Pereyra González Isabel, Farías-Antúnez Simone, Buffarini Romina, Gómez Ayora Andrea, Fletcher Andrea Mary, Rodrigues Domingues Marlos, Freitas da Silveira Mariângela, Ferreira Umpiérrez Augusto Hernán
Faculty of Health Sciences, Catholic University of Uruguay, Uruguay; Faculty of Health Sciences, Catholic University of Maule, Chile.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
J Pediatr Nurs. 2023 Mar-Apr;69:e120-e126. doi: 10.1016/j.pedn.2022.12.018. Epub 2023 Jan 4.
We evaluated the potential associations between the consumption of ultra-processed food (UPF) and the incidence of obesity among Uruguayan and Brazilian preschoolers.
We conducted a longitudinal analysis using data from preschool children from Uruguay and Brazil. The "Health, child development and nutritional survey" (ENDIS) was conducted in Uruguay in 2013-2014 and 2015-2016. The Brazilian survey (Pelotas 2015 Birth Cohort) has measures from 2017 and 2019. The main outcome measure was obesity defined as body mass index (BMI) for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Multilevel crude and adjusted Poisson regressions were performed to estimate risk ratios and the respective 95% Confidence Intervals (95% CI).
The overall incidence of obesity in this group of young Latin-American children with a mean age of 48 months was 4.1%. We observed a relationship between UPF and obesity with statistical significance (RR: 1.10 (95% CI, 1.02-1.18). Adjustment for weight at birth, age, sex, breastfeeding, country, and time between waves resulted in a similar relationship but lack of statistical significance.
Whilst in this study we did not find strong evidence of an association between the incidence of obesity and the intake at baseline and currently of UPF, results suggest that higher UPF consumption is more favorable than reduced consumption for the development of obesity.
The present study reinforces the importance of nutrition education and more effective public policies for promoting healthier food choices in early childhood.
我们评估了乌拉圭和巴西学龄前儿童食用超加工食品（UPF）与肥胖发生率之间的潜在关联。
我们使用乌拉圭和巴西学龄前儿童的数据进行了纵向分析。2013 - 2014年以及2015 - 2016年在乌拉圭开展了“健康、儿童发育与营养调查”（ENDIS）。巴西的调查（佩洛塔斯2015年出生队列）收集了2017年和2019年的数据。主要结局指标为肥胖，定义为年龄和性别的体重指数（BMI）≥ +3标准差。UPF消费得分是主要的暴露测量指标。进行了多水平粗泊松回归和调整泊松回归以估计风险比及相应的95%置信区间（95%CI）。
这群平均年龄为48个月的拉丁美洲幼儿的肥胖总体发生率为4.1%。我们观察到UPF与肥胖之间存在具有统计学意义的关联（RR：1.10（95%CI，1.02 - 1.18））。对出生体重、年龄、性别、母乳喂养、国家以及各波次之间的时间进行调整后，结果显示出类似的关联，但缺乏统计学意义。
虽然在本研究中我们没有找到肥胖发生率与基线及当前UPF摄入量之间存在关联的有力证据，但结果表明，较高的UPF消费量比减少消费量更有利于肥胖的发展。
本研究强化了营养教育以及更有效的公共政策对于促进幼儿选择更健康食物的重要性。
