Commercial foods for infants under the age of 36 months: an assessment of the availability and nutrient profile of ultra-processed foods.

OBJECTIVE: Considering the negative impact of the consumption of ultra-processed foods on health, the current study assessed the availability and nutritional profile of commercial ultra-processed foods for infants in Natal, Brazil. DESIGN: A cross-sectional exploratory study. SETTING: Foods targeted at children under the age of 36 months sold in retail establishments located in high- and low-income areas of the one capital city of Brazil. PARTICIPANTS: 1645 food products consisting of ninety-five different types of food were available. The foods were assessed according to the NOVA classification: minimally processed, processed and ultra-processed. The nutritional content per 100 g was assessed according to processing classification. RESULTS: Half of foods founded were breast milk substitutes and cereal foods (31·6 and 26·3 %, respectively). The foods were predominantly ultra-processed (79 %) and only 4·2 % were minimally processed, with similar proportions of ultra-processed foods being found in both high- and low-income areas. After excluding breast milk substitutes and follow-up formulas, all cereals, food supplements and some of the fruit or vegetable purees were ultra-processed, higher in energy density, fat, carbohydrate and protein and low in fibre (P < 0·05). CONCLUSIONS: The findings reveal that ultra-processed foods for infants are widely available in Brazil, reaffirming the need to strengthen the regulation of foods for infants and young children by introducing complementary measures designed to promote the production and marketing of foods manufactured using lower levels of processing.

Degree of processing and nutritional value of children's food products.

OBJECTIVE: This study aimed to characterise the availability, the nutritional composition and the processing degree of industrial foods for 0-36-month-old children according to the neighbourhoods affluence. DESIGN: A cross-sectional exploratory study. SETTING: All food products available in retail stores for children aged 0-36 months were analysed. Data collection took place in two neighbourhoods, comparing two different sociodemographic districts (high v. low per capita income), Campanhã and Foz do Douro in Porto, Portugal. PARTICIPANTS: A total of 431 commercially processed food products for children aged 0-36 months which are sold in 23 retail stores were identified. Food products were classified according to their processing degree using the NOVA Food Classification System. RESULTS: For NOVA analysis, of the 244 food products that were included 82 (33·6 %) were minimally processed, 25 (10·2 %) processed and 137 (56·1 %) ultra processed. No food product was classified as a culinary ingredient. The products included mostly cereals, yogurts, prevailed in high-income neighbourhoods for the 0-6-month-old group. It was observed that some categories of ultra-processed food (UPF) presented higher amounts of energy, sugars, saturated fat and salt than unprocessed/minimally processed products. CONCLUSIONS: The high availability of UPF offered for 0-36-month-old children should be considered when designing interventions to promote a healthy diet in infancy.

Breast Milk Retinol Levels after Vitamin A Supplementation at Different Postpartum Amounts and Intervals.

Maternal vitamin A (VA) supplementation in risk areas for Vitamin A deficiency (VAD) was launched to improve the level of this nutrient in nursing mothers and in their breast milk. This longitudinal and randomized study aimed to evaluate the levels of retinol in breast milk after supplementation with VA in varying amounts (200,000 IU or 400,000 IU) and different postpartum intervals. Women were distributed into four intervention groups and given a single 200,000 IU postnatal dosage of VA at time 0 h (postnatal morning) (G200 0H); a single 200,000 IU dosage of VA in week four (G200 4W); 200,000 IU of VA at time 0 h + 200,000 IU of VA 24 h after the first supplementation (G400 24H); and 200,000 IU of VA at time 0 h + 200,000 IU of VA one week after the first supplementation (G400 1W). Breast milk samples were collected over a 12-week period (0 h, 24 h and 1, 4, 12 weeks post-natal). Retinol levels were determined by high-performance liquid chromatography. The Generalized Estimated Equation (GEE) assessed the different retinol levels. The G200 (0H), G400 (24H), and G400 (1W) groups presented higher retinol levels at 24 h than the G200 (4W) group (p < 0.001). The retinol levels of all groups were similar at times 1, 4 and 12 weeks after delivery (p > 0.05). Maternal VA supplementation increased retinol levels in the colostrum. Different supplementation dosages or postpartum administration times did not result in added benefit to retinol levels in mature breast milk.

