Amamentação está associada à diversidade alimentar infantil no Brasil

Bortolini, Gisele Ane; Giugliani, Elsa Regina Justo; Gubert, Muriel Bauermann; Santos, Leonor Maria Pacheco

doi:10.1590/1413-812320182411.29312017

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FREE THEMES • Ciênc. saúde coletiva 24 (11) • Nov 2019 • https://doi.org/10.1590/1413-812320182411.29312017 copiar

Amamentação está associada à diversidade alimentar infantil no Brasil

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

O objetivo foi descrever o padrão de consumo alimentar em crianças brasileiras entre 6 e 24 meses e verificar as diferenças entre crianças em aleitamento materno (AM) que consomem ou não outros tipos de leites não-humano (LNH), e aquelas não amamentadas (NAM). Foram usados dados da Pesquisa Nacional de Demografia e Saúde (2006). O consumo alimentar de 1455 crianças foi avaliado usando um questionário de frequência alimentar. Avaliou-se a presença de dieta saudável e diversificada. A associação entre AM e o consumo alimentar foi testado pela regressão de Poisson. Na entrevista, 15,8% das crianças estavam em AM sem consumo de LNH, 30,7% estavam em AM com consumo de LNH e 53% não estavam em AM. Mais da metade consumiam os alimentos recomendados, 78% consumiam alimentos ricos em açúcar, gordura e sal, e apenas 3,4% estavam em uma dieta saudável e diversificada. As crianças em AM que não consumiam LNH tinham quase cinco vezes mais chances de ter uma dieta saudável e diversificada e tinham 19% menos chance de consumir alimentos ricos em açúcar, gordura e sal, comparadas àquelas que também consumiam LNH e àquelas que não estavam em AM.

Palavras-chave
Consumo alimentar; Aleitamento materno; Leite não-humano; Dieta saudável

Foods	Minimum Recommended Frequency*
Fruit/Vegetables	Intake of fruit, vegetables, or leafy greens at least four times a week
Meat	Intake of chicken, beef, or pork at least four times a week
Beans	Intake of beans at least four times a week
Cereals/Tubers	Intake of cereals or tubers at least four times a week
Foods rich in sugar, fat, and salt	No intake of candies, soft drinks, processed snacks, or fried foods in the previous week
Healthy diverse diet	Intake of fruit, vegetables, or leafy greens at least four times a week + intake of meat at least four times a week + intake of fish, liver, or egg at least once a week + intake of beans at least four times a week + intake of cereals or tubers at least four times a week + no intake of candies, soft drinks, processed snacks, or fried foods in the previous week

Household		% (95%CI) ^a a Expanded sample.
Geographic region	North	11.2 (9.5-13.2)
	Northeast	25.5 (22-29.3)
	Southeast	42 (37.2-46.9)
	South	12.7 (10.9-14.8)
	Central-West	8.6 (7.4-10.0)
Residence area	Urban	82.4 (79.4-85)
	Rural	17.6 (15-20.6)
Socioeconomic level	A/B	17.4 (13.5-22.2)
	C	36.0 (31.4-40.8)
	D/E	46.6 (41.1-52.1)
Number of residents in the household	2-3	34.1 (30-38.5)
	4-5	48.4 (43.9-53)
	≥ 6	17.4 (14.6-20.7)
Mother's education level (years)	0-4	37.5 (32.6-42.6)
	5-8	28.7 (24.7-33.1)
	9-11	24.6 (20.9-28.7)
	≥ 12	9.2 (6.7-12.5)
Household food insecurity level	Severe insecurity	7.9 (5.7-10.7)
	Moderate insecurity	12.3 (9.4-16)
	Mild insecurity	27.4 (22.4-33)
	Security	52.4 (46.9-57.8)
Mothers
Age (years)	< 20	15.8 (12.4-19.9)
	≥ 20	84.2 (80.1-87.6)
Marital status	Single\widow\divorced	14.6 (11.3-18.7)
	Married or living with partner	85.4 (81.3-88.7)
Child
Sex	Male	53.5 (48.6-58.4)
	Female	46.5 (41.6-51.4)
Age (months)	6-12	38.2 (34.2-42.4)
	13-23	61.8 (57.6-65.8)
Breastfeeding	Yes	45.0 (40.2-49.9)
	No	55.0 (50.1-59.8)
Breastfeeding status	Breastfed/ non other milks	15.8 (12.8-19.3)
	Breastfed/ other milks	30.7 (26.2-35.5)
	Non-breastfed	53.5 (48.4-58.6)

