Home availability of ultraprocessed foods in families who prepare meals at home / Disponibilidade de alimentos ultraprocessados nos domicílios de famílias que preparam refeições em casa

ABSTRACT Objective This study characterized the degree of processing of the food items available at home and the routine of shopping for food in families with children and/or teenagers and whose meals are usually prepared at home. Methods Mixed methods (interview, questionnaires, and food inventory). Interview's transcripts were submitted to thematic analysis and the foods identified in the inventory were classified according to the degree of processing and analyzed for their availability and access in the home food environment. Results Results revealed the high availability of ultra-processed foods; that the supermarket was the main source of food acquisition; and that purchasing food is part of an organized routine where time and control of expenses are the most valued aspects. Conclusion Actions which focus on planning and executing the acquisition of unprocessed and minimally processed foods are needed to promote greater availability and increased intake of such foods, so that the composition of homemade meals may be in line with what is recommended by the national dietary guidelines.

RESUMO Objetivo O presente estudo caracterizou o grau de processamento dos alimentos disponíveis e a rotina de compra de alimentos de famílias com crianças e/ou adolescentes e que costumam preparar refeições em casa. Métodos Métodos mistos (entrevista, questionário e inventário de alimentos). As transcrições das entrevistas foram submetidas à análise temática e os alimentos identificados no inventário foram classificados segundo o grau de processamento e analisados quanto à disponibilidade e acessibilidade no ambiente alimentar domiciliar. Resultados Os resultados revelaram que a disponibilidade de alimentos ultraprocessados foi alta; que o supermercado foi o principal local de aquisição de alimentos e que a compra de alimentos faz parte de uma rotina previamente organizada em que o tempo e o controle de gastos são os aspectos mais valorizados. Conclusão Ações focadas no planejamento e execução da compra de alimentos in natura e minimamente processados são necessárias para promover maior disponibilidade domiciliar e, consequentemente, o consumo de alimentos in natura e minimamente processados, aproximando as refeições realizadas em casa do que é preconizado pelo Guia Alimentar para a População Brasileira.

"Macho food": Masculinities, food preferences, eating practices history and commensality among gay bears in São Paulo, Brazil.

This article describes and explore eating practices and food preferences among gay men who call themselves bears in São Paulo, Brazil, and their relation with their life history, masculinities representations, and sexuality. It is a qualitative and quantitative research within an ethnographic perspective. A purposive sample of thirty-five self-declared gay bears. The data were analyzed identifying the regular, expressive and meaningful significance units collected through the interviews. We identified that the self-declared bears in São Paulo, Brazil, build a solid relation between food preferences, eating practices, masculinity, and group belonging. From the bear's perspective, meat, especially bovine, is related to masculinity and extensively understood as a strong common bond within the community, leveraging their sexuality. For these persons, eating meat as well as drinking beer can build the ideal mannish and unfeminine body that is overvalue. Being gay and "eating like a man," as well as exposing a "macho" body while disdaining other body types constructions could represent a strategy to avoid discrimination, shame and humiliation. On the other way, this community does not just linearly imitate heterosexual men although their conducts can reproduce patriarchal representations and meanings through eating practices. These findings could be used to understand the complexity of alimentary practices, particularly food preferences as well as commensalities, among specific communities or membership groups.

Nutrition Label Use Is Related to Chronic Conditions among Mexicans: Data from the Mexican National Health and Nutrition Survey 2016.

