Consumo de alimentos ultraprocessados e gordura corporal na primeira infância: Coorte de Nascimentos de 2015

Abstract

The consumption of ultra-processed foods (UPF) has increased substantially during childhood and is linked to poor dietary patterns and potential adverse health outcomes. In early childhood, UPF intake may be influenced by family and maternal factors, with possible impacts on growth and body composition. This thesis aimed to investigate UPF consumption in childhood through the development of an assessment tool, the analysis of maternal factors associated with consumption, and the exploration of longitudinal effects on body composition. The first study developed and validated a UPF score based on a food frequency questionnaire covering 16 UPF subgroups. The score showed a significant association with the percentage of energy from UPF estimated by a 24-hour dietary recall, with substantial agreement between methods. The second cross-sectional study examined the association between maternal characteristics and high UPF consumption among 6–7-year-old children from the 2015 Pelotas Birth Cohort. High consumption was defined by the upper quintile of a score based on 16 UPF subgroups consumed the previous day. Maternal sociodemographic, behavioral, and lifestyle factors were evaluated. High consumption prevalence was 18.3%, higher among children of mothers with low education, intermediate family income, single status, and multiparity (five or more children). The types of UPF consumed also varied according to maternal profiles, highlighting social inequalities in children's UPF consumption and emphasizing the need for public policies promoting healthier food environments from early childhood. The third longitudinal study assessed associations between UPF consumption trajectories at 24 months, 4 years, and 6–7 years and body fat at 67 years, testing different theoretical models (risk accumulation, critical period, and mobility). Distinct associations were found by child sex: in girls, early increased consumption was linked to higher body fat; in boys, continuous high consumption was associated with lower body fat, though not statistically significant after adjustment. Findings underline the importance of maternal characteristics in understanding childhood dietary patterns and suggest that UPF consumption may differently affect body development by sex and consumption trajectory. This thesis provides evidence reinforcing the need to monitor and reduce UPF intake from early life, considering family contexts—particularly maternal factors—as part of strategies to promote healthier childhood nutrition.