Primary Health Care Intervention Reduces Added Sugars Consumption During Childhood

Abstract

Objective: To investigate the effectiveness of a training program for health workers regarding infant feeding practices to reduce sugar consumption in children.

Design: A cluster randomized trial was conducted at 20 health centers in southern Brazil randomly assigned to an intervention (n = 9) or control (n = 11) group.

Participants: The 715 pregnant women enrolled were assessed when their children were aged 6 months, 3 years, and 6 years.

Intervention: A training session for primary care workers based on the Brazilian National Guidelines for Children.

Main outcome measure: Mothers were asked when sugar was first offered to children. Added sugars intake was obtained from dietary recalls.

Analysis: The effectiveness of the intervention was modeled using generalized estimation equations and Poisson regression with robust variance.

Results: Children 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.

Conclusions and implications: Health 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.

Keywords: dietary sugars; early intervention education; primary care.