BACKGROUND: Non-communicable diseases, such as obesity, diabetes, and hypertension, can be prevented and treated through a balanced nutrient-rich diet. Nutrition labels have been recognized as crucial to preventing obesity and non-communicable diseases through a healthier diet. OBJECTIVE: Our aim was to examine the association between nutrition label use and chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension) among an adult Mexican population. DESIGN: This was a cross-sectional study that used data from the Mexican National Health and Nutrition Survey of 2016 (ENSANUT MC 2016). PARTICIPANTS/SETTING: The participants were 5,013 adults aged 20 to 70 years old. Older adults (>70 years), illiterate participants, pregnant women, and participants with implausible blood pressure data were excluded from the sample. The survey was conducted from May to August 2016 in the participants' households. MAIN OUTCOME MEASURES: We measured chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension). STATISTICAL ANALYSES PERFORMED: Pearson χ2 test was used to examine the associations among the use of nutrition labels and sociodemographic characteristics and chronic conditions. Multiple logistic regression was used to determine the association between nutrition label use and chronic conditions adjusting for the effect of confounding variables like sex, age, body mass index, education level, marital status, ethnicity, residence area, region, and socioeconomic status. RESULTS: From the total sample, 40.9% (95% CI 38.4% to 43.8%) reported using nutrition labeling. Respondents with overweight or obesity were less likely to use nutrition labels (odds ratio 0.74; P<0.05). Participants who self-reported diabetes had significantly lower odds of nutrition label use than participants who did not report to have diabetes (odds ratio 0.66; P<0.05). Participants having 3 chronic conditions had lower odds of nutrition label use (odds ratio 0.34; P<0.01) relative to having zero chronic conditions. CONCLUSIONS: This study suggests an association between nutrition label use and chronic conditions (obesity and diabetes). These findings demonstrate that people with obesity, diabetes, and a combination of chronic conditions were less likely to use nutrition labels than people without these conditions.

Consumer perception and use of nopal (Opuntia ficus-indica): A cross-cultural study between Mexico and Brazil.

The objective of the present study was, in a first moment, to observe the consumers' perception, qualitatively and quantitatively, with respect to nopal through a cross-cultural study among participants from Mexico (n = 200) and Brazil (n = 200), traditional and potential consumers, respectively. And, secondly, to use a Brazilian nopal cookie to complement the perception of the Brazilians regarding the nopal, evaluating their sensory acceptance and possible commercial potential in this country through the Check All That Apply (CATA) test. The cross-cultural study using the word association task has shown that although nopal is not part of the Brazilian food culture, people are willing to accept it as food because of its functional properties. This result, coupled with the positive acceptance of Mexican nopal cookies, confirmed the primary objective of working with products made from this unfamiliar vegetable in Brazil. In this context, the use of Brazilian nopal cladodes resulted in cookies with satisfactory sensory acceptance. This acceptance was similar to the one obtained by the Mexican commercial cookies. The affective and the CATA tests constitute a potential tool to evaluate and develop innovative products made with nopal, thus increasing their commercial potential. The results obtained provide support for a better utilization of this food, mainly in the arid and semi-arid regions, where this cactus is generally abundant, considering the social and cultural context to which the nopal is inserted in each country.

A cross-cultural analysis of children's vegetable preferences.

The successful promotion of vegetable consumption by children requires a deep understanding of children's vegetable preferences as well as the factors shaping them throughout childhood. This study analyzed children vegetable liking in four different age ranges (5-6, 7-8, 9-10 and 11-12 years old) in Chile, China and the United States. Three hundred and eighty-four children completed this study. All participants tasted and rated 14 different vegetables for liking and described the samples using Check-All-That-Apply (CATA). We found significant differences in degree of overall liking among children from the three countries (p < 0.001). Specifically, children in China gave higher overall liking scores than children in the US, and in the US higher than in Chile. Child age and gender did not influence children's vegetable overall liking across the three countries. Across all countries and age groups, liking of taste and texture were the best predictors of children overall liking. The penalty analysis of CATA selections by children showed that the mean impact of the attributes that children used to describe the samples on their liking varied among countries, with the descriptors having the least impact on liking for Chinese children.

Contribution of the production for self-consumption to food availability and food security in households of the rural area of a Brazilian city.

Production for self-consumption can meet the principles of food safety such as respect for food habits and diversity. The participation of production for self-consumption in food availability was compared to the purchase of food for 30 days in 79 households (272 inhabitants) of the rural area of a Brazilian city in 2012. The food security was evaluated by the method "Food energy deficiency in the domicile" that classified 12.7% of the households as insecure. In all households, staple foods (rice, pasta, corn, beans, milk, eggs, meats) were available and more than 60% had processed foods (cookies, soft drinks). Only 22.7% of the calories came from production for own consumption and the biggest expense was the purchase of carbohydrates (91.1%), mainly sugar (12.2%). Evaluating only the energy availability of food is not sufficient since the quality and origin of food is of great relevance in the food security condition.

Consumer profile and acceptability of cooked beef steaks with edible and active coating containing oregano and rosemary essential oils.

