higher in children of mothers with less than eight years of schooling. Artificial juice and soft drink consumption was 7% and 8% higher in public school students respectively and 6% higher in bottle-fed children. Most schoolchildren consumed the ultra-processed foods assessed once or twice a week. Consumption was associated with the independent variables assessed.

Coexistence of high content of critical nutrients and claims in food products targeted at Brazilian children

ABSTRACT Objective: This study aimed to evaluate food labels targeted at children and identify the concomitant presence of claims and high levels of critical nutrients and/or the presence of sweeteners. As a secondary objective, it aimed to list different types of claims and check which marketing strategies are most used. Methods: We collected 409 products, from 8 popular food groups targeted at children, in Brazilian market (i.e., fruit drinks, dairy drinks, sandwich cookies, cakes, breakfast cereals, jellies, corn snacks, and yogurts). The contents of critical nutrients (e.g., sugar, total fat, saturated fat, and trans-fat, and sodium) and presence/absence of sweetener were calculated, considering Pan American Health Organization (PAHO) parameters. Then, we verified the presence and types of claims in these products. Results: Overall, 265 (64.7%) labels presented claims. In three of the eight categories (i.e., breakfast cereals, dairy drinks, and yogurt), all products with claims (50, 34, and 34 products, respectively) had one or more nutrients in harmful concentrations (critical nutrients above PAHO’s nutritional profile and/or presence of sweeteners). In the other categories, only one product (of 63 sandwich cookies and 26 breakfast cereals with claims) and three products (of 22 cakes and 28 jellies with claims) had no nutrient in critical concentration. The presence of claims, like “rich/source” of micronutrient, was predominant in seven of the eight food groups. Conclusion: In the present study, there was a high presence of claims, of different types, in foods targeted at children, which, for the most part, also have excess of at least one critical nutrient, according to PAHO.

Maternal and child characteristics correlated with frequency of consuming ultra-processed food by children aged 6 to 24 months old

Abstract Objectives: to verify the correlation between the consumption of ultra-processed food among mothers and children under two years of age and the main characteristics related to this consumption. Methods: cross-sectional study conducted in public health services. Three 24-hour recalls were applied to assess food intake. The ultra-processed food was grouped into: sugary drinks; meat; sauces and creams; dairy products; snacks; pastas; and mucilage. Themother’s body mass index and waist/hip ratio, and the child’s weight/height, height/age, weight/age and body mass index/age were calculated. The children’s ultra-process frequency as correlated with: anthropometric dyadic variables; ultra-process frequency on breastfeeding. The children’s average ultra-process intake was compared to pacifier, bottle, breastfeeding and socioeconomic status. Linear regression models were conducted. Results: 172 pairs were evaluated. Similarity was found in the mothers and children’s consumption of ultra-processed products. The higher frequency of ultra-processed products was correlated with older child and the higher body mass/age index and weight/age index. Of the 39 ultra-processed food present in the mothers’ diet, 22 were correlated to child’s Conclusion: the consumption of ultra-processed food by children is similar to their mothers and correlates with higher z-score values of weight/age and body mass/age index.

Association between Food Intake and Overweight in Children Assisted by Primary Care

Background:

The child feed in the first two years of life is of fundamental importance for a healthy growth and development.

Aims:

To verify the association between food consumption indicators and overweight in children under the age of two, followed up by primary care health professionals.

Methods:

A cross-sectional study was conducted on 232 children assisted by primary care. A structured questionnaire was used with questions on sociodemographic data of mothers or guardians and food intake and anthropometric data of children. The analysis of the association between excess weight and food intake indicators was performed using the Pearson’s chi-square test (χ2) and Fisher’s exact test (f ˂ 5).

Results:

Regarding food intake in children under 6 months of age, 35.1% of the children were exclusively breastfed. Among children at the age of 6 to 23 months: 66.3% were on continued breastfeeding; 16.7% consumed adequate foods at the age of 6 to 8 months; 90.4% consumed foods that belonged to the six food groups; 76.3% consumed food at the minimum frequency and with adequate consistency; 88.9% consumed iron-rich and vitamin A-rich foods, and 59.3% consumed ultra-processed foods. Regarding nutritional status, 24.5% of the children were overweight.

Conclusion:

There was no statistically significant association between overweight and food consumption indicators among the surveyed children. However, exclusive breastfeeding was below the recommended level, a low percentage of the introduction of complementary foods at the appropriate age and high consumption of ultra-processed foods reveal the need to improve the assistance provided by primary care to this group.

Degree of processing and nutritional value of children's food products

OBJECTIVE

This study aimed to characterise the availability, the nutritional composition and the processing degree of industrial foods for 0-36-month-old children according to the neighbourhoods affluence.

DESIGN

A cross-sectional exploratory study.

SETTING

All food products available in retail stores for children aged 0-36 months were analysed. Data collection took place in two neighbourhoods, comparing two different sociodemographic districts (high v. low per capita income), Campanhã and Foz do Douro in Porto, Portugal.

PARTICIPANTS

A total of 431 commercially processed food products for children aged 0-36 months which are sold in 23 retail stores were identified. Food products were classified according to their processing degree using the NOVA Food Classification System.

RESULTS

For NOVA analysis, of the 244 food products that were included 82 (33·6 %) were minimally processed, 25 (10·2 %) processed and 137 (56·1 %) ultra processed. No food product was classified as a culinary ingredient. The products included mostly cereals, yogurts, prevailed in high-income neighbourhoods for the 0-6-month-old group. It was observed that some categories of ultra-processed food (UPF) presented higher amounts of energy, sugars, saturated fat and salt than unprocessed/minimally processed products.

CONCLUSIONS

The high availability of UPF offered for 0-36-month-old children should be considered when designing interventions to promote a healthy diet in infancy.

