Abstract
ObjectiveTo investigate the effectiveness of a training program for health workers regarding infant feeding practices to reduce sugar consumption in children. DesignA cluster randomized trial was conducted at 20 health centers in southern Brazil randomly assigned to an intervention (n = 9) or control (n = 11) group. ParticipantsThe 715 pregnant women enrolled were assessed when their children were aged 6 months, 3 years, and 6 years. InterventionA training session for primary care workers based on the Brazilian National Guidelines for Children. Main Outcome MeasureMothers were asked when sugar was first offered to children. Added sugars intake was obtained from dietary recalls. AnalysisThe effectiveness of the intervention was modeled using generalized estimation equations and Poisson regression with robust variance. ResultsChildren attending intervention health centers had a 27% reduced risk of sugar introduction before 4 months of age (relative risk, 0.73; 95% confidence interval [CI], 0.61-0.87) as well as lower added sugars consumption (difference, −6.36 g/d; 95% CI, −11.49 to −1.23) and total daily energy intake (difference, −116.90 kcal/d; 95% CI, −222.41 to −11.40) at 3 years of age. Conclusions and ImplicationsHealth care worker training in infant feeding guidelines may be an effective intervention to delay the introduction of added sugars and lower the subsequent intake of added sugars in infants and toddlers.
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