Journal of nutrition education and behavior | 2021
Primary Health Care Intervention Reduces Added Sugars Consumption During Childhood.
Abstract
OBJECTIVE\nTo investigate the effectiveness of a training program for health workers regarding infant feeding practices to reduce sugar consumption in children.\n\n\nDESIGN\nA cluster randomized trial was conducted at 20 health centers in southern Brazil randomly assigned to an intervention (n\u202f=\u202f9) or control (n\u202f=\u202f11) group.\n\n\nPARTICIPANTS\nThe 715 pregnant women enrolled were assessed when their children were aged 6 months, 3 years, and 6 years.\n\n\nINTERVENTION\nA training session for primary care workers based on the Brazilian National Guidelines for Children.\n\n\nMAIN OUTCOME MEASURE\nMothers were asked when sugar was first offered to children. Added sugars intake was obtained from dietary recalls.\n\n\nANALYSIS\nThe effectiveness of the intervention was modeled using generalized estimation equations and Poisson regression with robust variance.\n\n\nRESULTS\nChildren attending intervention health centers had a 27% reduced risk of sugar introduction before 4 months of age (relative risk, 0.73; 95% confidence interval [CI], 0.61-0.87) as well as lower added sugars consumption (difference, -6.36 g/d; 95% CI, -11.49 to -1.23) and total daily energy intake (difference, -116.90 kcal/d; 95% CI, -222.41 to -11.40) at 3 years of age.\n\n\nCONCLUSIONS AND IMPLICATIONS\nHealth care worker training in infant feeding guidelines may be an effective intervention to delay the introduction of added sugars and lower the subsequent intake of added sugars in infants and toddlers.