Contribution of ultra-processed food to the nutritional dietary profile of young children school feeding
Palabras clave:
Child day care centers, Food analysis, Food processing, School feeding, Ultra-processed foodsResumen
Objective
To investigate the contribution of ultra-processed food to the nutritional dietary profile of school feeding in public child day-care centers.
Methods
Cross-sectional study carried out from June-November/2013. Samples from six daily meals were collected in twenty non-consecutive days. A total of 117 school meals (123 food items) were offered to children from 12-36 months of age. The served portions were determined by direct weighting. Physicochemical analyses were performed to establish the nutritional composition. School meals were classified according to the processing degree: (A) unprocessed/minimally processed/culinary preparations, (B) processed food, or (C) ultra-processed food. The contribution of each group to the quantity of energy, macronutrients and sodium was calculated. Student’s t test was applied for comparison between groups.
Results
Ultra-processed meals contributed to 45.8% of energy, 33.9% of lipids, 42.8% of proteins, 48.9% of carbohydrates, and 20.9% of sodium. All lunches and 90% of dinners were classified as unprocessed/minimally processed/culinary preparations. 39.0% of the meals were ultra-processed (mainly breakfast and snacks). Ultra-processed meals had a greater quantity of energy (p=0.026) and carbohydrates (p<0.001) per serving, while unprocessed/minimally processed/ culinary preparations offered more sodium per serving (p<0.001).
Conclusion
Although most meals were classified as unprocessed/minimally processed/culinary preparations, ultra-processed food, which should be avoided at this stage of life, are offered daily, contributing with higher energy and carbohydrates offer per serving. The municipality need to improve the quality of the meals offered to children in these child day-care centers, observing the new Resolution nº 6/2020 that came into effect in 2021.
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World Food Programme. Revised school feeding policy: promoting innovation to achieve national ownership. Rome: World Food Programme; 2013 [cited 2019 Jan 9]. Available from: https://goo.gl/ndAeW8
United Nations International Children’s Emergency Fund. The state of the world’s children 2019. Children, food and nutrition: growing well in a changing world. New York: Unicef; 2019 [cited 2022 Apr 6]. Available from: http:// encurtador.com.br/gtC07
Ministério da Educação (Brasil). Resolução/CD/FNDE nº 26, de 17 de junho de 2013. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do Programa Nacional de Alimentação Escolar – PNAE. Brasília: Ministério; 2013 [cited 2019 Jan 9]. Available from: https://goo.gl/VQQSUP
Ministério da Educação (Brasil). Resolução/CD/FNDE nº 6, de 8 de maio de 2020. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do Programa Nacional de Alimentação Escolar – PNAE. Brasília: Ministério; 2020 [cited 2019 Jan 9]. Available from: https://bit.ly/3kPtBuZ
Ministério da Educação (Brasil). Resolução/CD/FNDE nº 38, de 16 de julho de 2009. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no Programa Nacional de Alimentação Escolar – PNAE. Brasília: Ministério; 2009 [cited 2022 Apr 6]. Available from: http://encurtador.com.br/gipxO
Monteiro CA, Cannon G, Moubarac JC, Martins AP, Martins CA, Garzillo J, et al. Dietary guidelines to nourish humanity and the planet in the twenty-first century: a blueprint from Brazil. Public Health Nutr. 2015;18(13):2311-22. https://doi.org/10.1017/S1368980015002165
Oliveira MSS, Santos LAS. Dietary guidelines for Brazilian population: an analysis from the cultural and social dimensions of food. Ciên Saúde Colet. 2020;25:2519-28
Monteiro CA, Cannon G, Levy RB, Moubarac JC, Jaime P, Martins APea. NOVA: the star shines bright. World Nutr J. 2016;7(1-3):28-38
Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936-41. https://doi.org/10.1017/S1368980018003762
Moreira PV, Baraldi LG, Moubarac JC, Monteiro CA, Newton A, Capewell S, et al. Comparing different policy scenarios to reduce the consumption of ultra-processed foods in UK: impact on cardiovascular disease mortality using a modelling approach. Plos One. 2015;10(2):e0118353. https://doi.org/10.1371/journal.pone.0118353
Moubarac JC, Parra DC, Cannon G, Monteiro CA. Food Classification systems based on food processing: significance and implications for policies and actions: a systematic literature review and assessment. Curr Obes Rep. 2014;3(2):256-72. https://doi.org/10.1007/s13679-014-0092-0
Passos CM, Maia EG, Levy RB, Martins APB, Claro RM. Association between the price of ultra-processed foods and obesity in Brazil. Nutr Metab Cardiovasc Dis. 2020;30(4):589-98. https://doi.org/10.1016/j.numecd.2019.12.011
Beslay M, Srour B, Méjean C, Allès B, Fiolet T, Debras C, et al. Ultra-processed food intake in association with BMI change and risk of overweight and obesity: a prospective analysis of the French NutriNet-Santé cohort. Plos Med. 2020;17(8):e1003256. https://doi.org/10.1371/journal.pmed.1003256
Machado PP, Steele EM, Levy RB, da Costa Louzada ML, Rangan A, Woods J, et al. Ultra-processed food consumption and obesity in the Australian adult population. Nutr Diabetes. 2020;10(1):39. https://doi.org/10.1038/s41387-020- 00141-0
Rauber F, Steele EM, Louzada MLC, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016). Plos One. 2020;15(5):e0232676. https://doi. org/10.1371/journal.pone.0232676
Nardocci M, Leclerc BS, Louzada ML, Monteiro CA, Batal M, Moubarac JC. Consumption of ultra-processed foods and obesity in Canada. Can J Public Health. 2019(100):4-14.