Fresh animal products are highly perishable and characterized by a short shelf-life. Edible coatings with natural antioxidants (essential oils: EOs) could improve stability, ensure quality, and increase the shelf-life of fresh products. Due to the strong flavor of EOs, their use should consider consumer preferences and sensory acceptability. This study evaluated the effects of edible coating (with oregano and rosemary essential oil) on beef in relation to consumer preferences, besides the determination of habits of consumption and buying intentions of consumers. Acceptability scores from three clusters of consumers was described. Coating with oregano was the preferred. The higher consumer acceptance and willingness to buy this product indicate a great potential and possibility of using coatings with essential oils in fresh animal products.

Characterization of the Types of Sweeteners Consumed in Honduras.

Sweeteners are found in all types of foods, and their high consumption is associated with chronic degenerative diseases, such as diabetes and obesity, among others. A characterization was carried out of food products with sweeteners from the three biggest supermarkets at a national level; they were identified by the list of ingredients and classified according to caloric or non-caloric intake, and pursuant to their country of origin. A statistical interpretation of results was made using descriptive measures such as the number of times the sweeteners were found in the formulation of the products and how many of them were found in a product at the same time. In total, 341 products were evaluated and classified according to the processed food categories of the Pan American Health Organization (PAHO) nutrient profile. The category of beverages had the highest quantity of products with sweeteners, and their consumption by the inhabitants represents a high exposure. Overall, 60.1% of the products evaluated were of US origin; these US exports have a significant impact on the Honduran market. A high-fructose corn syrup caloric sweetener was the one most frequently found in these products; at least 51% are combined with additional sweeteners to increase the sweetening effect.

Changing Places, Changing Plates? A Binational Comparison of Barriers and Facilitators to Healthful Eating Among Central American Communities.

To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus groups, n = 28 adults) and in the US (30 in-depth interviews n = 15 mothers recently migrated from Central America). There was a strong emphasis on hygiene and vitamin-content of foods among participants in El Salvador. In both settings, participants perceived that their respective community food environments (schools, food stores) exposed their families to highly processed, unhealthful foods. In both settings, they described similar struggles to encourage their families to eat foods healthfully (traditional, home-made foods). These results underscore the importance of acknowledging the changing food environment in sending countries where people may already be exposed to processed foods.

A comparison of five methodological variants of emoji questionnaires for measuring product elicited emotional associations: An application with seafood among Chinese consumers.

Product insights beyond hedonic responses are increasingly sought and include emotional associations. Various word-based questionnaires for direct measurement exist and an emoji variant was recently proposed. Herein, emotion words are replaced with emoji conveying a range of emotions. Further assessment of emoji questionnaires is needed to establish their relevance in food-related consumer research. Methodological research contributes hereto and in the present research the effects of question wording and response format are considered. Specifically, a web study was conducted with Chinese consumers (n=750) using four seafood names as stimuli (mussels, lobster, squid and abalone). Emotional associations were elicited using 33 facial emoji. Explicit reference to "how would you feel?" in the question wording changed product emoji profiles minimally. Consumers selected only a few emoji per stimulus when using CATA (check-all-that-apply) questions, and layout of the CATA question had only a small impact on responses. A comparison of CATA questions with forced yes/no questions and RATA (rate-all-that-apply) questions revealed an increase in frequency of emoji use for yes/no questions, but not a corresponding improvement in sample discrimination. For the stimuli in this research, which elicited similar emotional associations, RATA was probably the best methodological choice, with 8.5 emoji being used per stimulus, on average, and increased sample discrimination relative to CATA (12% vs. 6-8%). The research provided additional support for the potential of emoji surveys as a method for measurement of emotional associations to foods and beverages and began contributing to development of guidelines for implementation.

Secular trends in dietary patterns of young children in Brazil from 1996 to 2006.