Influence of prematurity and birth weight on the concentration of α-tocopherol in colostrum milk.

OBJECTIVE: To assess vitamin E levels in the breast milk, analyzing the prematurity and the birth weight influence in α-tocopherol concentration of colostrum milk. METHODS: Cross-sectional study, in which the colostrum was collected from 93 nursing mothers in a public maternity of Natal, Rio Grande do Norte, Northeast Brazil. The newborns were classified based on gestational age and birth weight. The analysis of α-tocopherol in the milk was carried out by high performance liquid chromatography. RESULTS: The α-tocopherol concentration in the colostrum of lactating women whose children were born at term was 1,093.6±532.4µg/dL; for preterm infants, the concentration was 1,321.6±708.5µg/dL (p=0.109). In the preterm group, the α-tocopherol concentration in the colostrum of lactating women whose children were born with low and normal birth weight was 1,316.0±790.7 and 1,327.2±655.0µg/dL, respectively (p=0.971). In the term group, the α-tocopherol levels were higher in mothers of children with birth weight >4000g, being 1,821.0±575.4µg/dL, compared to 869.5±532.1µg/dL and 1,039.6±477.5µg/dL with low and adequate birth weight, respectively (p>0.05). CONCLUSIONS: Prematurity did not influence α-tocopherol levels in the colostrum milk. Mothers who had macrossomic term neonates presented increased α-tocopherol levels. These results indicate that birth weight can influence α-tocopherol leves in the colostrum milk.

Influence of prematurity and birth weight on the concentration of -tocopherol in colostrum milk / Influencia de la prematuridad y del peso al nacer sobre la concentracion de -tocoferol en la leche calostro / Influencia da prematuridade e do peso ao nascer sobre a concentracao de -tocoferol no leite colostro

OBJECTIVE: To assess vitamin E levels in the breast milk, analyzing the prematurity and the birth weight influence in α-tocopherol concentration of colostrum milk. METHODS: Cross-sectional study, in which the colostrum was collected from 93 nursing mothers in a public maternity of Natal, Rio Grande do Norte, Northeast Brazil. The newborns were classified based on gestational age and birth weight. The analysis of α-tocopherol in the milk was carried out by high performance liquid chromatography. RESULTS: The α-tocopherol concentration in the colostrum of lactating women whose children were born at term was 1,093.6±532.4µg/dL; for preterm infants, the concentration was 1,321.6±708.5µg/dL (p=0.109). In the preterm group, the α-tocopherol concentration in the colostrum of lactating women whose children were born with low and normal birth weight was 1,316.0±790.7 and 1,327.2±655.0µg/dL, respectively (p=0.971). In the term group, the α-tocopherol levels were higher in mothers of children with birth weight >4000g, being 1,821.0±575.4µg/dL, compared to 869.5±532.1µg/dL and 1,039.6±477.5µg/dL with low and adequate birth weight, respectively (p>0.05). CONCLUSIONS: Prematurity did not influence α-tocopherol levels in the colostrum milk. Mothers who had macrossomic term neonates presented increased α-tocopherol levels. These results indicate that birth weight can influence α-tocopherol leves in the colostrum milk. .

