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Emerging evidence suggests that the consumption of ultra-processed foods (UPF) plays a role in the development of chronic diseases, but evidence of their influence in children is limited. Our objective was to study longitudinal trends of UPF intake and determine their impact on blood lipids in young children. The present study was a follow-up of a randomised field trial of children (n 308) from Porto Alegre, Brazil. Dietary intake was collected using two 24-h recalls at 3 and 6 years of age, and consumption of UPF was classified according to the NOVA system, a food classification based on the extent and purpose of industrial food processing. At age 6 years, blood tests were performed to measure lipid profile. Contribution of UPF to total energy intake increased by 10 % during the follow-up period, from 43·4 % at 3 years to 47·7 % at 6 years of age. Linear regression models showed that children in the highest tertile of UPF consumption at age 3 years had higher levels of total cholesterol (TC; β 0·22 mmol/l; 95 % CI 0·04, 0·39) and TAG at age 6 years (β 0·11 mmol/l, 95 % CI 0·01, 0·20) compared with those in the lowest tertile. A positive dose–response was observed for an absolute increment of 10 % of UPF on TC (β 0·07 mmol/l, 95 % CI 0·00, 0·14) and TAG (β 0·04 mmol/l, 95 % CI 0·01, 0·07). Based on our data, consumption of UPF increased significantly over time and was associated with higher blood lipid levels in children from a low-income community. Our findings highlight the need for effective strategies to minimise the consumption of UPF in early life.

The health workers' training was effective with respect to improving infant feeding practices.

This study aimed to evaluate the association between eating context patterns and ultra-processed food consumption at two main meal occasions in a representative sample of UK adolescents. Data was acquired from four-day food records of adolescents aged 11–18 years, who participated in the 2014–2016 UK National Diet and Nutrition Survey (n=542). The eating context was assessed considering the location of the meal (lunch and dinner) occasion, the individuals present, whether the television was on and if the food was consumed at a table. Ultra-processed foods were identified using the NOVA classification. Exploratory factor analysis was used to identify eating context patterns for lunch and dinner. Linear regression models adjusted for the covariates were utilised to test the association between eating context patterns and the proportion of total daily energy intake derived from ultra-processed foods. Their contribution was about 67% to total energy intake. Three patterns were retained for lunch (‘At school with friends’, ‘TV during family meal’, and ‘Out-of-home (no school)’); and three patterns were retained for dinner (‘Watching TV alone in the bedroom’, ‘TV during family meal’, and ‘Out-of-home with friends’). At lunch, there was no significant association between any of the three patterns and ultra-processed food consumption. At dinner, the patterns ‘Watching TV alone in the bedroom’ (coeff: 95%CI 4.95: 1.87–8.03) and ‘Out-of-home with friends’ (coeff: 95%CI 3.13: 0.21–6.14) were associated with higher consumption of ultra-processed food. Our findings suggest a potential relationship between the immediate eating context and ultra-processed food consumption by UK adolescents.

Background The first 2 years of life are the window of opportunity to promote healthy feeding practices. Thus, the present study aimed to assess the impact of a health workers training in infant dietary guidelines on energy intake and anthropometric measurement into childhood. Methods Cluster randomised field trial (NCT00635453) was conducted in Porto Alegre, Brazil. Healthcare centres were randomised into intervention (n = 9) and control (n = 11) groups. In intervention sites, health workers were trained to promote healthy feeding practices based on the Brazilian guideline for children's nutrition. Pregnant women who were in the last trimester of pregnancy were registered as potential mothers who would receive dietary counselling from the health workers. Energy and macronutrient intake and anthropometric measurements were obtained from children at ages 6 months, 12 months, 3 years and 6 years from low‐income families. Results At age 3 years, intervention group had lower consumption of energy [−92.5 kcal; 95% confidence interval (CI) = −153.5 to −31.5], carbohydrates (−11.9 g; 95% CI = −19.9 to −2.3), and total fat (−3.9 g; 95% CI = −6.2 to −1.2), compared to the control group. At 6 years of age, children in the intervention group had lower waist circumference (−1.3 cm; 95% CI = −2.7 to −0.0), triceps (−1.3 mm; 95% CI = −2.5 to −0.0) and subscapular skinfolds (−1.3 mm; 16 95% CI = −2.6 to −0.0) thickness measurements compared to those in the control group. Conclusions The health workers training to promote infant healthy feeding practices resulted in lower energy, carbohydrates and fat intake at 3 years and lower waist circumference, triceps and subscapular skinfolds measurements at 6 years.

The health workers training to promote the "Ten Steps" was an effective way to reduce the prevalence of constipation among children at 6 years of age.

Objectives Poor diet quality is a major risk factor for the development of anemia. An increased consumption of fortified ultra-processed food (UPF) among children presents a new contributor to micronutrient intake, one that could potentially improve anemia biomarkers despite having a concomitantly low diet quality. Our objective was to investigate the impact of fortified UPF consumption on the prevalence of anemia and diet quality among children from low-income families in Brazil. Methods A cross-sectional analyses from a randomized field trial of children at 3 years of age (n = 432) from Porto Alegre, Brazil. Capillary blood samples were taken to measure hemoglobin concentration (Hb) and used to determine anemia status. Dietary data was assessed using two multiple-pass 24-h recalls and the consumption of UPF was classified according to the NOVA system. Results UPF account for 42.6% of total energy intake. Children in the highest tertile of UPF consumption had significantly lower risk of anemia (Hb < 110 g/L) compared to those in the lowest tertile (tertile 3 vs. tertile 1; OR 0.56 95% CI 0.39 to 0.82). Similarly, a 10% increase in the consumption of UPF was associated with a 22% lower risk of anemia (95% CI 0.64 to 0.94). Conversely, consumption of UPF was negatively associated with consumption of unprocessed/minimally processed foods. Finally, as the contribution of UPF to total energy intake increased, the intake of added sugars, total fats, and sodium increased, whereas the intake of proteins, fiber, and calcium decreased. Conclusions The consumption of fortified UPF was associated with a lower risk of anemia and a poor diet quality in children from a low-income community in Brazil. The co-existence of normal Hb with poor diet quality suggests the need for a more nuanced assessment of dietary patterns in low-income settings to best address this paradoxical situation as the prevalence of the double burden of disease continues to increase throughout the world. Funding Sources Coordination for the Improvement of Higher Education Personnel (CAPES).

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