{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T23:22:04Z","timestamp":1772234524299,"version":"3.50.1"},"reference-count":64,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Helpo NGOD","award":["UIDB\/04750\/2020"],"award-info":[{"award-number":["UIDB\/04750\/2020"]}]},{"name":"Helpo NGOD","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]},{"name":"Cam\u00f5es I.P. (Instituto da Coopera\u00e7\u00e3o e da L\u00edngua, I.P.)","award":["UIDB\/04750\/2020"],"award-info":[{"award-number":["UIDB\/04750\/2020"]}]},{"name":"Cam\u00f5es I.P. (Instituto da Coopera\u00e7\u00e3o e da L\u00edngua, I.P.)","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]},{"name":"World Food Programme","award":["UIDB\/04750\/2020"],"award-info":[{"award-number":["UIDB\/04750\/2020"]}]},{"name":"World Food Programme","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]},{"name":"Foundation for Science and Technology\u2014FCT (Portuguese Ministry of Science, Technology and Higher Education)","award":["UIDB\/04750\/2020"],"award-info":[{"award-number":["UIDB\/04750\/2020"]}]},{"name":"Foundation for Science and Technology\u2014FCT (Portuguese Ministry of Science, Technology and Higher Education)","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Globally, dietary patterns are shifting toward an increased consumption of ultra-processed foods, raising the risk of some metabolic and nutritional diseases from a young age. This trend is now also affecting low- and middle-income countries. Considering this, we aimed to assess the contribution of ultra-processed foods to total energy intake and their association with the nutritional intake of children and adolescents in Cantagalo, S\u00e3o Tom\u00e9 and Pr\u00edncipe. Methods: We conducted a cross-sectional study with a sample of 546 households. Data were collected on anthropometrics, sociodemographic characteristics, and lifestyle, including 24 h food recall questionnaires for children and adolescents. The reported foods were nutritionally assessed and categorized according to the NOVA classification to estimate the contribution of ultra-processed foods. Logistic regression models were used to estimate the magnitude of the associations between higher consumption of ultra-processed foods and nutritional intake, adjusting for confounders. Results: The contribution of ultra-processed foods to daily energy intake was 9.5% for girls and 8.5% for boys. Higher consumption of ultra-processed foods was significantly associated with a lower intake of fiber (OR = 0.932; 95%CI, 0.872\u20130.996), vitamin B12 (OR = 0.812; 95%CI, 0.668\u20130.985), and zinc (OR = 0.443; 95%CI, 0.308\u20130.639) and a higher intake of iron (OR = 1.479; 95%CI, 1.065\u20132.055) and sodium (OR = 1.001; 95%CI, 1.000\u20131.001), after adjusting for confounders. Conclusion: Higher consumption of ultra-processed foods was especially associated with a lower intake of fiber, vitamin B12, and zinc, and with a higher intake of iron.<\/jats:p>","DOI":"10.3390\/children11091089","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T11:23:19Z","timestamp":1725535399000},"page":"1089","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ultra-Processed Foods and Nutritional Intake of Children and Adolescents from Cantagalo, S\u00e3o Tom\u00e9 and Pr\u00edncipe"],"prefix":"10.3390","volume":"11","author":[{"given":"Rita","family":"Morais","sequence":"first","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"}]},{"given":"M\u00f3nica","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"}]},{"given":"Francisca","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-1720","authenticated-orcid":false,"given":"Renata","family":"Barros","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6310-4956","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Padr\u00e3o","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"}]},{"given":"Madalena","family":"Ortig\u00e3o","sequence":"additional","affiliation":[{"name":"Helpo\u2013Non-Governmental Organization for Development, 2750-318 Cascais, Portugal"}]},{"given":"Maria","family":"Tavares","sequence":"additional","affiliation":[{"name":"Helpo\u2013Non-Governmental Organization for Development, 2750-318 Cascais, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7035-7799","authenticated-orcid":false,"given":"Pedro","family":"Moreira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"ref_1","unstructured":"Fundo das Na\u00e7\u00f5es Unidas para a Inf\u00e2ncia (UNICEF) (2022). Relat\u00f3rio Anual do UNICEF S\u00e3o Tom\u00e9 e Pr\u00edncipe 2022, UNICEF."},{"key":"ref_2","unstructured":"The World Bank (2024, June 21). The World Bank in Sao Tome and Principe. Available online: https:\/\/www.worldbank.org\/en\/country\/saotome\/overview."