Risk Characteristics and Behaviors for Ultra-processed Food Consumption in a Sample of Brazilian Children

Abstract

Identify food patterns among 2-9 year olds, and explore potential associations among less healthy dietary patterns, parental feeding practices and parent and child characteristics. Cross-sectional study. Participants were parents of 2-9 year old children enrolled in private schools of São Paulo and Campinas, Brazil (n=929). Parents completed a Food Frequency Questionnaire, feeding practices measured using a validated Brazilian version of the Comprehensive Feeding Practices Questionnaire and questionnaires regarding parent and child characteristics. First, we conducted a factor analysis on the Food Frequency Questionnaire to derive food patterns, followed by a univariate and a multivariate logistic regression model to identify predictors of less healthy dietary patterns. Two dietary patterns emerged: traditional foods, and ultra-processed foods. ‘Healthy Eating Guidance’ and ‘Monitoring’, factors of the Comprehensive Feeding Practices Questionnaire, were negatively associated with the ultra-processed food pattern, while the screen use during mealtimes, lower perceived parental responsibility for adequacy of food groups’ intake, lower maternal education, and higher maternal weight status were positively associated with this pattern. This is the first study to evaluate associations between less healthy dietary patterns of Brazilian 2-9 year olds, parental feeding practices and other risk characteristics. Our findings highlight demographic and behavioral factors within families that could be used to target tailored policies and interventions in risk populations for obesity and its consequences.