Abstract
Purpose: To estimate the effect of the consumption of products with an excessive amount of critical nutrients associated with NCDs, according to the PAHO Nutrient Profile Model on the quality of the diet of Uruguayan school-age children (4 to 12 years). Methods: A 24 h recall of food intake was conducted in a representative sample of 332 participants in the evaluation of the School Feeding Program in 2018 in public schools in Montevideo, Uruguay. Food and preparations were categorized according to the NOVA food classification, according to the nature, extent, and purposes of the industrial processes they undergo. Later, they were analyzed according to the Pan American Health Organization Nutrient Profile Model (PAHO NPM) to identify processed and ultra-processed products with an excessive content of critical nutrients. Results: Only 0.52% of children consumed exclusively natural foods, or culinary ingredients. Twenty-five per cent of children consumed ≥4 products categorized with an excessive content of free sugars, total fat, or saturated fat according to the PAHO NPM; in the case of excessive sodium, this was 40%. In general, children who included products with excessive free sugars, sodium, or saturated fat in their diet exceeded the limits established by the World Health Organization, and, as a result, their diet is of poorer nutritional quality compared to children who did not consume such products. Conclusion: Diets free of ultra-processed and processed products with excess free sugars, total fats, saturated fats, and sodium increased the chances of school-age children in Montevideo of meeting WHO nutrient intake recommendations. Meanwhile, intake of each additional gram of products with excessive critical nutrients according to PAHO NPM, significantly worsens diets, preventing children from meeting WHO recommendations.
Highlights
The existing evidence reaffirms the need for children to eat adequately, because it is their right, and because meeting dietary guidelines results in healthier children who reach their maximum potential, and improves education outcomes [1,2,3,4,5]
Childhood overweight and obesity result from the imbalance between caloric intake and caloric expenditure, a situation that has been largely related to the socalled obesogenic environment. This is part of profound changes in dietary patterns that displaced a diet based on healthy and minimally processed foods for ultra-processed products (UPP) [6,7,10,11,12]. The latter have a very low nutritional value, and their consumption has been proposed as an indicator of the nutritional quality of the diet, in particular for the study of nutrients related to noncommunicable diseases (NCDs) [12,13,14,15,16,17,18,19]
The aim of the study was to estimate the effect of the consumption of products with an excessive amount of critical nutrients associated with NCDs, according to the PAHO Nutrient Profile Model (PAHO NPM) on the quality of the diet of children 4 to 12 years in Montevideo, Uruguay
Summary
The existing evidence reaffirms the need for children to eat adequately, because it is their right, and because meeting dietary guidelines results in healthier children who reach their maximum potential, and improves education outcomes [1,2,3,4,5]. Childhood overweight and obesity result from the imbalance between caloric intake and caloric expenditure, a situation that has been largely related to the socalled obesogenic environment This is part of profound changes in dietary patterns that displaced a diet based on healthy and minimally processed foods for ultra-processed products (UPP) [6,7,10,11,12]. The definition of UPP was taken from to the “NOVA food classification”, which has been described elsewhere [22] This classification defines UPP as those products that include a large number of ingredients, many of them exclusively for industrial use, and that are the result of a sequential process in the industry [22,24] The sale of these products in Uruguay grew by 146% between 2000 and 2013, whereas the region of the America reached a 68% increase on average. This increase in sales combined with household consumption may lead to an excessive intake of free sugars, sodium, total fat, saturated fat, and trans fatty acids [9,25]
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