Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Doutor Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
Núcleo de Evidências, Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo. São Paulo SP Brasil.
Cien Saude Colet. 2021 Jan;26(1):209-220. doi: 10.1590/1413-81232020261.06892019. Epub 2019 Apr 17.
The objective was to evaluate the influence of individual and contextual determinants on infant's consumption of fruits and vegetables (FV), and ultra-processed foods (UPF). The data was obtained from the Survey of Prevalence of Breastfeeding in Brazilian Municipalities, 2008. A representative sample of 14,326 infants 6-11.9 months old, from seventy-five municipalities of São Paulo state was evaluated. The influence of determinants on FV and UPF consumption was analyzed using Poisson multilevel regression. Mother's educational level and maternal age had positive dose-response effect for the consumption of FV (p trend < 0.001) and negative for UPF (p trend < 0.001). Infants of multiparous women and those who received outpatient care in public medical system showed lower prevalence of FV (p < 0.001 for both) and higher prevalence of UPF (respectively, p < 0.001 and p = 0.001). Moreover, the contextual variable related to population size indicated that the prevalence of consumption of FV decreased (p < 0.001) and UPF increased (p = 0.081) with decreased population size. Therefore, infants born to women with low education levels, who received outpatient care in the public health network, and who reside in small municipalities should be prioritized for educational programs related to feeding practices.
目的在于评估个体和环境决定因素对婴儿食用水果和蔬菜(FV)和超加工食品(UPF)的影响。该数据来自于 2008 年巴西市政母乳喂养流行情况调查。评估了来自巴西圣保罗州 75 个城市的 14326 名 6-11.9 个月大的婴儿的代表性样本。使用泊松多层次回归分析了决定因素对 FV 和 UPF 消费的影响。母亲的教育水平和母亲年龄对 FV 的消费有正向剂量反应效应(p 趋势 < 0.001),对 UPF 的消费有负向剂量反应效应(p 趋势 < 0.001)。多产妇的婴儿和在公共医疗系统接受门诊治疗的婴儿,其 FV 的流行率较低(两者均为 p < 0.001),UPF 的流行率较高(分别为 p < 0.001 和 p = 0.001)。此外,与人口规模相关的环境变量表明,随着人口规模的减少,FV 的消费流行率降低(p < 0.001),而 UPF 的消费流行率增加(p = 0.081)。因此,教育水平低的妇女所生的婴儿、在公共卫生网络中接受门诊治疗的婴儿以及居住在小市镇的婴儿,应优先考虑开展与喂养实践相关的教育计划。