},{"key":"ref_3","unstructured":"UNICEF (2016). An\u00e1lise da Situa\u00e7\u00e3o das Crian\u00e7as e das Mulheres em S\u00e3o Tom\u00e9 e Pr\u00edncipe 2015, UNICEF."},{"key":"ref_4","unstructured":"Associa\u00e7\u00e3o Nacional das Emrpesas Metal\u00fargicas e Eletromec\u00e2nicas (2018). Estudo de Levantamento e Caracteriza\u00e7\u00e3o das Empresas Industriais de S\u00e3o Tom\u00e9 e Pr\u00edncipe, Associa\u00e7\u00e3o Nacional das Emrpesas Metal\u00fargicas e Eletromec\u00e2nicas."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100466","DOI":"10.1016\/j.gfs.2020.100466","article-title":"The Processed food revolution in African food systems and the Double Burden of Malnutrition","volume":"28","author":"Reardon","year":"2021","journal-title":"Glob. Food Sec."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.14434\/gjte.v1i1.26141","article-title":"Nutrition Transition in Africa: Consequences and Opportunities","volume":"1","author":"Mbogori","year":"2019","journal-title":"Glob. J. Transform. Educ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/nyas.12433","article-title":"Obesity and the nutrition transition in Sub-Saharan Africa","volume":"1311","author":"Steyn","year":"2014","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nel, J.H., and Steyn, N.P. (2022). The Nutrition Transition and the Double Burden of Malnutrition in Sub-Saharan African Countries: How Do These Countries Compare with the Recommended Lancet Commission Global Diet?. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192416791"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s13679-017-0285-4","article-title":"Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content?","volume":"6","author":"Poti","year":"2017","journal-title":"Curr. Obes. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1017\/S1368980018003762","article-title":"Ultra-processed foods: What they are and how to identify them","volume":"22","author":"Monteiro","year":"2019","journal-title":"Public Health Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1017\/S1368980023002811","article-title":"Dietary intake of low-income adults in South Africa: Ultra-processed food consumption a cause for concern","volume":"27","author":"Frank","year":"2024","journal-title":"Public Health Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12937-020-00604-1","article-title":"Consumption of ultra-processed foods and health outcomes: A systematic review of epidemiological studies","volume":"19","author":"Chen","year":"2020","journal-title":"Nutr. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Martini, D., Godos, J., Bonaccio, M., Vitaglione, P., and Grosso, G. (2021). Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples. Nutrients, 13.","DOI":"10.3390\/nu13103390"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.cmet.2019.05.008","article-title":"Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake","volume":"30","author":"Hall","year":"2019","journal-title":"Cell Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e077310","DOI":"10.1136\/bmj-2023-077310","article-title":"Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses","volume":"384","author":"Lane","year":"2024","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1017\/jns.2024.13","article-title":"Processed food consumption and risk of non-communicable diseases (NCDs) in South Africa: Evidence from Demographic and Health Survey (DHS) VII","volume":"13","author":"Godbharle","year":"2024","journal-title":"J. Nutr. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Akombi, B.J., Chitekwe, S., Sahle, B.W., and Renzaho, A.M.N. (2019). Estimating the Double Burden of Malnutrition among 595,975 Children in 65 Low- and Middle-Income Countries: A Meta-Analysis of Demographic and Health Surveys. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16162886"},{"key":"ref_18","unstructured":"World Health Organization (2024, June 12). WHO Child Growth Standards: Training Course on Child Growth Assessment. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241595070."},{"key":"ref_19","unstructured":"World Health Organization (2009). WHO AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World\u2019s Children and Adolescents, WHO."},{"key":"ref_20","unstructured":"World Health Organization (2024, June 07). BMI-for-Age (5\u201319 Years). Available online: https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/bmi-for-age."},{"key":"ref_21","unstructured":"Vincent, A., Grande, F., Compaor\u00e9, E., Annor, G.A., Addy, P.S., Aburime, L.C., Ahmed, D., Loh, A.M.B., Cabia, S.D., and Deflache, N. (2020). FAO\/INFOODS Food Composition Table for Western Africa (2019), Food and Agriculture Organization for the United Nations."