OBJETIVO: Evaluar los niveles de vitamina E en la leche materna, una vez que los lactantes son considerados grupo de riesgo para la deficiencia de esa vitamina, analizando la influencia de la prematuridad y del peso al nacer en la concentración de α-tocoferol en la leche calostro. MÉTODOS: Estudio transversal, con colecta de leche calostro de 93 mujeres atendidas en una maternidad pública de Rio Grande do Norte (Brasil). Los recién nacidos fueron clasificados con base en la edad gestacional y en el peso al nacer. El α-tocoferol fue determinado por cromatografía líquida de alta eficiencia. RESULTADOS: La concentración de α-tocoferol en el calostro de lactantes cuyos hijos nacieron a término fue de 1.093,6±532,4µg/dL; en el caso de recién nacidos pretérmino, la concentración fue de 1.321,6±708,5µg/dL (p=0,109). En el grupo pretérmino, las mujeres con neonatos de bajo peso y de peso adecuado presentaron valores de α-tocoferol de 1.316,0±790,7 y 1.327,2±655,0µg/dL (p=0,971), respectivamente. En el grupo a término, hubo valores superiores de α-tocoferol en mujeres con niños de peso al nacer >4.000g, siendo 1.821,0±575,4µg/dL en comparación a 869,5±532,1µg/dL y 1.039,6±477,5µg/dL con bajo peso y peso adecuado, respectivamente (p>0,05). CONCLUSIONES: A pesar de presentar tendencia de aumento respecto al grupo a término, la prematuridad no influenció el α-tocoferol en el calostro. Sin embargo, lactantes que tuvieron recién nacidos a término con macrosomía presentaron niveles aumentados de α-tocoferol. Esos resultados indican que el peso al nacer puede influenciar el α-tocoferol de la leche, sugiriendo que neonatos con bajo peso pueden ingerir menos vitamina E cuando amamantados. .

OBJETIVO: Avaliar os níveis de vitamina E no leite materno, analisando-se a influência da prematuridade e do peso ao nascer na concentração de α-tocoferol no colostro. MÉTODOS: Estudo transversal, com coleta de leite colostro de 93 mulheres atendidas em uma maternidade pública do Rio Grande do Norte. Os recém-nascidos foram classificados com base na idade gestacional e no peso ao nascer. O α-tocoferol no leite foi determinado por cromatografia líquida de alto desempenho. RESULTADOS: A concentração de α-tocoferol no colostro de lactantes cujos filhos nasceram a termo foi de 1.093,6±532,4µg/dL; no caso de recém-nascidos pré-termo, a concentração foi de 1.321,6±708,5µg/dL (p=0,109). No grupo pré-termo, as mulheres com neonatos de baixo peso e de peso adequado apresentaram valores de α-tocoferol de 1.316,0±790,7 e 1.327,2±655,0µg/dL (p=0,971), respectivamente. No grupo a termo, houve valores maiores de α-tocoferol em mulheres com crianças de peso ao nascer >4000g (1.821,0±575,4µg/dL), em comparação a 869,5±532,1µg/dL e 1.039,6±477,5µg/dL com baixo peso e peso adequado, respectivamente (p>0,05). CONCLUSÕES: Apesar de apresentar tendência de aumento em relação ao grupo a termo, a prematuridade não influenciou o α-tocoferol no colostro. Lactantes que tiveram recém-nascidos a termo com macrossomia apresentaram níveis aumentados de α-tocoferol. Esses resultados indicam que o peso ao nascer pode influenciar o α-tocoferol do colostro. .

Influência da lecitina sobre os níveis de retinol do leite materno / Influence of lecithin on retinol concentration in human milk

O objetivo do estudo foi avaliar o efeito da adição de lecitina sobre a concentração e conseqüente disponibilidade de retinol do leite humano processado. Para tanto, coletaram-se 400mL de leite materno do banco de leite humano da Maternidade Escola Januário Cicco, Brasil. Foram retiradas 10 alíquotas de 1 mL (leite sem lecitina), e em seguida foram adicionados 2g de lecitina. Posteriormente, mais 10 alíquotas foram removidas (leite com lecitina). O leite, após saponificação, foi extraído com hexano e a determinação do retinol foi realizada por meio de cromatografia líquida de alta eficiência. Para análise estatística utilizou-se o teste t de Student. As concentrações médias de retinol nas amostras de leite sem e com lecitina foram respectivamente de 28,0±5,1g/100mL e 35,3±5,0g/100mL, sendo estatisticamente diferentes (p<0,001). Os resultados sugerem que a adição de lecitina ao leite proporciona uma maior oferta de vitamina A. Assim, esta informação é válida para os bancos de leite, pois garantiria o fornecimento de um leite com maior valor nutricional, e para estudos que utilizam o leite como indicador do estado nutricional de lipídios ou vitaminas lipossolúveis.