Maternal schooling and child's age interaction and its association with ultra-processed food consumption in Brazilian children <5 years of age: results from the Brazilian National Survey on Child Nutrition (ENANI-2019)

Abstract

Background The consumption of ultra-processed foods (UPFs) has increased worldwide, including among children. Maternal schooling has been associated with children's UPF consumption. The present study examined the interaction between maternal schooling and child age in the association with UPF consumption in Brazilian children <5 years.

Methods The Brazilian National Survey on Child Nutrition (ENANI-2019) is a household-based population survey of 14,558 children <5 years residing in 123 Brazilian municipalities. A structured questionnaire was used to quantify the consumption of nine groups of UPF, according to the NOVA classification, on the day before the interview. The mean, standard deviation and 95% CI for UPF consumption are presented. A multiple Poisson regression model was used, including an interaction between maternal schooling and child age, to estimate the predicted consumption of UPF.

Results The prevalence of consumption of at least one UPF group was 81% in Brazilian children <5 years, with the most consumed UPFs being sweet or savoury biscuits/cookies (51.0%), sweetened beverages (37.5%), baby cereals (29.4%) and yogurt (28.1%). Children 6–11 months of age had a lower mean consumption of UPF when maternal schooling was >12 years (0.73 [95% CI: 0.48–0.98]) compared to those whose mothers had ≤7 years (1.55 [95% CI: 1.18–1.92]) and 8–11 years of schooling (1.40 [95% CI: 1.19–1.61]). The interaction model between maternal schooling and child age (p < 0.001) indicated that children of mothers with higher schooling had significantly lower consumption of UPF up to 8 months of age. However, no significant differences in consumption were observed thereafter.

Conclusions The child age modifies the association of maternal schooling on UPF consumption, that is, UPF consumption was lower for children up to 8 months when their mothers had higher schooling, whereas no significant results were found for older infants.