OBJECTIVE: To describe dietary patterns (DP) from 1996 to 2006 and in the first 5 years of life and to explore individual and contextual characteristics associated with each DP. DESIGN: DP were defined by principal component analysis. The association between DP and individual (sociodemographic, maternal and child) and contextual (geographic regional and year) characteristics was analysed by multilevel analysis. SETTING: Two complex probabilistic Brazilian Demographic and Health Surveys (BDHS 1996, 2006). SUBJECTS: Brazilian children under 5 years of age. RESULTS: DP1 included yoghurt, vegetables, fruits, tubers, red meat. DP2 included liquids, milk, fruits, egg/chicken/fish, red meat, breast milk (negative loading). DP3 included fruit juices, 'papilla', yoghurt, red meat (negative loading). DP4 included formulas, milk, enriched 'papilla', egg/chicken/fish (negative loading). DP prevalence within the age range from 1996 to 2006 remained constant for DP1; increased after 12 and 6 months, respectively, for DP2 and DP3; and decreased for DP4. DP1 was explained by higher maternal education, wealth, lower number of children at home; DP2 by living in rural area and younger mothers; and DP4 by lower maternal education and wealth. The total variance of the model attributable to geographic region was 30·2, 20·7 and 54·2 % for DP2, DP3 and DP4, respectively. CONCLUSIONS: DP trends observed from 1996 to 2006 show positive aspects, such as: maintenance of DP1 as the main DP after 12 months; an increase in the prevalence of DP2 and DP3 followed by a decrease of DP4 after 6 months. DP1 is explained mainly by socio-economic factors, regardless of contextual characteristics, and DP2, DP3, DP4 are partially explained by contextual effects.

Sensory properties of chile pepper heat - and its importance to food quality and cultural preference.

Chile peppers are one of the most important vegetable and spice crops in the world. They contain capsaicinoids that are responsible for the characteristic burning (pungency) sensation. Currently, there are 22 known naturally occurring capsaicinoids that can cause the heat sensation when consumed. Each produces a different heat sensation effect in the mouth. A need exists for a standard and new terminology to describe the complex heat sensation one feels when eating a chile pepper. A comprehensive set of descriptors to describe the sensory characteristics of chile pepper heat was developed. It was validated with trained panelists tasting samples representing the five domesticated species and 14 pod-types within these species. Five key attributes that define and reference a lexicon for describing the heat sensation of chile peppers were determined to describe the heat sensation in any product, and importantly, can be used in the food industry worldwide.

Impact of front-of-pack nutrition information and label design on children's choice of two snack foods: Comparison of warnings and the traffic-light system.

Research on the relative influence of package features on children's perception of food products is still necessary to aid policy design and development. The aim of the present work was to evaluate the relative influence of two front-of-pack (FOP) nutrition labelling schemes, the traffic light system and Chilean warning system, and label design on children's choice of two popular snack foods in Uruguay, wafer cookies and orange juice. A total of 442 children in grades 4 to 6 from 12 primary schools in Montevideo (Uruguay) participated in the study. They were asked to complete a choice-conjoint task with wafer cookies and orange juice labels, varying in label design and the inclusion of FOP nutrition information. Half of the children completed the task with labels featuring the traffic-light system (n = 217) and the other half with labels featuring the Chilean warning system (n = 225). Children's choices of wafer cookies and juice labels was significantly influenced by both label design and FOP nutritional labels. The relative impact of FOP nutritional labelling on children's choices was higher for the warning system compared to the traffic-light system. Results from the present work stress the need to regulate the design of packages and the inclusion of nutrient claims, and provide preliminary evidence of the potential of warnings to discourage children's choice of unhealthful products.

Food cravings among Brazilian population.

This study aimed to develop and validate a Brazilian version of the Food Craving Inventory (FCI-Br), adapted to the cultural-gastronomic context of Brazil, and to explore this behavior among adult Brazilians. The Study 1 population consisted of 453 adults from all regions of Brazil. Participants responded to a preliminary form of the instrument online. Exploratory factor analysis revealed an FCI-Br presenting 23 items and three factors: High Fat, Sweet Food and Traditional Meal. The FCI-Br overall reliability was considered adequate (α = 0.82), as were each of the sub-scales. The food items receiving higher average scores from the application of the instrument were chocolate (3.14 ± 1.28; women) and bread (2.94 ± 1.44, men). A significant association was observed between the specific-craving for Sweet Food and female respondents. Most participants reported experiencing more frequent episodes of food craving when alone (68.0%; n = 391) and during the afternoon (32.2%; n = 127) or evening (43.8%; n = 173) hours. Application of the FCI-Br in a population of 649 university students (Study 2) demonstrated a good adjustment of the model developed according to the Confirmatory factor analysis (χ2/gl = 2.82, CFI = 0.94; TLI = 0.93; RMSEA = 0.06). The current findings indicate that the FCI-Br has adequate psychometric properties to measure craving behavior with respect to specific food groups in the resident population of Brazil. The results of this study also shed light on the importance of considering the cultural diversity of a population when investigating eating behaviors.

