Effectiveness of an Intervention to Prevent Ultra-Processed Foods and Added Sugar in the First Year of Life: A Multicentre Randomised Controlled Trial in Brazil

Abstract

Background

The early consumption of ultra-processed foods (UPFs) and added sugars (AS) has been linked to adverse outcomes in infancy. The objective of this study was to determine the effectiveness of a dietary counselling strategy to prevent the consumption of UPFs and AS in the first year of life.

Methodology

A multicentre randomised controlled trial was conducted with 516 mother–child pairs in three state capitals of Brazil. Mothers were randomly assigned to the control group (CG) or intervention group (IG) after childbirth. The IG received orientation based on UNICEF dietary guidelines and five monthly telephone calls to reinforce the intervention. Dietary intake was measured using food introduction questionnaires and 24-h recalls during home visits at 6 and 12 months. Between-group differences were analysed by generalised estimating equations and presented as mean difference (95% CI).

Results

Children in the IG had lower UPF intake at 6 and 12 months of age (−20.69 g/day; 95% CI: −37.87 to −3.50; p = 0.018 and −32.51 g/day; 95% CI: −61.03 to −3.99; p = 0.025) and lower AS intake at 12 months of age (−4.92 g/day; 95% CI: −9.43 to −0.41; p = 0.033). The intervention also had a positive impact on the period of exclusive breastfeeding, reducing the offer of infant formula, cow's milk, and toddler milk in the first year of life.

Principal Conclusions

The dietary counselling strategy was effective at preventing the early consumption of UPFs and AS in the first year of life. Future research should focus on social and cultural barriers to improve adherence to infant feeding interventions.