	Weekly frequency of consumption^a a Expanded sample. (%)
	No intake	1-3 times	4-6 times	Every day
Beans	11.5	18.3	7.5	62.8
Tubers	25.2	45.5	10.2	19.1
Cereals (rice and pasta)	7.8	16.2	6.1	69.9
Leafy greens	59.4	26	4.3	10.4
Vegetables	25.1	37.3	12	25.6
Fruit	14.4	27.9	12.2	45.4
Natural/fresh juice	24.7	26.2	12.7	36.4
Meat (beef or pork)	25.8	44.2	11	19.1
Chicken	29.8	54.7	10.3	5.2
Fish	68.2	28.4	2.4	0.9
Liver	77.1	20.9	1.3	0.8
Egg	50.6	39.3	7.2	2.8
Bread	20	33.0	6.5	40.4
Yogurt	29.0	33.8	14.3	22.9
Fried foods	66.1	26.3	3.8	3.9
Candies	44.0	34.3	8.3	13.5
Cookies	11.1	28.0	18.3	42.7
Processed snacks	58.4	28.5	6.2	6.9
Soft drinks or artificial fruit juices	42.0	33.0	9.6	15.5

Food group	Criteria	% (95%CI) ^a a Expanded sample.
Fruit/vegetables	Intake at least four times a week.	65.1 (59.6-70.2)
Meat	Intake at least four times a week.	40.0 (35.4-44.9)
Beans	Intake at least four times a week.	70.3 (66.2-74)
Cereals/tubers	Intake at least four times a week.	82.3 (78.9-85.3)
No intake of foods rich in sugar, fat, and salt	No intake of candies, soft drinks, processed snacks, or fried foods in the previous week.	22.4 (19.0-26.3)
Healthy diverse diet	Intake of fruit, vegetables, or leafy greens at least four times a week + intake of chicken, beef, or pork at least four times a week + intake of fish, liver or egg at least once a week + intake of beans at least four times a week + intake of cereals or tubers at least four time a week + no intake of candies, soft drinks, processed snacks, or fried foods in the previous week.	3.4 (1.9-5.9)

	Breastfeeding category^a a Breastfeeding categories: Breastfed/ non-other milks: receiving only breast milk and not receiving any other milks; Breastfed/ other milks: receiving other milks in addition to breast milk; non-breastfed: receiving other milks only (and not receiving breast milk). Other milks include animal (cow or goat) milk, powder milk, artificial formula feeding, and soya or rice milk.	% intake	PR (95%CI) Crude Poisson	PR (95%CI) Adjusted Poisson^b b Analyses adjusted for child's age, mother's education level, household region and area, mother's age, number of residents in the household, food insecurity level, and socioeconomic level.
Fruit/Vegetables^c c least 4 times weekly.	Breastfed/non-other milks	58.3	0.85 (0.69-1.05)	0.89 (0.70-1.14)
	Breastfed/ other milks	64.9	0.95 (0.79-1.13)	1.00 (0.82-1.22)
	Non-breastfed	68.3	1	1
Meat^c c least 4 times weekly.	Breastfed/non-other milks	36.2	0.85 (0.61-1.19)	1.00 (0.76-1.31)
	Breastfed/ other milks	36.3	0.85 (0.65-1.12)	1.15 (0.88-1.49)
	Non-breastfed	42.3	1	1
Beans^c c least 4 times weekly.	Breastfed/non-other milks	64.4	0.84 (0.72-0.98)	0.96 (0.82-1.11)
	Breastfed/ other milks	64.5	0.84 (0.73-0.96)	0.95 (0.84-1.07)
	Non-breastfed	76.2	1	1
Cereals/Tubers^c c least 4 times weekly.	Breastfed/non-other milks	75.2	0.86 (0.76-0.98)	0.92 (0.82-1.04)
	Breastfed/ other milks	80.6	0.92 (0.85-1.00)	1.01 (0.94-1.10)
	Non-breastfed	86.6	1	1
Foods rich in sugar, fat, and salt^d d No intake of candies or soft drinks or processed snacks or fried foods in the previous week.	Breastfed/non-other milks	60.4	0.71 (0.58-0.87)	0.81 (0.68-0.97)
	Breastfed/ other milks	76.2	0.90 (0.81-0.99)	0.99 (0.90-1.09)
	Non-breastfed	84.3	1	1
Healthy diverse diet^e e Intake of fruit or vegetables or leafy greens at least 4 times weekly + intake of chicken or beef/pork at least 4 times weekly + intake of fish or liver or egg at least once weekly + intake of beans at least 4 times weekly + intake of cereals or tubers at least 4 times weekly + no intake of candies or soft drinks or processed snacks or fried foods in the previous week.	Breastfed/non-other milks	9.5	3.57 (0.96-13.24)	4.57 (1.67-12.46)
	Breastfed/ other milks	1.5	0.56 (0.12-2.52)	0.89 (0.19-4.19)
	Non-breastfed	2.7	1	1

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborators

The authors participated equally in the writing of this manuscript.