Energy and nutrient intake across Nova food groups by quintiles of ultra-processed food energy contribution among Brazilian children aged 6–59 months

The objective is to describe energy, macro-, and micronutrient intake according to Nova food groups and to estimate its association with ultra-processed foods (UPF) energy participation in the diets of children, stratified by age (6-23m/24-59m). A single 24-hour recall from 12,553 children in the Brazilian National Survey on Child Nutrition was used to estimate the relative energy contribution of Nova groups: unprocessed or minimally processed foods and culinary ingredients (G1+G2); processed foods (G3); and UPF (G4). Age-stratified linear regression and 95%CI assessed differences in nutrient intake (per 1,000kcal) across UPF energy quintiles. The G1+G2 group accounted for most of the energy consumed (6-23m: 74.5%; 24-59m: 65.1%) compared to G3 or G4. For both age groups, in the lowest quintile of UFP participation, ≤2% of energy came from UPF, while in the highest quintile, this proportion was >55%; and the G1+G2 group provided most nutrients. In 6-23m, higher UPF quintiles were associated with lower fat [β: -3.1 (-3.6; -2.5)], potassium [β: -49.7 (-67.9; -31.4)], and vitamin A RAE [β: -113.7 (-136.7; -90.6)] intake, but higher calcium [(β: 75.5 (57.6; 93.4)], iron [β: 2.9 (2.5; 3.3)], vitamin A RE [β: 104.3 (72.3; 136.3)], and folate [β: 15.7 (12.0; 19.5)] intake. In 24-59m, nutrient intake generally decreased with increasing UPF quintiles. For 6-23m/24-59m, UPF consumption was positively associated with energy [β: 73.6 (44.6; 102.7); 92.8 (66.7; 118.8), respectively] and carbohydrate [β: 7.3 (5.8; 8.7); 2.3 (1.2; 3.3), respectively], while contributing little to overall micronutrient intake.