Dietary Patterns in Portuguese Children and Adolescent Population: The UPPER Project.

Milena Miranda De Moraes,Renata Bertazzi Levy,Fernanda Rauber,Duarte Torres,Cláudia Afonso,Sara Rodrigues,Cristina Santos,Carla Lopes,Bruno Oliveira,Luiza Antoniazzi,Renata Costa De Miranda

doi:10.3390/nu13113851

Abstract

Considering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015–2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: “Unhealthy” (higher sugar-sweetened beverages, industrial breads, and sausages intake), “Traditional” (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and “Dairy” (higher intake of milk, yogurt, and milk-based beverages). “Unhealthy” was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.

Highlights

Childhood and adolescence are important stages of growth and development, which demand special energy and nutrient requirements, representing a phase of potential nutritional risk
This study aims to identify dietary patterns using food groups based on the NOVA classification system and their associations with socioeconomic, demographic, and nutritional factors in Portuguese children and adolescents
12.7% of subjects followed DP3 labelled “Dairy”, which had the highest consumption of milk and plain yogurt, and milkbased beverages and the lowest consumption of most NOVA group 3 items, likewise some other NOVA 4 group subgroups, such as industrial breads and sausages and other reconstituted meat products

Summary

Introduction

Childhood and adolescence are important stages of growth and development, which demand special energy and nutrient requirements, representing a phase of potential nutritional risk Food consumption in this age group is usually characterized by fast foods, snacks and sugar-sweetened beverages, insufficient fibre intake, and high intake of saturated fats and sodium [1,2]. As a consequence of advances in the food production systems and social and lifestyle trends, the intake of fat and sugars, and consumption of ready-to-eat products have been increasing worldwide, reflecting changes in the populations’ dietary pattern worldwide, including Portugal [5,6] In this context, a new classification system named NOVA [7] has been proposed to categorize foods according to the nature, extent, and purpose of industrial processing into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods (UPF). According to the NOVA classification system, UPF are ‘formulations of ingredients, mostly for industrial use only, derived from a series of industrial processes’ [7] and their use in dietary intake assessment has been increasing worldwide

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