# Description and evaluation of an ultra-processed food consumption score for children

## TL;DR

This study introduces a quick tool to assess ultra-processed food consumption in young children and shows it effectively reflects their dietary intake.

## Contribution

A practical ultra-processed food consumption screener for children is proposed and validated using a 24-hour food recall.

## Key findings

- The ultra-processed food consumption score was significantly associated with the percentage of energy from ultra-processed foods.
- There was substantial agreement between the score and dietary intake as measured by the 24-hour recall (Pabak index = 0.65).
- The screener is a practical and effective tool for assessing ultra-processed food consumption in young children.

## Abstract

To present a screener for consumption of ultra-processed foods for children in early childhood, evaluating the ability of the score generated by this screener to reflect the participation of ultra-processed foods in children’s diets.

This study was conducted with a convenience subsample of the 2015 Pelotas Birth Cohort (n = 365). The mothers of the participating children answered a food consumption questionnaire the day before the interview (screener) containing 16 subgroups of ultra-processed foods, followed by a traditional 24-hour food recall (24hR). Each participant’s ultra-processed food consumption score corresponded to the number of food subgroups consumed and the percentage of energy derived from the participation of ultra-processed foods in the diet on the same day was calculated from the answers in the 24hR. The association between the score and the percentage of energy from ultra-processed foods was tested using linear regression models. The degree of agreement between the classification of participants according to approximate fifths of the percentage of calories from ultra-processed foods and according to the score intervals was assessed using the Pabak index.

The average percentage share of ultra-processed foods in the total caloric value of the diet, calculated using the 24hR, was directly and significantly associated with an increase in the ultra-processed food consumption score. There was substantial agreement between the ranges of the ultra-processed food consumption score obtained by the screener and the approximate fifths of the share of ultra-processed foods in the diet calculated by the 24hR (Pabak index = 0.65).

The ultra-processed food consumption score, obtained from an ultra-processed food consumption screener, a practical and agile instrument, is capable of reflecting the participation of ultra-processed foods in children’s diets, with regard to the 2015 Pelotas Birth Cohort.

Apresentar um rastreador para consumo de alimentos ultraprocessados para crianças na primeira infância, avaliando a capacidade do escore gerado por esse rastreador de refletir a participação de alimentos ultraprocessados na alimentação das crianças.

Estudo realizado com uma subamostra de conveniência da Coorte de Nascimentos de Pelotas de 2015 (n = 365). As mães das crianças participantes responderam a um questionário de consumo alimentar no dia anterior à entrevista (rastreador) contendo 16 subgrupos de alimentos ultraprocessados, seguido por um recordatório alimentar tradicional de 24 horas (R24h). O escore de consumo de alimentos ultraprocessados de cada participante correspondeu ao número de subgrupos de alimentos consumidos e o percentual de energia proveniente da participação dos alimentos ultraprocessados na alimentação do mesmo dia foi calculado a partir das respostas do R24h. A associação entre o escore e o percentual de energia proveniente de alimentos ultraprocessados foi testada por modelos de regressão linear. A avaliação do grau de concordância entre a classificação dos participantes segundo quintos aproximados do percentual de calorias de alimentos ultraprocessados e segundo os intervalos do escore foi feita a partir do índice Pabak.

O percentual médio de participação de alimentos ultraprocessados no valor calórico total da dieta, calculado com base no R24h, foi direta e significativamente associado com o aumento do escore de consumo de alimentos ultraprocessados. Foi observada concordância substancial entre os intervalos do escore de consumo de alimentos ultraprocessados, obtido pelo rastreador, e os quintos aproximados da participação de alimentos ultraprocessados na dieta, calculada pelo R24h (índice Pabak = 0,65).

O escore de consumo de alimentos ultraprocessados, obtido a partir de um rastreador de consumo de alimentos ultraprocessados, um instrumento prático e ágil, é capaz de refletir a participação de alimentos ultraprocessados na alimentação das crianças, no que diz respeito à Coorte de Nascimentos de Pelotas de 2015.