Association of exclusive breastfeeding duration with consumption of ultra-processed foods, fruit and vegetables in Brazilian children
There has been little evidence of the influence of breastfeeding on childhood eating habits.
To evaluate the association between duration of exclusive breastfeeding (EB) and consumption of ultra-processed foods, fruits and vegetables by Brazilian children.
This is a cross-sectional study nested in a cohort of 403 children age 4–7 years. Food consumption was evaluated by three food records and the foods were grouped by the amount of processing involved (minimal, including fruit and vegetables to ultra-processed foods). Adjusted linear and multinomial regression models were proposed to evaluate the association of EB with children’s food intake. Median duration of EB was 4.0 (2.0–6.0) months and the prevalence of EB of 4 months or more was 60.9%.
Mean energy consumption was 1536 kcal/day, 38% of energy was from ultra-processed foods. Mean intake of fruit and vegetables was 130 g/day. For each 1-month increase in duration of EB there was a 0.7% decrease in energy from ultra-processed foods (β: − 0.7; 95% CI: − 1.3 to 0.1; p = 0.038). EB of less than 4 months was associated with the child being in the lowest tercile for consumption of fruit and vegetables (Adjusted OR: 1.8; 95% CI: 1.1–3.0; p = 0.030) and the highest for consumption of ultra-processed foods (adjusted OR: 1.7; 95% CI: 1.1–2.9; p = 0.040).
In addition to other benefits of EB, we emphasize its importance for the formation of healthy eating habits, contributing to a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods in childhood.
KeywordsChildren Exclusive breastfeeding Infant nutrition Fruit Vegetables Ultra-processed foods
We thank the mothers of the children who participated in our study and the hospital staff who collaborated with the data collection. Thanks also to all data collection team.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 4.Monteiro CA, Cannon G, Levy RB, Moubarac JC, Jaime P, Martins AP, Canella D, Louzada ML, P D, Ricardo C, Calixto G, Machado P, Martins C, Martinez E, Baraldi L, Garzillo J, I. S (2016) NOVA. A estrela brilha (Classificação dos alimentos Saúde Pública) World Nutrition 7(1–3):12Google Scholar
- 8.de Lauzon-Guillain B, Jones L, Oliveira A, Moschonis G, Betoko A, Lopes C, Moreira P, Manios Y, Papadopoulos NG, Emmett P, Charles MA (2013) The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts. Am J Clin Nutr 98(3):804–812. https://doi.org/10.3945/ajcn.112.057026 CrossRefPubMedGoogle Scholar
- 16.BRASIL (2015) Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Saúde da criança: aleitamento materno e alimentação complementar / Ministério da Saúde. In: Secretaria de Atenção à Saúde, Departamento de Atenção Básica. – 2. Ministério da Saúde, Brasília (DF)Google Scholar
- 17.WHO (1995) World Health Organization. Physical status: use and interpretation of antropometry. Report of WHO Expert Committee (WHO Technical Report Series, 854), GenevaGoogle Scholar
- 18.BRASIL (2011) Ministério da Saúde. Orientações para coleta e análise de dados antropométricos em serviços de saúde: norma técnica do sistema de Vigilância Alimentar e Nutricional—SISVAN. Disponível em: http://188.8.131.52/dab/docs/portaldab/publicacoes/orientacoes_coleta_analise_dados_antropometricos.pdf.
- 21.BRASIL (2014) Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Guia alimentar para a população brasileira. 2a. edição. Brasília (DF)Google Scholar
- 22.Louzada ML, Martins AP, Canella DS, Baraldi LG, Levy RB, Claro RM, Moubarac JC, Cannon G, Monteiro CA (2015) Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica 49:45. https://doi.org/10.1590/S0034-8910.2015049006211 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Mendonca RD, Lopes AC, Pimenta AM, Gea A, Martinez-Gonzalez MA, Bes-Rastrollo M (2017) Ultra-processed food consumption and the incidence of hypertension in a Mediterranean cohort: the Seguimiento Universidad de Navarra Project. Am J Hypertens 30(4):358–366. https://doi.org/10.1093/ajh/hpw137 CrossRefPubMedGoogle Scholar
- 35.WHO (2001) Expert consultation on the optimal duration of exclusive breastfeeding. Conclusions and recommendations. World Wealth Organization. Document A54/INF.DOC./4, Geneva, 28-3Google Scholar