Associação entre a duração do aleitamento materno exclusivo e total e o consumo de alimentos in natura ou minimamente processados e ultraprocessados adolescentes da coorte BRISA

Abstract

Introduction: Breastfeeding is the first dietary practice in a child's life, providing long-lasting benefits for both maternal and child health. The study of adolescent food consumption is broad and relevant, as it allows for a better understanding of their eating habits and enables interventions to promote health and prevent diet-related diseases. Objective: To investigate the association between the duration of exclusive and total breastfeeding and the consumption of natural or minimally processed foods and ultra-processed foods during adolescence. Methods: This prospective cohort study was conducted with data from 12- to 13-year-old adolescents participating in the BRISA birth cohort, São Luís, Maranhão, 2010. The exposure variable was the duration of exclusive and total breastfeeding, assessed through interviews using structured questionnaires when the participants were 2 years old. The outcome variable was the consumption of natural or minimally processed and ultra-processed foods, evaluated at ages 12- 13 using a 24-hour dietary recall (R24h), in which all foods consumed on the previous day were recorded with the assistance of a photographic manual for children's food quantification. Food intake data were reported in household measures and converted into weight units (grams) and calorie values (Kcal) to calculate total energy intake. Foods were then classified according to the NOVA system, and the caloric percentage of each food group was calculated in relation to the adolescents' total energy intake. Socioeconomic, demographic, and behavioral variables were collected through questionnaires administered at birth, at 2 years, and at 12-13 years. A theoretical model was developed using a Directed Acyclic Graph (DAG) in DAGitty 3.1 software to select variables for confounding control. Descriptive analyses of quantitative and qualitative variables were conducted, along with multinomial regression analyses in R Studio 4.2.1®️ to assess associations, adopting a 5% significance level. Results: The median duration of exclusive and total breastfeeding was 5 and 8 months, respectively. Among all participants, 41.8% were exclusively breastfed for up to 6 months, and 63.9% were breastfed for less than 12 months. Adolescents consumed an average of 1,711.8 Kcal/day, with 52.5% from natural or minimally processed foods and 27.9% from ultra-processed foods. However, the duration of exclusive and total breastfeeding showed no statistically significant association with the consumption of these food groups after multinomial regression analyses. Conclusion: Further research is necessary to explore the long-term protective effects of breastfeeding on the development of healthier eating habits. Additionally, efforts should focus on reinforcing public policies that promote, protect, and support breastfeeding and adequate complementary feeding. Moreover, it is crucial to reduce the consumption of ultra-processed foods during adolescence and encourage diets based on traditional foods.