Complementary feeding patterns in the first year of
					life in the city of Rio de Janeiro, Brazil: time trends from 1998 to
					2008

Oliveira, Daniel Alves de; Castro, Inês Rugani Ribeiro de; Jaime, Patricia Constante

doi:10.1590/0102-311X00120013

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ARTICLE • Cad. Saúde Pública 30 (8) • Aug 2014 • https://doi.org/10.1590/0102-311X00120013 copy

Complementary feeding patterns in the first year of life in the city of Rio de Janeiro, Brazil: time trends from 1998 to 2008

Padrões de alimentação complementar no primeiro ano de vida no Município do Rio de Janeiro, Brasil: tendência temporal (1998-2008)

Patrones de alimentación complementaria durante el primer año de vida en la ciudad de Río de Janeiro, Brasil: tendencias temporales (1998-2008)

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study aimed to analyze time trends in complementary feeding practices among children under one year of age in the city of Rio de Janeiro, Brazil, from 1998 to 2008. Based on comparable questions on food consumption in five surveys conducted in representative randomized samples of children in 1998 (n = 3,762), 2000 (n = 3,670), 2003 (n = 4,305), 2006 (n = 3,686), and 2008 (n = 2,621), 16 complementary feeding indicators were constructed. The percentage frequency of all indicators was estimated for each year of the study. Linear trend analyses were also conducted by means of multivariate regression models. All indicators of early complementary feeding decreased from 1998 to 2008. In the 6-11.9 month age group, there was a significant downward trend in the proportion of children receiving food with adequate consistency for their age, consumption of iron-rich foods, and overall adequacy of the diet. A significant upward trend in fruit consumption was observed. There was a decrease in the early complementary feeding, and generally a worsening of complementary feeding practices in children aged 6-11.9 months in Rio de Janeiro during the period studied.

Supplementary Feeding; Infant Nutrition; Temporal Distribution

Variable	Survey year										p-value *
	1998		2000		2003		2006		2008
	n	%	n	%	n	%	n	%	n	%
Infant’s age bracket (months)
< 4	1,201	31.9	1,272	34.7	1,493	34.7	1,275	34.6	923	35.2
4-5.9	654	17.4	647	17.6	741	17.2	566	15.4	428	16.3	0.011
6-11.9	1,907	50.7	1,748	47.6	2,071	48.1	1,845	50.1	1,270	48.5
Maternal age bracket (years)
< 20	724	19.3	670	18.3	602	16.9	600	16.4	358	16.4
20-24	1,054	28.1	1,025	28.0	1,007	28.3	986	26.9	568	26.1
25-29	911	24.3	894	24.4	883	24.8	899	24.6	571	26.2	0.045
30-34	641	17.1	656	17.9	636	17.9	689	18.8	366	16.8
≥ 35	416	11.1	414	11.3	432	12.1	487	13.3	316	14.5
Maternal schooling (complete years of school)
≤ 7	1,410	38.4	1,474	42.0	1,198	35.1	1,049	33.8	627	29.2
8-10	1,179	32.1	927	26.4	933	27.3	930	30.0	589	27.4	0.000
≥ 11	1,083	29.5	1,111	31.6	1,281	37.5	1,123	36.2	934	43.4
Primiparity	3,669	47.6	3,660	46.4	4,254	45.3	3,643	48.5	2,173	46.9	0.106
Maternal work	3,662	24.4	3,634	21.3	4,249	23.3	3,636	26.7	2,167	21.3	0.003

Indicators of early complementary feeding	Survey year										Δ (%) *	p-value **	p-value ***
	1998		2000		2003		2006		2008
	%	SE	%	SE	%	SE	%	SE	%	SE
Water or tea	71.5	1.5	66.3	1.0	64.0	1.3	50.4	1.7	39.7	1.6	(-) 44.0	< 0.001	< 0.001
Fruit or fruit juice	40.6	1.3	36.5	1.4	36.0	1.2	27.9	1.1	25.1	1.3	(-) 38.0	< 0.001	< 0.001
Milk other than breast milk	56.8	1.3	53.7	1.2	48.5	1.0	44.5	1.4	42.0	1.4	(-) 26.0	< 0.001	< 0.001
Any food other than breast milk	81.3	1.2	77.4	0.9	73.8	1.1	63.4	1.5	56.3	1.6	(-) 31.0	< 0.001	< 0.001

Complementary feeding indicators in infants above six months of age	Survey year										Δ (%) *	p-value **	p-value ***
	1998		2000		2003		2006		2008
	%	SE	%	SE	%	SE	%	SE	%	SE
Solid, semi-solid, or soft food consistency among infants 6 to 8.9 months of age	88.7	1.1	92.7	1.0	86.8	1.2	87.6	1.1	86.7	1.4	(-) 2.0	0.004	0.001
Solid consistency food among infants 9 to 11.9 months of age	81.0	1.7	74.5	2.1	76.8	1.6	60.3	1.9	NA	NA	(-) 26.0	< 0.001	< 0.001
Pieces of fruit or mashed fruit among infants 6 to 11.9 months of age	64.1	1.6	65.9	1.7	67.2	1.2	66.0	1.3	72.8	1.6	(+) 14.0	0.003	0.003
Iron-rich foods among infants 6 to 11.9 months of age	84.4	1.1	84.8	1.1	83.1	1.1	81.3	1.2	NA	NA	(-) 4.0	0.121	0.001

Complementary feeding indicators for infants above 6 months of age	Survey year *								Δ (%) **	p-value ***	p-value ^#
	1998		2000		2003		2006
	%	SE	%	SE	%	SE	%	SE
Consumption of at least four food groups	71.9	1.6	71.7	1.6	71.2	1.5	72.5	1.4	(-) 1.0	0.927	0.281
Food groups comprising the above indicator
Legumes	56.9	1.6	54.6	1.8	56.6	1.5	61.3	1.7	(+) 8.0	0.043	0.135
Vegetables	74.6	1.4	76.9	1.4	73.8	1.4	79.4	1.2	(+) 6.0	0.011	0.109
Dairy products	99.5	0.2	99.5	0.2	99.9	0.1	99.9	0.1	0.0	0.109	0.184
Meat	72.7	1.6	73.9	1.5	72.0	1.5	74.6	1.2	(-) 3.0	0.564	0.525
Fruit ^##	83.3	1.2	83.4	1.3	85.8	0.9	83.5	1.0	0.0	0.249	0.165

Summary indicators for complementary feeding among infants above 6 months of age	Survey year *								Δ (%) **	p-value ***	p-value ^#
	1998		2000		2003		2006
	%	SE	%	SE	%	SE	%	SE
Consumption of at least four of five food groups ^## and appropriate consistency for age	67.7	1.7	64.4	1.9	64.6	1.5	56.5	1.4	(-) 17.0	< 0.001	< 0.001
Consumption of the five food groups and appropriate consistency for age	33.2	1.7	31.7	1.8	34.4	1.5	25.2	1.4	(-) 24.0	< 0.001	< 0.001

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[1] Correspondence D. A. Oliveira. Faculdade Bezerra de Araújo. Rua Professor Henrique Costa. 268, apto. 402, Rio de Janeiro, RJ 22770-233, Brasil. ferroliver@yahoo.com.br