},{"key":"ref_22","unstructured":"Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge (2024, June 16). Tabela da Composi\u00e7\u00e3o de Alimentos. Available online: http:\/\/portfir.insa.pt\/."},{"key":"ref_23","unstructured":"Goios, A., Martins, M.L., Oliveira, A.C., Afonso, C., and Amaral, T. (2021). Pesos e Por\u00e7\u00f5es de Alimentos, U.Porto Press. [3rd ed.]."},{"key":"ref_24","unstructured":"Pisco, A.M.S., and Catarino, E. (2015). \u00c1lbum Fotogr\u00e1fico Para Quantifica\u00e7\u00e3o de Alimentos\u2014S\u00e3o Tom\u00e9 e Pr\u00edncipe, Helpo."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e1590","DOI":"10.1016\/S2214-109X(22)00367-9","article-title":"Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: A pooled analysis of individual-level data from population-representative surveys","volume":"10","author":"Stevens","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1038\/sj.ijo.0801376","article-title":"Critical evaluation of energy intake using the Goldberg cut-off for energy intake:basal metabolic rate. A practical guide to its calculation, use and limitations","volume":"24","author":"Black","year":"2000","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_27","first-page":"5","article-title":"Predicting basal metabolic rate, new standards and review of previous work","volume":"39","author":"Schofield","year":"1985","journal-title":"Hum. Nutr. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1590\/S0102-311X2010001100005","article-title":"A new classification of foods based on the extent and purpose of their processing","volume":"26","author":"Monteiro","year":"2010","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_29","first-page":"28","article-title":"NOVA. The star shines bright","volume":"7","author":"Monteiro","year":"2016","journal-title":"World Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1220S","DOI":"10.1093\/ajcn\/65.4.1220S","article-title":"Adjustment for total energy intake in epidemiologic studies","volume":"65","author":"Willett","year":"1997","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e13387","DOI":"10.1111\/obr.13387","article-title":"Ultraprocessed food consumption and dietary nutrient profiles associated with obesity: A multicountry study of children and adolescents","volume":"23","author":"Neri","year":"2022","journal-title":"Obes. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1017\/S1368980017001161","article-title":"Ultra-processed foods and added sugars in the Chilean diet (2010)","volume":"21","author":"Cediel","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.11606\/s1518-8787.2020054001176","article-title":"Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia","volume":"54","author":"Khandpur","year":"2020","journal-title":"Rev. Saude Publica"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1017\/S1368980017002129","article-title":"Energy contribution of NOVA food groups and sociodemographic determinants of ultra-processed food consumption in the Mexican population","volume":"21","author":"Louzada","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1016\/j.jped.2023.09.006","article-title":"Ultra-processed food consumption and children and adolescents\u2019 health","volume":"100","author":"Mescoloto","year":"2024","journal-title":"J. Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1017\/S0029665121002822","article-title":"GeNuIne (gene-nutrient interactions) Collaboration: Towards implementing multi-ethnic population-based nutrigenetic studies of vitamin B(12) and D deficiencies and metabolic diseases","volume":"80","author":"Vimaleswaran","year":"2021","journal-title":"Proc. Nutr. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Barber, T.M., Kabisch, S., Pfeiffer, A.F.H., and Weickert, M.O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12.","DOI":"10.3390\/nu12103209"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Sekgala, M.D., McHiza, Z.J., Parker, W.A., and Monyeki, K.D. (2018). Dietary Fiber Intake and Metabolic Syndrome Risk Factors among Young South African Adults. Nutrients, 10.","DOI":"10.3390\/nu10040504"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/obr.12107","article-title":"Ultra-processed products are becoming dominant in the global food system","volume":"14","author":"Monteiro","year":"2013","journal-title":"Obes. