Ultra-processed foods and early childhood caries in 0–3‐year‐olds enrolled at Primary Healthcare Centers in Southern Brazil

Abstract

Objective: To investigate the relationship between ultra-processed food consumption and early childhood caries. Design: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. Setting: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. Participants: Children aged 0–3 years (n 309). Results: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. Conclusions: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children’s oral health.

In This Issue: Ultra-processed food and health

“…In southern Brazil, the daily frequency of consuming ultra-processed foods was associated with the risk of dental caries. More than two out of three children consumed ultra-processed foods four or more times per day; the prevalence ratios for non-cavitated (PR 2•25, 95 % CI 1•19, 4•27) and cavitated caries (PR 3•48, 95 % CI 1•18, 10•30) in this group was elevated relative to less frequent consumption (8,11) . Marçal et al (9) examined breast-feeding and ultra-processed food intake in Brazilian infants aged 6-24 months based on a single 24-h recall.…”

“…The remaining five studies were in children (7)(8)(9)(10)(11) or related to foods targeted to children (12) . In Spanish children with a mean age of 5•3 (SD 1•0) years, dietary intakes were collected using FFQ, foods classified according to the NOVA system and adherence to a Mediterranean style diet assessed by the KIDMED index.…”

Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis

“…Figure 3 presents the risk bias assessment for cross-sectional and case-control studies. In relation to the 32 cross-sectional studies, (26, 27, 29, 31-38, 41-46, 48-52, 55, 56, 58, 61-67) , only nine (26,32,33,35,37,44,49,55,58,63,67) were classified as having low risk of bias. The main methodological problems were the evaluation of the UPF without valid and reliable measures (26,29,31,34,36,37,41,44,46,56,58,62,(64)(65)(66)(67) , and without considering the main confounders or established appropriate strategies to deal with them.…”

“…Other non-sweet UPF, such as instant noodles and fast foods, were investigated only in five studies (26,30,35,61,64) , three of them were cross-sectional included in the metaanalysis. (26,35,61) A detailed description of the 42 selected studies can be found in Appendix 2.…”

Estado nutricional y caries de infancia temprana en niños de 0 a 3 años: Revisión de la literatura

“…A su vez, Souza et al 21 mencionan que al analizar la interacción de los alimentos ultraprocesados y caries de la primera infancia de 0 -3 -años en Brasil, se demostró que los alimentos ultraprocesados estaban asociados a la caries de primera infancia, por la razón de que cerca de los dos tercios de niños pertenecientes a este grupo de edad, los consumían cuatro o más veces al día, siendo más proclives a presentar caries cavitarias y no cavitarias, la relación encontrada fue mayor en niños de 2 a 3 años 21 . En otro estudio ejecutado por Folayan et al 23 mencionan sobre riesgo de caries en la primera infancia en una comunidad de Nigeria, se demostró que los niños de 0-2 años son menos propensos de contraer caries de primera infancia, sin embargo, en niños de 3-5 años aumentó en prevalencia y gravedad, concluyendo así, que en la primera infancia la caries no estaba relacionada con niños nutridos o desnutridos 22,23 .…”