Preparações lácteas consumidas por crianças menores de dois anos usuárias do SUS no município do Rio de Janeiro: caracterização, adequação às recomendações e composição nutricional segundo a participação de alimentos ultraprocessados

Abstract

Introduction: The use of milk preparations (MP) in the diet of children in the first two years of life is recurrent, however, little is known about their composition. Objective: To analyze the nutritional composition of MP consumed by children from six to 23 months of age. Methods: This is a subsample of a larger, sectional study, conducted in a probabilistic and representative sample of children aged six to 59 months using the Unified Health System in the city of Rio de Janeiro (n = 536). We analyzed the PLs referred by those responsible for children from 6 to 23 months (n = 190) and considered only those with complete description of the recall in the 24h recall (n = 183). They were divided into four types and 25 subtypes according to their ingredients, being characterized and compared to breast milk considering the averages of energy, protein, fat, carbohydrate, calcium, iron, zinc, vitamin A (retinol equivalent) and vitamin C in 100 milliliters. The appropriateness of the reconstitution of milk products in powder form has been examined; 500 mL of PL (considered the maximum recommended volume for breast milk substitutes) in relation to the nutrient needs of the child, considering DRI; the percentage of energy intake from UPAs in 100 kcal of each PL was calculated and the nutritional composition of PLs was analyzed as a function of this participation. Results: The majority of the MP referred by the participants of this study was composed of cow's milk, whether pure (1.6%) or added with a thickener and / or sugar and / or fruit (77.6%). Of the total MP analyzed, 85% contained at least one AUP. In most preparations where powdered milk products (71.6%) have been used, reconstitution of the product was performed with product concentration below that recommended by the manufacturer. However, they were high in protein, calories and had excessive levels of micronutrients when compared to breast milk. In general, they extrapolated the daily nutrient requirements for proteins and micronutrients into 500 mL of product. Although they had a positive correlation for carbohydrates and most of the analyzed micronutrients and a negative correlation for proteins and lipids due to the relative participation of AUP in MP, independently of this participation, the analyzed MP presented a very different nutritional profile than that of the breast milk Conclusion: The studied PL had low nutritional quality, which could compromise the formation of eating habits and the health of the children. It is necessary to qualify the approach of health professionals on nutrition in the first years of life in basic health care units, aiming the promotion of complementary breastfeeding and healthy feeding, as well as other public policies aimed at guaranteeing the human right to health. adequate and healthy food