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      Early feeding practices and consumption of ultraprocessed foods at 6 y of age: Findings from the 2004 Pelotas (Brazil) Birth Cohort Study

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          Abstract

          Objective

          The aim of this study was to examine the association between early feeding practices and consumption of ultraprocessed foods in children at age 6 y.

          Methods

          This was a prospective cohort study using data from 3427 children who participated in the 2004 Pelotas Cohort Study and who had available food frequency questionnaire information at 6 y. Information about exclusive and total breastfeeding duration as well as age at introduction of semisolid and solid foods was used to define early feeding practices. Consumption of ultraprocessed foods was defined as proportion of total daily energy intake that came from ultraprocessed foods at age 6 y. Crude and adjusted linear regression models were employed to analyze the effect of early feeding practices on ultraprocessed foods consumption.

          Results

          It was determined that 40.3% of total daily energy intake at 6 y came from ultraprocessed foods. In crude linear regression models, early feeding practices (exclusive and total breastfeeding duration, and age at introduction of semisolid and solid foods) were negatively associated with ultraprocessed foods consumption. After adjustment, only exclusive breastfeeding duration and age at introduction of solid foods remained associated with consumption of ultraprocessed foods, although the observed effects size was small. Children exclusively breastfed for ≥3 mo and those who had solid foods introduced at ≥4 mo consumed a lower proportion of daily energy intake from ultraprocessed foods.

          Conclusion

          This study supports the need to promote healthy early feeding practices including the support of breastfeeding to promote healthier eating habits later in childhood.

          Highlights

          • Newborn infants from southern Brazil were followed up in infancy and childhood.

          • Breastfeeding duration and timing of introduction of foods were recorded.

          • Ultraprocessed food intake was evaluated by a food frequency questionnaire.

          • Introduction of solid foods was related with consumption of ultraprocessed foods.

          • Longer exclusively breastfed infants had lower ultraprocessed food consumption later.

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          Most cited references23

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          Parental influence on eating behavior: conception to adolescence.

          The first years of life mark a time of rapid development and dietary change, as children transition from an exclusive milk diet to a modified adult diet. During these early years, children's learning about food and eating plays a central role in shaping subsequent food choices, diet quality, and weight status. Parents play a powerful role in children's eating behavior, providing both genes and environment for children. For example, they influence children's developing preferences and eating behaviors by making some foods available rather than others, and by acting as models of eating behavior. In addition, parents use feeding practices, which have evolved over thousands of years, to promote patterns of food intake necessary for children's growth and health. However in current eating environments, characterized by too much inexpensive palatable, energy dense food, these traditional feeding practices can promote overeating and weight gain. To meet the challenge of promoting healthy weight in children in the current eating environment, parents need guidance regarding alternatives to traditional feeding practices.
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            Ultra-Processed Food Products and Obesity in Brazilian Households (2008–2009)

            Background Production and consumption of industrially processed food and drink products have risen in parallel with the global increase in overweight and obesity and related chronic non-communicable diseases. The objective of this study was to analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight (overweight plus obesity) and obesity in Brazil. Methods The study was based on data from the 2008–2009 Household Budget Survey involving a probabilistic sample of 55,970 Brazilian households. The units of study were household aggregates (strata), geographically and socioeconomically homogeneous. Multiple linear regression models were used to assess the relationship between the availability of processed and ultra-processed products and the average of Body Mass Index (BMI) and the percentage of individuals with excess weight and obesity in the strata, controlling for potential confounders (socio-demographic characteristics, percentage of expenditure on eating out of home, and dietary energy other than that provided by processed and ultra-processed products). Predictive values for prevalence of excess weight and obesity were estimated according to quartiles of the household availability of dietary energy from processed and ultra-processed products. Results The mean contribution of processed and ultra-processed products to total dietary energy availability ranged from 15.4% (lower quartile) to 39.4% (upper quartile). Adjusted linear regression coefficients indicated that household availability of ultra-processed products was positively associated with both the average BMI and the prevalence of excess weight and obesity, whereas processed products were not associated with these outcomes. In addition, people in the upper quartile of household consumption of ultra-processed products, compared with those in the lower quartile, were 37% more likely to be obese. Conclusion Greater household availability of ultra-processed food products in Brazil is positively and independently associated with higher prevalence of excess weight and obesity in all age groups in this cross-sectional study.
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              Influence of parental attitudes in the development of children eating behaviour.

              The present paper is a review of available data on effects of parental feeding attitudes and styles on child nutritional behaviour. Food preferences develop from genetically determined predispositions to like sweet and salty flavours and to dislike bitter and sour tastes. There is evidence for existence of some innate, automatic mechanism that regulate appetite. However, from birth genetic predispositions are modified by experience. There are mechanisms of taste development: mere exposure, medicine effect, flavour learning, flavour nutrient learning. Parents play a pivotal role in the development of their child's food preferences and energy intake, with research indicating that certain child feeding practices, such as exerting excessive control over what and how much children eat, may contribute to childhood overweight. Mothers are of particular interest on children's eating behaviour, as they have been shown to spend significantly more time than fathers in direct interactions with their children across several familial situations.A recent paper describes two primary aspects of control: restriction, which involves restricting children's access to junk foods and restricting the total amount of food, and pressure, which involves pressuring children to eat healthy foods (usually fruits and vegetables) and pressuring to eat more in general. The results showed significant correlations between parent and child for reported nutritional behaviour like food intake, eating motivations, and body dis- and satisfaction. Parents create environments for children that may foster the development of healthy eating behaviours and weight, or that may promote overweight and aspects of disordered eating. In conclusion positive parental role model may be a better method for improving a child's diet than attempts at dietary control.
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                Author and article information

                Contributors
                Journal
                Nutrition
                Nutrition
                Nutrition (Burbank, Los Angeles County, Calif.)
                Elsevier Science
                0899-9007
                1873-1244
                1 March 2018
                March 2018
                : 47
                : 27-32
                Affiliations
                [a ]Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
                [b ]Nutrition Department, Federal University of Pelotas, Brazil
                [c ]Nutrition School, Federal University of Pampa, Brazil
                [d ]Department of Preventive Medicine, School of Medicine, University of São Paulo, Brazil
                Author notes
                [* ]Corresponding author. Tel./fax: +55 (53) 32841300. renatabielemann@ 123456hotmail.com
                Article
                S0899-9007(17)30213-7
                10.1016/j.nut.2017.09.012
                5825382
                29429531
                916354ea-2371-4fd2-8a83-d6695041eaf5
                © 2017 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 17 February 2017
                : 26 September 2017
                Categories
                Article

                Nutrition & Dietetics
                ultraprocessed foods,complementary feeding,breastfeeding,cohort studies
                Nutrition & Dietetics
                ultraprocessed foods, complementary feeding, breastfeeding, cohort studies

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