Brazilian infant and preschool children feeding: literature review

Mello, Carolina Santos; Barros, Karina Vieira; Morais, Mauro Batista de

doi:10.1016/j.jped.2016.02.013

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review articles • J. Pediatr. (Rio J.) 92 (5) • Sep-Oct 2016 • https://doi.org/10.1016/j.jped.2016.02.013 copy

Brazilian infant and preschool children feeding: literature review^☆ ☆ Please cite this article as: Mello CS, Barros KV, Morais MB. Brazilian infant and preschool children feeding: literature review. J Pediatr (Rio J). 2016;92:451-63.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake.

Data source

This review analyzed studies carried out in Brazil that had food survey data on infants and preschool children. The search was limited to publications from the last 10 years included in the LILACS and MEDLINE electronic databases.

Data summary

The initial search identified 1480 articles, of which 1411 were excluded after the analysis of abstracts, as they were repeated or did not meet the inclusion criteria. Of the 69 articles assessed in full, 31 articles contained data on food survey and were selected. Only three studies concurrently assessed children from different Brazilian geographical regions. Of the assessed articles, eight had qualitative data, with descriptive analysis of food consumption frequency, and 23 had predominantly quantitative data, with information on energy and nutrient consumption.

Conclusions

The articles assessed in this review showed very heterogeneous results, making it difficult to compare findings. Overall, the feeding of infants and preschool children is characterized by low consumption of meat, fruits, and vegetables; high consumption of cow's milk and inadequate preparation of bottles; as well as early and high intake of fried foods, candies/sweets, soft drinks, and salt. These results provide aid for the development of strategies that aim to achieve better quality feeding of Brazilian infants and preschoolers.

Keywords
Feeding; Child nutrition; Infant; Preschool child; Brazil

Reference	Type of study/place and year of collection	Sample size/age	Food survey	Summary of results
Bortolini et al. (2012)	Cross-sectional 5 regions of Brazil; 2006/2007	n = 4322 6-59 months	Food frequency questionnaire	The children living in the South, Southwest, and Midwest regions more often consumed the recommended foods (rice, bread, potatoes, beans, leafy vegetables, legumes, meat, yogurt) as well as non-recommended ones (sweets and soft drinks). Those living in the Northeast region more often consumed fruit, cookies, and snacks. The children living in the urban stratum more often consumed recommended and non-recommended foods when compared to rural areas.
Cagliari et al. (2009)	Cross-sectional Campina Grande, PB; 2007	n = 112 2-5 years	Food frequency questionnaire	Food groups more often consumed every day: rice, milk, sugar/snacks and oil. The less often consumed daily were vegetables and meat.
Castro et al. (2004)	Cross-sectional Tumiritinga, MG; 2001	n = 69 0-60 years	Food frequency questionnaire	Food consumed more often by those older than 1 year: legumes, cereals, and milk. Vegetables, fruits and meats showed low consumption or were absent from the daily diet (47.3%, 63.6, and 72.7% consumed less than four times/week). High consumption of sweets (67.3% consumed at least once a week).
Gatica et al. (2012)	Longitudinal Pelotas, RS; 2004-2008	n = 4231 12-48 years	Frequency of food consumption in the past 24 h	Low-socioeconomic level children consumed more sweets, coffee, bread/cookies. High-socioeconomic status children consumed more fruits, yoghurt, and soft drinks.
Nobre et al. (2012)	Cross-sectional nested in a cohort Diamantina, MG; 2009-2010	n = 232 5 years	Food frequency questionnaire	Low maternal education was associated with a greater chance of consumption of a "mixed diet" and a lower chance to consume "snacks"; while those with higher per capita income are more likely to consume "unhealthy" foods.
Palmeira et al. (2011)	Cross-sectional Paraíba - 14 municipalities; 2005	n = 539 0-24 months	24-h food recall	High consumption of dairy products between 6 and 24 months. Insufficient daily consumption of food sources of iron between 12 and 24 months.
Pereira et al. (2008)	Cross-sectional Teresina, PI; 2003	n = 135 36-83 months	Food frequency questionnaire	A low consumption of foods with high or moderate levels of vitamin A and high consumption of foods low in this vitamin was observed.
Saldiva et al. (2007)	Cross-sectional São Paulo - 136 municipalities; 2004	n = 24,448 6-12 months	24-h food recall	At 6 months there was a high probability of consumption of milk and soups. The probability of consumption of food sources of iron is 66% at 6 months and 90% at 12 months.

