Tendência da alimentação infantil no Brasil: uma análise comparativa da PNS 2013 e 2019.

Abstract

Abstract Objective: To analyze trends in food consumption among children under two years of age in Brazil between 2013 and 2019, stratified by age group (0–11 and 12–23 months) and family income. Methods: A cross-sectional study was conducted using data from the National Health Survey (PNS) in 2013 and 2019. Children under 24 months were included, and the consumption of 15 food items (yes/no) in the last 24 hours was analyzed. Family income per capita was categorized into quintiles. Temporal trends (2013 vs. 2019) were assessed by comparing prevalence rates and 95% confidence intervals (CI) across age groups and income quintiles (comparing the 1st and 5th quintiles). Statistical significance was determined by non-overlapping 95% CIs. Differences in prevalence between years were expressed in percentage points (p.p.). Results: Among infants under 12 months, over 60% were breastfed, with no significant change between 2013 and 2019. There was a significant increase in the consumption of fruits/natural juices (+7.4 p.p.), vegetables (+7.2 p.p.), and meat/eggs (+8.3 p.p.), along with a modest decrease in cookies/cakes (−2.4 p.p.). Among children aged 12–24 months, 30% remained breastfed, with increased intake of fruits/natural juices (+4.8 p.p.) and a sharp decline in artificial juices (−14.6 p.p.), sweets (−10.2 p.p.), and soda (−8.6 p.p.). Cookies/cakes, though still prevalent, decreased (−5.2 p.p.). In both age groups, children in the highest income quintile consumed more fruits/natural juices (0–12 months: 65.7% in 2013 vs. 76.7% in 2019; 12–24 months: 94.2% in 2013 vs. 96.3% in 2019), vegetables (0–12 months: 57.7% vs. 69.4%; 12–24 months: 91.3% vs. 90.5%), and meat/eggs (0–12 months: 42.1% vs. 62.5%; 12–24 months: 90.2% vs. 91.5%). In contrast, the lowest-income quintile had higher consumption of porridge (0–12 months: 48.0% vs. 48.1%; 12–24 months: 57.1% vs. 51.0%) and soda (significant only in infants: 5.6% vs. 5.2%). Cookies/cakes were more prevalent among 12–24-month-olds in the highest quintile, though declining (82.5% in 2013 vs. 69.7% in 2019). Income-based inequalities decreased for vegetables and breastfeeding (12–24 months). Conclusion: This study examined trends in food consumption among Brazilian children under two between 2013 and 2019, revealing progress and persistent challenges. Increased intake of fresh foods (fruits, vegetables, meat/eggs) and reduced ultra-processed consumption (artificial juices, sweets, soda) were observed, especially in 12–23-month-olds. However, breastfeeding rates remained stable (60% <12 months; 30% 12–23 months), below international targets, with early introduction of other milks. Socioeconomic disparities persisted: wealthier families consumed more fresh foods, while poorer families relied more on ultra-processed items and basic preparations (porridge). Despite reduced gaps for some foods, structural and cultural barriers remain, requiring intersectoral policies to promote equity and healthy feeding practices in early childhood. Study limitations include the cross-sectional design and lack of exclusive breastfeeding data. Keywords: Food Consumption; Breastfeeding; Processed Foods; Socioeconomic Factors; Nutrition Surveys.