Mello Juliana Vieira de Castro, Schincaglia Raquel Machado, Andrade Pedro Gomes, Alves-Santos Nadya Helena, Farias Dayana Rodrigues, Oliveira Natália, Lacerda Elisa Maria de Aquino, Carneiro Leticia Barroso Vertulli, Normando Paula, de Castro Inês Rugani Ribeiro, Kac Gilberto
Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Collective Health Institute, Federal University of South and Southeast Pará, Marabá, Pará, Brazil.
J Hum Nutr Diet. 2025 Feb;38(1):e13399. doi: 10.1111/jhn.13399.
The consumption of ultra-processed foods (UPFs) has increased worldwide, including among children. Maternal schooling has been associated with children's UPF consumption. The present study examined the interaction between maternal schooling and child age in the association with UPF consumption in Brazilian children <5 years.
The Brazilian National Survey on Child Nutrition (ENANI-2019) is a household-based population survey of 14,558 children <5 years residing in 123 Brazilian municipalities. A structured questionnaire was used to quantify the consumption of nine groups of UPF, according to the NOVA classification, on the day before the interview. The mean, standard deviation and 95% CI for UPF consumption are presented. A multiple Poisson regression model was used, including an interaction between maternal schooling and child age, to estimate the predicted consumption of UPF.
The prevalence of consumption of at least one UPF group was 81% in Brazilian children <5 years, with the most consumed UPFs being sweet or savoury biscuits/cookies (51.0%), sweetened beverages (37.5%), baby cereals (29.4%) and yogurt (28.1%). Children 6-11 months of age had a lower mean consumption of UPF when maternal schooling was >12 years (0.73 [95% CI: 0.48-0.98]) compared to those whose mothers had ≤7 years (1.55 [95% CI: 1.18-1.92]) and 8-11 years of schooling (1.40 [95% CI: 1.19-1.61]). The interaction model between maternal schooling and child age (p < 0.001) indicated that children of mothers with higher schooling had significantly lower consumption of UPF up to 8 months of age. However, no significant differences in consumption were observed thereafter.
The child age modifies the association of maternal schooling on UPF consumption, that is, UPF consumption was lower for children up to 8 months when their mothers had higher schooling, whereas no significant results were found for older infants.
超加工食品（UPF）在全球范围内的消费量都有所增加，包括在儿童中。母亲的受教育程度与儿童的UPF消费量有关。本研究调查了巴西5岁以下儿童中，母亲受教育程度与儿童年龄在与UPF消费关联中的相互作用。
巴西全国儿童营养调查（ENANI - 2019）是一项基于家庭的人口调查，涉及居住在巴西123个城市的14558名5岁以下儿童。采用结构化问卷根据NOVA分类法量化访谈前一天九组UPF的消费量。呈现了UPF消费的均值、标准差和95%置信区间。使用多元泊松回归模型，包括母亲受教育程度和儿童年龄之间的相互作用，来估计UPF的预测消费量。
巴西5岁以下儿童中至少食用一组UPF的患病率为81%，消费最多的UPF是甜或咸饼干/曲奇（51.0%）、含糖饮料（37.5%）、婴儿谷物（29.4%）和酸奶（28.1%）。与母亲受教育年限≤7年（1.55 [95%置信区间：1.18 - 1.92]）和8 - 11年（1.40 [95%置信区间：1.19 - 1.61]）的儿童相比，母亲受教育年限>12年的6 - 11个月大儿童的UPF平均消费量较低（0.73 [95%置信区间：0.48 - 0.98]）。母亲受教育程度和儿童年龄之间的相互作用模型（p < 0.001）表明，母亲受教育程度较高的儿童在8个月大之前的UPF消费量显著较低。然而，此后未观察到消费量的显著差异。
儿童年龄改变了母亲受教育程度与UPF消费之间的关联，即母亲受教育程度较高时，8个月大以下儿童的UPF消费量较低，而对较大婴儿则未发现显著结果。