Ultra-Processed Food Intake and Associations With Demographic Factors in Young New Zealand Children

BACKGROUND

Children consume ultra-processed food (UPF) from a young age, but the proportional contribution of UPF to young children's total energy intakes has not been evaluated in developed countries.

OBJECTIVES

To describe UPF intake and associations with demographic factors in young children from 12 to 60 months of age.

DESIGN

Cohort study comprising a secondary analysis of data from a randomized controlled trial. Demographic data were collected by questionnaire. At 12, 24, and 60 months of age validated food frequency questionnaires estimated percentage of energy intake from UPF (%kcal UPF).

PARTICIPANTS/SETTING

The 669 children were born in Dunedin, New Zealand, between May 2009 and December 2010.

MAIN OUTCOME MEASURES

Mean percentage of energy intake from UPF at 12, 24, and 60 months of age, mean differences in %kcal UPF by demographic variables.

STATISTICAL ANALYSES PERFORMED

Mixed effects regression models were used to estimate relationships between demographics and %kcal UPF. Multiple imputation methods were used to impute missing UPF data.

RESULTS

UPF contributed mean (95% confidence interval) 45% (44%, 47%), 42% (41%, 44%), and 51% (50%, 52%) of energy intake to the diets of children at 12, 24, and 60 months of age, respectively. Energy intake from UPF was moderately correlated between 24 and 60 months (r = 0.36). No demographic factors were associated with mean %kcal UPF across time points, except for maternal obesity predicting higher UPF intake at 12 months. Bread, yoghurt, crackers, whole-wheat breakfast cereal, sausages, and muesli bars were among the 10 foods making the greatest contribution to mean %kcal UPF intakes at all time points.

CONCLUSIONS

UPF contribute a substantial proportion of energy to the diets of young children. A range of foods with varying nutritional profiles contribute to these high intakes.

Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors

Abstract: The aim of this study was to evaluate the consumption of processed and ultra-processed foods among children aged 13-35 months and its associated factors. We studied 1,185 children within the BRISA cohort in São Luís, Maranhão State, Brazil. The food consumption was investigated using a 24-hour recall, and the percentages of daily caloric intake and nutrients were estimated by food groups according to “NOVA” classification. We chose to categorize children belonging to the upper tertile of the distribution as having a high consumption of processed and ultra-processed food products. The Poisson regression model with robust variance estimation using a hierarchical modeling approach was used to calculate the prevalence ratios (PRs) of variables associated with high consumption of processed and ultra-processed food products. The mean energy intake was 1,226Kcal/day. After adjustments, there was a higher proportion of high consumption of processed and ultra-processed food products among children whose mothers had < 12 years of education and among children who were older than 16 months. Mothers with low schooling and children older than 16 months should be the targets of interventions aimed at reducing consumption of these food products and preventing adverse health outcomes in later life.

Age at introduction of ultra-processed food among preschool children attending day-care centers

OBJECTIVE

To identify the age of introduction of ultra-processed food and its associated factors among preschool children.

METHODS

Cross-sectional study carried out from March to June 2014 with 359 preschool children aged 17 to 63 months attending day-care centers. Time until ultra-processed food introduction (outcome variable) was described by the Kaplan-Meier analysis, and the log-rank test was used to compare the survival functions of independent variables. Factors associated with ultra-processed food introduction were investigated using the multivariate Cox proportional hazards model. The results were shown as hazard ratios with their respective 95% confidence intervals.

RESULTS

The median time until ultra-processed food introduction was six months. Between the 3rd and 6th months, there is a significant increase in the probability of introducing ultra-processed food in the children's diet; and while the probability in the 3rd month varies from 0.15 to 0.25, at six months the variation ranges from 0.6 to 1.0. The final Cox proportional hazards model showed that unplanned pregnancy (1.32 [1.05-1.65]), absence of prenatal care (2.50 [1.02-6.16]), and income >2 minimum wages (1, 50 [1.09-2.06]) were independent risk factors for the introduction of ultra-processed food.

CONCLUSION

Up to the 6th month of life, approximately 75% of preschool children had received one or more ultra-processed food in their diet. In addition, it was observed that the poorest families, as well as unfavorable prenatal factors, were associated with early introduction of ultra-processed food.

Estimation of iron deficiency anemia in Iranian children and adolescents: a systematic review and meta-analysis

OBJECTIVES

Iron deficiency anemia (IDA) is a major health issue in those aged less than 18 years old with high impact on their development. There are several reports from Iran with variable results. Systematic review and met analysis of these data would reveal a more realistic view of the prevalence of iron deficiency (ID).

METHODS

We conducted a systematic search of national and international databases from December 1990 to 31 January 2016 for population-based studies providing estimates on the prevalence of IDA in Iran. From the extracted crude prevalence rates, the heterogenic index of the studies was determined using the Cochran's test (Q) and I2. Then, based on the heterogenetic results, a random effects model for estimate pooled prevalence of IDA was used. Meta-regression was applied to determine heterogeneity suspected factors.

RESULTS

The overall prevalence of IDA in Iranian population with age less than 18 years was estimated to be 13.9% (95% CI: 10.8-17.1) and the overall prevalence of ID was 26.9% (95% CI: 19.7-34.1). The prevalence of IDA was 7.9% (95% CI: 4.1-11.7) in males and 8.5% (95% CI: 6.1-10.8) among females aged under than 18 years.

DISCUSSION

Despite the efforts of ministry of health and medical education of Iran in implementing free iron supplements for infants and for girls, the prevalence of ID and resultant anemia is considerable. Further interventions to increase use of supplements when they are provided and special programs for non-covered groups including boys under six are in great need.