# Ultra-Processed Food Consumption Among Caregivers and Children in the “Happy Smile” Project: Associations with Family Dietary Patterns and Periodontal Health-Related Quality of Life

## TL;DR

This study shows that caregivers' high consumption of ultra-processed foods is linked to similar habits in children and affects caregivers' oral health quality of life.

## Contribution

The study reveals a strong link between caregiver and child ultra-processed food consumption and its impact on periodontal health-related quality of life.

## Key findings

- High caregiver ultra-processed food consumption is strongly associated with high consumption in children (OR = 9.96).
- Children with high ultra-processed food consumption show more oral health risk behaviors like nighttime sweetened bottle use.
- Caregivers with high ultra-processed food consumption report worse physical disability in periodontal health-related quality of life.

## Abstract

Background/Objectives: The consumption of ultra-processed foods (UPFs) has increased markedly in recent decades and has been associated with adverse health outcomes. In childhood, the family environment plays a central role in shaping dietary habits and oral health behaviors. This study investigated the association between UPF consumption by caregivers and children, its relationship with caregivers’ periodontal health-related quality of life, and described children’s dietary practices and oral hygiene habits. Methods: This cross-sectional study was conducted with caregivers of children participating in the Happy Smile Project in Birigui, São Paulo, Brazil. UPF consumption was assessed using a questionnaire based on the NOVA classification, and periodontal health-related quality of life was evaluated using the OHIP-14-PD. Results: A high frequency of UPF consumption was observed among both caregivers and children. Children whose caregivers had high UPF consumption were more likely to also present high consumption (OR = 9.96; 95% CI: 5.38–18.44; p < 0.001). Higher caregiver education was associated with lower odds of high UPF consumption among children. Children in the high-consumption group were older and showed higher consumption of sweetened milk beverages (p < 0.001). Risk behaviors for oral health, such as nighttime use of sweetened bottles and absence of toothbrushing afterward, were frequently reported. Regarding periodontal health-related quality of life, only the physical disability domain showed significantly higher scores among caregivers with high UPF consumption (p = 0.014). Conclusions: This study demonstrated that high consumption of ultra-processed foods by caregivers significantly increased the odds of children’s consumption and was associated with a greater negative impact on caregivers’ periodontal health-related quality of life, specifically in the physical disability domain. In addition, children exhibited a high frequency of oral health-damaging behaviors. These findings highlight the importance of family-centered strategies aimed at reducing the intake of ultra-processed foods and promoting healthier dietary and oral health behaviors.