Moreira Paula Ruffoni, Nunes Leandro Meirelles, Giugliani Elsa Regina Justo, Gomes Erissandra, Führ Jordana, Neves Renata Oliveira, Belin Christy Hannah Sanini, Bernardi Juliana Rombaldi
Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Graduate Program in Food, Nutrition, and Health, Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Front Nutr. 2022 Dec 7;9:1043400. doi: 10.3389/fnut.2022.1043400. eCollection 2022.
Complementary feeding (CF) is defined as a period when foods, other than milk, are introduced to the infant's diet. Unfortunately, frequent consumption of ultra-processed foods (UPF) has become highly prevalent early in an infant's life. The aim was to verify the association of CF methods with the introduction of UPF in early childhood.
This randomized clinical trial involved pairs of mother-infants, allocated in groups receiving different CF interventions: strict Parent-Led Weaning (PLW); strict Baby-Led Introduction to SolidS (BLISS), or mixed-method. The intervention consisted of a counseling session on healthy eating at the child's 5.5 months of age. A structured questionnaire was created based on the NOVA classification for the definition of UPF and applied at 9 and 12 months. The effect of the CF method intervention was measured by a survival curve for UPF offered for the first time in early childhood between groups. Cox regression was used to estimate its magnitude. The primary analysis was done in three groups (PLW, BLISS, and Mixed) and the secondary analysis was done in two groups (PLW, and BLISS + Mixed).
A total of 139 mother-infant pairs were eligible and 129 followed the study. The prevalence of infants who were exposed to UPF in early childhood was 58.9% ( = 76), being 71.4% in the PLW group, 53.3% in the BLISS group, and 52.4% in the Mixed group, without differences between them ( = 0.133). The PLW group intervention had a greater chance of exposure to ice cream or popsicles ( = 0.032) and sweet crackers ( = 0.009), compared with the other two CF groups. The Cox regression did not find significant differences between the three groups. However, the regression with two groups estimated a 38% reduction in the offer of UPF in the BLISS + Mixed group intervention ( = 0.049).
The CF intervention promoting greater infant autonomy (BLISS and Mixed) was associated with a reduction in the offer of UPF in early childhood. This knowledge may contribute to supporting strategies aimed at reducing UPF consumption by the young infant.
[https://ensaiosclinicos.gov.br/rg/RBR-229scm], identifier [RBR-229scm U1111-1226-9516].
辅食添加（CF）被定义为向婴儿饮食中引入除牛奶以外其他食物的时期。不幸的是，超加工食品（UPF）的频繁食用在婴儿早期生活中已变得极为普遍。本研究旨在验证辅食添加方法与幼儿期引入超加工食品之间的关联。
这项随机临床试验涉及母婴对，被分配到接受不同辅食添加干预的组中：严格的家长主导断奶（PLW）；严格的婴儿主导固体食物引入（BLISS），或混合方法。干预包括在孩子5.5个月大时进行一次关于健康饮食的咨询会议。基于NOVA分类创建了一份用于定义超加工食品的结构化问卷，并在9个月和12个月时应用。通过幼儿期首次提供超加工食品的生存曲线来衡量辅食添加方法干预的效果。使用Cox回归估计其影响程度。主要分析在三组（PLW、BLISS和混合组）中进行，次要分析在两组（PLW和BLISS + 混合组）中进行。
共有139对母婴符合条件，129对参与了研究。幼儿期接触超加工食品的婴儿患病率为58.9%（n = 76），其中PLW组为71.4%，BLISS组为53.3%，混合组为52.4%，各组之间无差异（P = 0.133）。与其他两个辅食添加组相比，PLW组干预下婴儿接触冰淇淋或冰棒（P = 0.032）和甜饼干（P = 0.009）的可能性更大。Cox回归未发现三组之间存在显著差异。然而，两组回归估计BLISS + 混合组干预中超加工食品的提供减少了38%（P = 0.049）。
促进婴儿更大自主性的辅食添加干预（BLISS和混合方法）与幼儿期超加工食品提供量的减少有关。这一知识可能有助于支持旨在减少幼儿超加工食品消费的策略。
巴西临床试验注册中心REBEC：[https://ensaiosclinicos.gov.br/rg/RBR-229scm]，标识符[RBR-229scm U1111-1226-9516]
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