Brazilian version of food cravings questionnaires: Psychometric properties and sex differences.

The Food Cravings Questionnaires, State (FCQ-State) and Trait (FCQ-Trait), are commonly used to assess food-craving behavior. This study aimed to develop and validate the Brazilian version of these questionnaires, and to explore potential gender differences in the trait version scores. Data were collected from (n = 611) undergraduate students. Confirmatory factor analysis was conducted to examine the questionnaires structure, and construct validity was assessed. The FCQ-State-Br and FCQ-Trait-Br presented good psychometric properties, adequate model fit, and internal consistency, in general and by gender. A conservation of original structure of the Food Cravings Questionnaires was verified in the Brazilian versions. A good performance in the evaluations concerning the discriminant and convergent validity seem to corroborate these structures. Overweight individuals showed an increase in food-craving behavior. In females, this increase occurred in the guilt dimension, whereas in males, the increase was in the lack of control dimension. In addition, female dieters presented higher scores on the guilt dimension compared with female non-dieters. FCQ-State-Br and FCQ-Trait-Br constitute valid instruments for measuring food-craving behavior in the Brazilian population. Moreover, these findings suggest that food cravings may be an important aspect to be considered in clinical management of overweight individuals, and may require a sex-specific approach.

Factors related to food involvement in the adult population / Fatores relacionados ao envolvimento com alimentação da população adulta

ABSTRACT Objective This study aimed to investigate aspects associated with food involvement and to ascertain whether individuals with higher food involvement consume larger amounts of fruits and vegetables. Methods This cross-sectional, analytical study was conducted with 301 adults (19-59 years old) from the Federal District, Brazil. Sample size calculation was based on numbers from the Brazilian Demographic Census and on consumption data for fruits and vegetables obtained from the Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Interviews survey. Data were collected in October of 2012. The questionnaire comprised 28 questions and included socio-demographic variables, reported fruit and vegetable consumption, and an adapted food involvement scale. Data were analyzed using Statistical Package for the Social Sciences software. Descriptive and comparative analyses were performed to determine population characteristics . Results Women and older individuals displayed a higher degree of food involvement than did men and younger individuals ( p <0.001). Among the factors included in food involvement, the highest influence was attributed to satisfaction in preparing food (cooking), pre-preparation of food, and pleasure in cooking for other people ( p <0.001). Conclusion The results presented here suggest that food involvement can be stimulated through innovative strategies of communication that go beyond the biological arguments and focus on the cultural expression of the elements of socialization, whose relationship with eating is well established.

RESUMO Objetivo Investigar os aspectos associados ao envolvimento com alimentação e verificar se os indivíduos que apresentam um maior envolvimento com alimentação consomem maiores quantidades de frutas e hortaliças. Métodos Estudo analítico transversal conduzido com 301 adultos (19-59 anos) do Distrito Federal. O cálculo amostral foi baseado no quantitativo fornecido pelo Censo Demográfico Brasileiro e em dados de consumo referido de frutas e hortaliças, de acordo com dados da pesquisa Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico. A coleta de dados ocorreu em outubro de 2012. O questionário, composto por 28 questões abrangeo as variáveis sócio-demográficas, consumo referido de frutas e hortaliças e uma escala de envolvimento com alimentação, adaptada. Os dados foram analisados utilizando o software Statistical Package for the Social Sciences. Análises descritivas e comparativas foram realizadas para verificar as características da população. Resultados Mulheres e indivíduos mais velhos apresentaram um grau de envolvimento com a alimentação maior que homens e pessoas mais jovens (p<0,001). Dentre os fatores que compõem o envolvimento com alimentação tiveram maior influência os relacionados à satisfação em preparar de alimentos (cozinhar), ao pré-preparo de alimentos e ao prazer de cozinhar para outras pessoas (p<0,001). Conclusão Os resultados apresentados sugerem que o envolvimento com alimentação pode ser estimulado por meio de estratégias de comunicação inovadoras, que ultrapassem o sentido biológico e se concentrem na expressão cultural sobre os elementos de socialização, reconhecidamente relacionados à alimentação.

