Ambiente alimentar, estado nutricional e consumo de alimentos ultraprocessados na população infantil

Abstract

Proper nutrition in childhood is essential for developing healthy eating habits, which impact short- and long-term health. The environment in which children live plays a crucial role, influencing their diet, nutritional status and health. Investigating eating practices and associated factors is essential to promote child growth and development and encourage healthy habits. The objective was to evaluate the food environment, nutritional status and consumption of ultraprocessed foods and associated factors in the living conditions of the child population in a municipality in the south of Minas Gerais. This is a study with a mixed design with an ecological and cross-sectional approach, carried out with children aged between six and 36 months, monitored by Family Health Strategy units, located in the urban area of the municipality of Lavras, Minas Gerais, Brazil. Socioeconomic and anthropometric variables and food consumption of guardians and children were collected using a structured questionnaire. The children's nutritional status was assessed using the anthropometric indicator body mass index for age. Food consumption of ultra-processed foods was analyzed using the food consumption marker form proposed by the Food and Nutrition Surveillance System. Information on the retail food environment was obtained from secondary data from public management and classified as: establishments that sell predominantly fresh or minimally processed foods, mixed establishments that sell predominantly ultra-processed foods. Food deserts and swamps were identified using the Brazilian methodology proposed by the Intersectoral Chamber of Food and Nutritional Security, calculating, respectively, the density of healthy and unhealthy establishments per ten thousand inhabitants. Continuous variables were described in measures of central tendency and dispersion, while for categorical variables, frequency distributions were estimated. The associations between environmental measures and the presence of excess weight and the consumption of ultra-processed foods were estimated using binary logistic regression, using the generalized estimating equations model. 817 food retailers were identified in the municipality, with mixed retailers being the most frequent (58.40%), followed by ultra-processed retailers (28.90%). In natura establishments were fewer in the lowest income tertile (p=0.01). Food deserts were found in 25.00% of census sectors, as well as presenting a greater number of people who declared themselves black and/or brown (p=0.03) and a lower per capita income (p=0.02) . Food swamps were present in 70.31% of census tracts. Excess weight was present in 26.70% (n=55) of the sample. There was a direct association between excess weight in children and the consumption of ultra-processed foods on the previous day [OR: 2.31, CI: 1.05 – 5.08] and the mother's age [OR: 2.70, CI: 1 .37 – 5.32]. Ultra-processed foods were present in the diet of 60.18%. Living in food swamps was associated with the consumption of instant noodles, packaged snacks or crackers [OR: 2.80; CI: 1.25 – 6.32] and stuffed biscuits, sweets or sweets [OR: 2.80; CI: 1.08 – 7.21]. It is concluded that the food environment plays a critical role in children's food consumption. Therefore, in order to prevent negative health outcomes related to excess weight and the consumption of ultra-processed foods, it is important to promote environments that facilitate healthy food choices among families and children. To this end, it is necessary to promote adequate and healthy eating, nutritional food education actions and policies that address issues of access, advertising and marketing of unhealthy foods.