Department of Nutrition, Postgraduate Studies Program in Food, Nutrition and Health, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre90035003, Brazil.
Department of Statistics, Institute of Mathematics and Statistics, Federal University of Rio Grande do Sul, Porto Alegre91509900, Brazil.
Br J Nutr. 2021 Oct 14;126(7):1048-1055. doi: 10.1017/S0007114520004869. Epub 2020 Dec 9.
This randomised clinical trial aimed to evaluate the effect of a pro-breast-feeding (BF) and healthy complementary feeding intervention performed during infants' first months of life on ultraprocessed food (UPF) consumption at 4-7 years. We enrolled 323 teenage mothers and their infants from South Brazil, 163 allocated to the intervention group and 160 to the control group. Intervention consisted of sessions on BF and healthy complementary feeding promotion and was carried out in the maternity ward and at home after delivery. Food consumption was assessed using three 24-h food recalls at child's age of 4-7 years. Foods were classified according to NOVA classification. Dietary contribution of UPF was adjusted for intra-individual variability by the SPADE method and categorised into tertiles. We used Poisson regression models with robust variance, adjusted for confounders, to estimate the effect of the intervention and duration of BF on the risk of high consumption of UPF. Our final analysis included 194 children, with mean age of 6·1 (sd 0·5) years. Mean dietary contribution of UPF was 38 % in the intervention group and 42·7 % in the control group, from total daily intakes. Results adjusted for BF duration, propensity score, income and total energy content demonstrated that the intervention reduced the risk of high consumption of UPF by 35 % (relative risk 0·65, 95 % CI 0·43, 0·98). BF duration was not associated with UPF consumption. The intervention was effective in reducing the risk of high UPF consumption at the age of 4-7 years.
这项随机临床试验旨在评估在婴儿生命的头几个月进行促进母乳喂养和健康补充喂养的干预措施对 4-7 岁儿童超加工食品（UPF）消费的影响。我们在巴西南部招募了 323 名青少年母亲及其婴儿，其中 163 名分配到干预组，160 名分配到对照组。干预措施包括母乳喂养和健康补充喂养促进课程，在分娩时的产房和产后在家中进行。在儿童 4-7 岁时，使用三次 24 小时食物回忆法评估食物消费情况。根据 NOVA 分类法对食物进行分类。通过 SPADE 方法调整个体内变异性来调整 UPF 的饮食贡献，并将其分为三分位。我们使用具有稳健方差的泊松回归模型，根据混杂因素进行调整，以估计干预措施和母乳喂养持续时间对高 UPF 消费风险的影响。我们的最终分析包括 194 名儿童，平均年龄为 6.1（标准差 0.5）岁。干预组 UPF 的平均饮食贡献为总日摄入量的 38%，对照组为 42.7%。调整母乳喂养持续时间、倾向评分、收入和总能量含量后，结果表明干预措施降低了高 UPF 消费的风险 35%（相对风险 0.65，95%CI 0.43，0.98）。母乳喂养持续时间与 UPF 消费无关。该干预措施在降低 4-7 岁儿童高 UPF 消费风险方面是有效的。