Reference	Type of study/place and year of collection	Sample size/age	Food survey	Summary of results
Antunes et al. (2010)	Cross-sectional Duque de Caxias, RJ; 2005	n = 384 6-30 months	24-h recall (2 days)	Consumption below recommendations for vegetables and dairy products. The higher the degree of food insecurity, the lower the protein and iron intake.
Azevedo et al. (2010)	Cross-sectional Recife, PE; 2007	n = 344 24-60 months	Direct weighing + 24-h recall (2 applications in 20% of children)	Median consumption of vitamin A higher than the EAR for children aged 24-47 months and older than 47 months.
Barbosa et al. (2006)	Longitudinal Ilha de Paquetá, RJ; 2003	n = 20 2-3 years	Initial assessment by dietary history and after 6 months by direct weighing of food and food diaries (2 days)	After 6 months of day care attendance, more children reached the recommendation for: meat (55-80%), fat (45-55%) and fruit consumption (20-85%). The percentage of the group of cereals remained unchanged (20%) and milk decreased (45-35%). No child reached the recommendation for the consumption of vegetables.
Beinner et al. (2010)	Longitudinal Diamantina, MG; 2006	n = 176 6-24 months	Food diary (3 days)	The average dietary consumption of zinc was higher than the recommendations. 30.6% of children ingested an amount of Zn below the EAR and 19.4%, higher than the UL.
Bernardi et al. (2011)	Cross-sectional Caxias do Sul, RS; 2007	n = 362 2-6 years	Direct weighing + food diary (1 day)	56.5% of the daily food intake of iron was provided by the school; 62.7% of the daily calcium intake, 55.3% of vitamin A intake and 51.4% of zinc intake were provided by the home. Children in private schools had higher intake of iron and vitamin A; those in public schools had higher consumption of zinc and calcium. According to household records 86.8% of children consumed dairy meals.
Bueno et al. (2013)	Cross-sectional Multicentric (9 Brazilian cities); 2007	n = 3058 2-6 years	Direct weighing + food diary (1 day)	The mean fat intake for children aged 2-3 years was lower than the recommended energy percentage. Higher consumption of sodium and saturated fat was observed for 90% and 30% of children, respectively.
Caetano et al. (2010)	Longitudinal Curitiba, São Paulo and Recife; 2005	n = 179 4-12 months	Food diary (7 days)	High frequency of weekly consumption of processed foods, soft drinks and artificial juices. High quantitative inadequacy of micronutrients: zinc (75%), iron (45%), vitamin A (38%), calcium (15%).
Castro et al. (2009)	Cross-sectional Assis Brasil and Acrelândia, AC; 2003	n = 69 0 and 24 months	Usual daily food intake	High intake of carbohydrate and cow's milk. Irregular consumption of fruits, vegetables, beans and meat. Consumption above and below the recommendations for protein and iron, respectively, in all age groups.
Cavalcante et al. (2006)	Cross-sectional Viçosa, MG; 2003-2004	n = 174 12-35 months	24-h recall + food frequency questionnaire (1 day)	Prevalence of inadequate intakes: vitamin A (36.8%), iron (13.2%) and zinc (99.4%). Consumption below the recommended level for lipids.
Costa et al. (2011)	Cross-sectional Gameleira - PE and São João do Tigre - PB; 2005	n = 445 0-23 months	24-h recall	Energy, macro- and micronutrients above recommendations, except: Vitamin A (children 7-11 months) showed median values below the AI; iron below and zinc and calcium above the references in all age groups.
Domene et al. (2006)	Cross-sectional Campinas, SP	n = 94 2 and 6 years	Direct weighing + 24-h recall	Lower consumption of vegetables and fruits, cereals and fats. Higher consumption of food sources of protein (meat, dairy products and legumes), rich in sugar and saturated fat.
Fernandes et al. (2005)	Cross-sectional Recife, PE; 1997-1999	n = 311 6-59 months	Direct weighing + 24-h recall	78.0% of the children had adequate vitamin A intake. Higher proportion of vitamin A consumption of animal origin (58%).
Fidelis et al. (2007)	Cross-sectional Pernambuco: metropolitan region of Recife, urban and rural countryside; 1997	n = 948 0-5 years	24-h recall	Deficit of energy and excess protein was high in all age groups and geographical areas. High incidence of inadequate iron and zinc intake in different age groups.
