Association of exclusive breastfeeding duration with consumption of ultra-processed foods, fruit and vegetables in Brazilian children.

Background: There has been little evidence of the influence of breastfeeding on childhood eating habits.

Aim: To evaluate the association between duration of exclusive breastfeeding (EB) and consumption of ultra-processed foods, fruits and vegetables by Brazilian children.

Methods: This is a cross-sectional study nested in a cohort of 403 children age 4-7 years. Food consumption was evaluated by three food records and the foods were grouped by the amount of processing involved (minimal, including fruit and vegetables to ultra-processed foods). Adjusted linear and multinomial regression models were proposed to evaluate the association of EB with children's food intake. Median duration of EB was 4.0 (2.0-6.0) months and the prevalence of EB of 4 months or more was 60.9%.

Results: Mean energy consumption was 1536 kcal/day, 38% of energy was from ultra-processed foods. Mean intake of fruit and vegetables was 130 g/day. For each 1-month increase in duration of EB there was a 0.7% decrease in energy from ultra-processed foods (β: - 0.7; 95% CI: - 1.3 to 0.1; p = 0.038). EB of less than 4 months was associated with the child being in the lowest tercile for consumption of fruit and vegetables (Adjusted OR: 1.8; 95% CI: 1.1-3.0; p = 0.030) and the highest for consumption of ultra-processed foods (adjusted OR: 1.7; 95% CI: 1.1-2.9; p = 0.040).

Conclusions: In addition to other benefits of EB, we emphasize its importance for the formation of healthy eating habits, contributing to a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods in childhood.