Elizabeth L, Machado P, Zinocker M, Baker P, Lawrence M. Ultra-Processed foods and health outcomes: a narrative review. Nutrients. 2020;12(7). https://doi.org/10.3390/nu12071955
World Health Organization. Obesity and overweight 2020. Geneva: Organization; 2020 [cited 2021 Apr 20]. Available from: http://encurtador.com.br/aAIK7
Oppitz IN, Cesar JA, Neumann NA. Overweight among children under five years of age in municipalities of the semiarid region. Rev Bras Epidemiol. 2014;17(4):860-72. https://doi.org/10.1590/1809-4503201400040006
Müller RM, Tomasi E, Facchini LA, Piccini RX, Silveira DS, Siqueira FV, et al. Prevalence of overweight and associated factors in under-five-year-old children in urban population in Brazil. Rev Bras Epidemiol. 2014;17(2):285-96. https:// doi.org/10.1590/1809-4503201400020001eng
Monteiro F, Schmidt ST, Costa IB, Almeida CC, Matuda NS. Bolsa Família: food and nutrition insecurity of children under five years of age. Ciên Saúde Colet. 2014;19(5):1347-57. https://doi.org/10.1590/1413-81232014195.21462013
Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos familiares 2008-2009 : antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. Rio de Janeiro: Instituto; 2011.
Dantas RR, Silva GAP. The role of the obesogenic environment and parental lifestyles in infant feeding behavior. Rev Paul Pediatr. 2019;37:363-71
Retondario A, Silva DL, Salgado SM, Alves MA, Ferreira SM. Nutritional composition of school meals serving children from 7 to 36 months of age in municipal day-care centres in the metropolitan area of Curitiba, Parana, Brazil. Br J Nutr. 2016;115(12):2203-11. https://doi.org/10.1017/S0007114516001434
Rodrigo CPS, Bartrina JA. Diário o registro dietético: métodos de doble pesada. In: Majem LSBJ, Verdú JM, editors. Nutricion y salud publica; métodos, bases científicas y aplicaciones. Barcelona: Masson; 1995. p. 107-19.
Association of Official Analytical Chemists International. Official methods of analysis of AOAC international. Rockville: Association; 2000.
Instituto Adolfo Lutz. Physico-chemical methods for food analysis. São Paulo: Instituto; 2008.
Osborne DR, Voog P. The analysis of nutrient in foods. London: Academic Press; 1978.
Louzada ML, Martins AP, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saúde Pública. 2015;49:45. https://doi.org/10.1590/S0034- 8910.2015049006211
Ministério da Saúde (Brasil). Guia Alimentar para a população brasileira. Brasília: Ministério; 2014 [cited 2019 Jan 9]. Available from: https://goo.gl/pjD97r
Ministério da Saúde (Brasil). Dez passos para uma alimentação saudável: Guia Alimentar para crianças menores de dois anos: um guia para o profissional da saúde na atenção básica. Brasília: Ministério; 2013 [cited 2019 Jan 9t]. Available from: https://encurtador.com.br/emrw4
Ministério da Saúde (Brasil). Guia Alimentar para crianças brasileiras menores de dois anos: versão resumida. Brasília: Ministério; 2021 [cited 2021 Mar 11]. Available from: https://encurtador.com.br/cxASX
Luiten CM, Steenhuis IH, Eyles H, Ni Mhurchu C, Waterlander WE. Ultra-processed foods have the worst nutrient profile, yet they are the most available packaged products in a sample of New Zealand supermarkets. Public Health Nutr. 2016;19(3):530-8. https://doi.org/10.1017/S1368980015002177
Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos familiares 2017-2018 : análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: Instituto; 2020.
Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14 Suppl 2:21-8. https://doi.org/10.1111/obr.12107
Karnopp EV, Vaz JD, Schafer AA, Muniz LC, Souza RL, Santos ID, et al. Food consumption of children younger than 6 years according to the degree of food processing. Unit J Pediatr. 2017;93(1):70-8. https://doi.org/10.1016/j. jped.2016.04.007
Sparrenberger K, Friedrich RR, Schiffner MD, Schuch I, Wagner MB. Ultra-processed food consumption in children from a Basic Health Unit J Pediatr. 2015;91(6):535-42. https://doi.org/10.1016/j.jped.2015.01.007
Silva DCGd, Ferreira FG, Pereira DLM, Magalhães ELG, Longo GZ. Degree of food processing and its relationship with overweight and body adiposity in Brazilian adults. Rev Nutr. 2021;34. https://doi.org/10.1590/1678- 9865202134e200135
Schreinemachers P, Baliki G, Shrestha RM, Bhattarai DR, Gautam IP, Ghimire PL, et al. Nudging children toward healthier food choices: an experiment combining school and home gardens. Glob Food Sec. 2020;26:100454. https://doi.org/10.1016/j.gfs.2020.100454
Teo CRPA. The partnership between the Brazilian School Feeding Program and family farming: a way for reducing ultra-processed foods in school meals. Public Health Nutr. 2017;21(1):230-7. https://doi.org/10.1017/ S1368980017002117
Mais LA, Warkentin S, Vega JB, Latorre MRDO, Carnell S, Taddei JAAC. Sociodemographic, anthropometric and behavioural risk factors for ultra-processed food consumption in a sample of 2–9-year-olds in Brazil. Public Health Nutr. 2017;21(1):77-86. https://doi.org/10.1017/S1368980017002452