Healthy casetas: A potential strategy to improve the food environment in low-income schools to reduce obesity in children in Guatemala City.

Developing countries have undergone transitions driven by globalization and development, accelerating increases in prevalence of overweight and obesity among children. Schools have been identified as effective settings for interventions that target children's dietary behaviors. In Guatemala, public schools commonly have food kiosks (Casetas) that sell products to children. From July through October 2013, observations during recess, in-depth interviews with school principals (n = 4) and caseta vendors (n = 4), and focus groups with children (n = 48) were conducted. This article explores products available to children at casetas. Factors that affect what casetas offer include regulations and enforcement, vendor investment and earnings, vendor resources, product demand, pricing, and children's preferences. These factors influence the products that are available and children's tendency to purchase them. Potential strategies for improvement include healthy food preparation, price manipulation and promotions, raffles and games to encourage healthier choices, and policy to push toward development of healthier products.

Barriers to Eating Traditional Foods Vary by Age Group in Ecuador With Biodiversity Loss as a Key Issue.

OBJECTIVE: To document the perceptions of indigenous peoples for the sustainable management of natural resources against malnutrition. DESIGN: Initially 4 and then 12 interviews were conducted with 4 different age groups. SETTING: Eight rural villages in Guasaganda, central Ecuador, were studied in 2011-2012. PARTICIPANTS: A total of 75 people (22 children, 18 adolescents, 20 adults, and 15 elders). MAIN OUTCOME MEASURES: Benefits, severity, susceptibility, barriers, cues to action, and self-efficacy of eating traditional foods. ANALYSIS: Qualitative content analysis was completed using NVivo software. Initial analysis was inductive, followed by a content analysis directed by the Health Belief Model. Coding was completed independently by 2 researchers and kappa statistics (κ ≥ 0.65) were used to evaluate agreement. RESULTS: Healthy perceptions toward traditional foods existed and differed by age. Local young people ate traditional foods for their health benefits and good taste; adults cultivated traditional foods that had an economic benefit. Traditional knowledge used for consumption and cultivation of traditional foods was present but needs to be disseminated. CONCLUSIONS AND IMPLICATIONS: Nutrition education in schools is needed that supports traditional knowledge in younger groups and prevents dietary changes toward unhealthy eating. Increased production of traditional food is needed to address current economic realities.

Promoting multi-micronutrient powders (MNP) in Peru: acceptance by caregivers and role of health personnel.

UNLABELLED: Iron deficiency causes anaemia and other adverse effects on the nutritional status and development of millions of children. Multi-micronutrient powders (MNP) have been shown to reduce anaemia in young children. In Peru, 50% of children 6-36 months are anaemic. Since 2009, the government has started distributing MNP. This qualitative study explored the acceptability of MNP by caregivers and the role of health personnel (HP) in three regions (Apurimac, Ayacucho and Cajamarca), piloting the MNP programme between 2009 and 2011. Data collection consisted of interviews (35) and observations (13) with caregivers and HP (11). In Cajamarca, 16 families were visited three times in their homes to understand caregivers' use and difficulties. Results showed the critical role HP has in influencing caregiver understanding and use of the MNP, as well as the need for training to avoid confusing messages and provide counselling techniques that consider cultural sensitivity to optimize HP interactions with caregivers and adapt the recommendations for MNP use to local family feeding routines. There was greater acceptance of MNP by caregivers giving semi-solid foods (e.g. purees) to their children than those who served dilute preparations (e.g. soups). Acceptance was similar across regions, but there were some differences between urban and rural settings. Home visits were shown to be a key in improving the use of MNP by caregivers as misunderstandings on preparation, required consistency and optimum practices were common. These findings can contribute to strategies to enhance acceptability and use. KEY MESSAGES: Acceptance and use of multi-micronutrient powders (MNP) by caregivers greatly depend upon how it is presented, promoted and counselled by health personnel. Counselling for MNP use needs to consider and adapt to the local cultural context and incorporate family and child feeding routines. MNP are presented as part of appropriate feeding practices, encouraging caregivers to find simple and acceptable ways of giving semi-solid or solid foods with which to mix it.

Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua.

Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours.