TOPLINE

Children aged 4-5 years with higher baseline consumption of ultraprocessed foods (UPF) were less likely to meet 24-hour movement recommendations after 2 years of follow-up. Those in the highest UPF consumption tertile had a higher daily screen time than those in the lowest tertile.

METHODOLOGY

• A prospective cohort study analyzed 586 Spanish children aged 4-5 years at baseline from the SENDO (Seguimiento del Niño para un Desarrollo Óptimo) project, with a 2-year follow-up.
• Dietary intake was assessed via a validated 149-item food frequency questionnaire completed by parents, with food items categorized using the NOVA classification system; participants were divided into tertiles based on UPF energy intake at baseline.
• Physical activity, recreational screen time, and sleep duration were evaluated through parent-completed questionnaires aligned with the 24-hour movement recommendations.
• For children under 5 years, adherence included at least 180 minutes of physical activity daily (at least 1 hour of intense play) and 1 hour or less of screen time, with sleep lasting 10-13 hours. For those aged 5 years or older, adherence required at least 60 minutes of moderate to vigorous activity, up to 2 hours of screen time, and 9-11 hours of sleep. Participants meeting all three domains were deemed fully adherent.

TAKEAWAY

• Overall, 92.0% of participants adhered to at least one guideline and 38.9% met all three guidelines simultaneously; only 8.0% of children did not meet any of the recommendations.
• After full adjustment, children in the highest UPF tertile had a 27% higher rate of not meeting 24-hour movement recommendations compared with those in the lowest tertile (rate ratio [RR], 1.27; P = .021), with a significant linear trend across tertiles of UPF consumption (P for trend = .022).
• Children in the highest UPF tertile were more likely to exceed the recreational screen time guideline than those in the lowest tertile (RR, 1.82; P = .036).
• Absolute recreational screen time was significantly higher in the highest vs lowest UPF tertile (mean, 1.31 vs 0.94 hours/day; P < .001).

IN PRACTICE

"The prospective design of this study is crucial, as it suggests that early-life dietary choices may precede and contribute to the establishment of future detrimental lifestyle patterns. This underscores the importance of adopting an integrated 24-h perspective in public health, recognizing that food choices, specifically a higher consumption of UPFs, are inherently intertwined with movement behaviors," the authors of the study wrote.

SOURCE

The study was led by Nadia Paladino, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy. It was published online on July 29 in European Journal of Pediatrics.

LIMITATIONS

Dietary and lifestyle data relied entirely on parental reporting, introducing potential recall bias and social desirability bias. The food frequency questionnaire was not originally designed based on NOVA classification and lacked detailed ingredient information. UPF intake was assessed only at baseline, potentially leading to exposure misclassification over time.

DISCLOSURES

Open Access funding was provided through the CRUE-CSIC agreement with Springer Nature. The authors reported having no relevant competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.