Energy contribution from ultra-processed foods in Peruvian children: Frequency, Bimodality and Determinants

Objective: To assess the energy contribution of ultra-processed foods (UPF) and its association to sociodemographic and anthropometric factors in 6-35 months old children in the databases of national surveys carried out in 2008-2010, 2015-2016 and 2019. Methods: All surveys were stratified multi-stage random samples. Sub-samples had 24-hr food recall on a random day for each child, using a modified multiple step method with visual aids and scales. UPF were defined based on the Nova 4 classification system. Factors were evaluated with two generalized linear models (binomial for the percentage of UPF consumers and normal for the mean UPF energy contribution among UPF consumers only). Estimations and models were adjusted by the sampling design. Results: 2887 children were included. UPF contributed 29% CI95 27 to 31 of the total energy intake. UPF contributed 31% 30 to 33% of energy intake among UPF consumers, decreasing with age, increasing with height-for-age and showing seasonal variation. UPF were consumed by 86% 84 to 89% of children, increasing with age and height-for-age, slightly increasing over the years and decreasing with poverty. UPF energy contribution comes mainly from milk and derivatives 19% 17 to 20 and cereals 5% 4 to 6. Conclusions: The mean UPF energy contribution and the percentage of UPF consumers vary with age, height, poverty and survey year in 6-35 months old children in Peru. Keywords: Peru; Children; Food Intake; Energy Intake; Ultra-processed Foods.