Effects of dietary guidelines on sugar intake and dental caries in 3-year-olds attending nurseries in Brazil

The health outcomes of food and health policies are seldom evaluated. The o bjective of this study was to assess the effect of adoption of dietary guid elines on sugars by nurseries on levels of sugar consumption and 1-year den tal caries increments in low-socio-economic 3-year-old children. Twenty-nin e nurseries out of the 50 largest nurseries in Recife, Brazil were randomly selected. Five hundred and ten children (78% of those approached were exam ined); 245 children attending 12 nurseries adopting guidelines on reduction of sugar intake, and 265 at 17 nurseries without guidelines were assessed. The children's sugar intakes at nursery and at home were assessed by measu ring 6 days weighed food intakes at the nursery and a food inventory comple ted by the children's mothers. Dental caries were examined using standard W HO criteria. There were statistically significant differences in frequency and weight of sugar intake between children attending nurseries adopting an d those not using dietary guidelines (p < 0.001). Children at nurseries ado pting guidelines consumed less than half of the amount of sugar consumed in a day by children at non-adopting nurseries; 22.9 versus 53.5 g Children a ttending nurseries without guidelines on reduction of sugar intake were 4.8 7 times more likely to develop caries in I year than those attending nurser ies with guidelines. Children who had a daily sugar intake of more than 32. 6 g had nearly three times the risk of developing a high caries increment t han those consuming less than 32.6 g. Dietary guidelines for sugar for nurs eries are effective in providing menus with lower levels of sugar. Children consuming such menus are much less likely to develop dental caries.