Garcia et al. (2011)	Cross-sectional Acrelândia, AC; 2007-2008	n = 164 (127 with survey) 6-24 months	Usual daily food intake	Ingestion of vitamin A (42%), zinc (46%) and iron (71%) below recommendations. Low consumption of fruits, vegetables and meat; excessive consumption of cow milk and porridge.
Levy-Costa, Monteiro (2004)	Cross-sectional São Paulo, SP; 1995-1996	n = 1280 (598 with survey) 0 and 59 months	24-h recall	It was observed that 1.1 mg/1000 kcal of iron were heme iron and 4.3 mg/1000 kcal were non-heme iron.
Menezes et al. (2007)	Cross-sectional Pernambuco: metropolitan region of Recife, urban and rural countryside (1997)	n = 948 0-60 months	24-h recall	High occurrence of energy intake inadequacy, especially in the age groups of 48-60 months and 0-6 months. Protein intake above recommendations, in all age groups.
Oliveira et al. (2005)	Cross-sectional Salvador, BA; 1996	n = 724 0-24 months	24-h recall	Average energy and protein consumption was higher than recommendations for all age groups. Carbohydrates contributed with the highest percentage to the total energy value of the diet and this percentage increased with age, while the contribution of lipids decreased.
Oliveira et al. (2006)	Cross-sectional Pernambuco: metropolitan region of Recife, urban and rural countryside (1997)	n = 746 6-59 months	24-h recall	High consumption of cow's milk (88.9%), especially whole milk powder (47.8%) and liquid milk (24.1%). Only 7.5% of children consumed modified or infant formula.
Portella et al. (2010)	Cross-sectional Belém, PA; 2005-2006	78 food samples 6-18 months	24-h recall (two) + chemical analysis of food	All samples analyzed showed amounts of iron below the recommended minimum. Excess sodium was found in 89.2 and 31.7% of samples from low and high socioeconomic status groups, respectively.
Rauber et al. (2013)	Longitudinal São Leopoldo, RS; 2001-2002	n = 345 3-4 years	24-h recall (two)	Only 9.6% of children had a good dietary pattern. Dietary variety and dairy consumption was higher and consumption of total and saturated fat was lower among children whose mothers had higher educational level.
Salles-Costa (2010)	Cross-sectional Rio de Janeiro - metropolitan region; 2005	n = 383 6-30 months	24-h recall (two)	Age and food insecurity affected the mean servings of food groups consumed by children. The variance ratio was higher for groups with moderate to severe food insecurity than those with food security; especially for protein in children aged 6-17 months and carbohydrates, for those aged 18-30 months.
Vitolo et al. (2007)	Longitudinal São Leopoldo, RS; 2001-2002	n = 369 <1 year	24-h recall	Meat consumption among children aged 12-16 months was present in 78.4% of surveys, but the consumed portion was insufficient. Higher iron and vitamin C intakes were associated with the absence of anemia.
Vitolo et al. (2010)	Longitudinal São Leopoldo, RS; 2001-2002	n = 345 3-4 years	24-h recall (two)	Dietary advice for mothers during the first year of life was associated with better-quality diet at 3-4 years. Greater number of servings of vegetables and fruits and a greater variety of the diet was observed in the intervention group, in addition to lower consumption of cholesterol. The groups did not differ regarding the consumption of meat, milk, sodium, and fat.

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:maurobmorais@gmail.com (M.B. de Morais).

Brasil

Brasil

Brazilian infant and preschool children feeding: literature review☆ ☆ Please cite this article as: Mello CS, Barros KV, Morais MB. Brazilian infant and preschool children feeding: literature review. J Pediatr (Rio J). 2016;92:451-63.

Abstract

Objective

Data source

Data summary

Conclusions

Brazilian infant and preschool children feeding: literature review^☆ ☆ Please cite this article as: Mello CS, Barros KV, Morais MB. Brazilian infant and preschool children feeding: literature review. J Pediatr (Rio J). 2016;92:451-63.