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e2411852","DOI":"10.1001\/jamanetworkopen.2024.11852","article-title":"Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children","volume":"7","author":"Khoury","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_41","first-page":"e000727","article-title":"Dietary fibre intake and its association with ultraprocessed food consumption in the general population of Switzerland: Analysis of a population-based, cross-sectional national nutrition survey","volume":"7","author":"Huwiler","year":"2024","journal-title":"BMJ Nutr. Prev. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1111\/dom.14176","article-title":"Dietary fibre intake in childhood or adolescence and subsequent health outcomes: A systematic review of prospective observational studies","volume":"22","author":"Reynolds","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Dreher, M.L. (2018). Overview of the Health Benefits of Adequate Fiber Intake. Dietary Fiber in Health and Disease, Springer International Publishing.","DOI":"10.1007\/978-3-319-50557-2_2"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Cena, H., and Calder, P.C. (2020). Defining a Healthy Diet: Evidence for the Role of Contemporary Dietary Patterns in Health and Disease. Nutrients, 12.","DOI":"10.3390\/nu12020334"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Menezes, C.A., Magalh\u00e3es, L.B., da Silva, J.T., da Silva Lago, R.M.R., Gomes, A.N., Ladeia, A.M.T., Vianna, N.A., and Oliveira, R.R. (2023). Ultra-Processed Food Consumption Is Related to Higher Trans Fatty Acids, Sugar Intake, and Micronutrient-Impaired Status in Schoolchildren of Bahia, Brazil. Nutrients, 15.","DOI":"10.3390\/nu15020381"},{"key":"ref_46","unstructured":"Monteiro, C.A., Cannon, G., Lawrence, M., Louzada, M.L.d.C., and Machado, P.P. (2019). Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System, FAO."},{"key":"ref_47","first-page":"45","article-title":"Impact of ultra-processed foods on micronutrient content in the Brazilian diet","volume":"49","author":"Louzada","year":"2015","journal-title":"Rev. Saude Publica"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Elgormus, Y., Okuyan, O., Dumur, S., Sayili, U., and Uzun, H. (2023). The Epidemiology of Deficiency of Vitamin B12 in Preschool Children in Turkey. Medicina, 59.","DOI":"10.3390\/medicina59101809"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"100181","DOI":"10.1016\/j.advnut.2024.100181","article-title":"Preventing and Controlling Zinc Deficiency Across the Life Course: A Call to Action","volume":"15","author":"Lowe","year":"2024","journal-title":"Adv. Nutr."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Berhe, K., Gebrearegay, F., and Gebremariam, H. (2019). Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: A systematic review and meta-analysis. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7979-3"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1590\/S0034-8910.2015049005572","article-title":"Consumption of ultra-processed foods and their impact on the diet of young adults","volume":"49","author":"Bielemann","year":"2015","journal-title":"Rev. Saude Publica"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4162\/nrp.2023.17.2.284","article-title":"Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults","volume":"17","author":"Hyun","year":"2023","journal-title":"Nutr. Res. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1111\/jch.13729","article-title":"Comparison of 24-hour urine and 24-hour diet recall for estimating dietary sodium intake in populations: A systematic review and meta-analysis","volume":"21","author":"McLean","year":"2019","journal-title":"J. Clin. Hypertens."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Calcaterra, V., Cena, H., Rossi, V., Santero, S., Bianchi, A., and Zuccotti, G. (2023). Ultra-Processed Food, Reward System and Childhood Obesity. Children, 10.","DOI":"10.3390\/children10050804"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12963-015-0068-7","article-title":"Salt intakes in sub-Saharan Africa: A systematic review and meta-regression","volume":"14","author":"Oyebode","year":"2016","journal-title":"Popul. Health Metr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1161\/HYPERTENSIONAHA.119.14168","article-title":"Elevated Blood Pressure in Childhood or Adolescence and Cardiovascular Outcomes in Adulthood: A Systematic Review","volume":"75","author":"Yang","year":"2020","journal-title":"Hypertension"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1093\/ije\/dyy121","article-title":"Sodium intake and blood pressure in children and adolescents: A systematic review and meta-analysis of experimental and observational studies","volume":"47","author":"Leyvraz","year":"2018","journal-title":"Int. J. Epidemiol."},{"key":"ref_58","unstructured":"Global Nutrition Report (2024, June 03). Country Nutrition Profile\u2014Sao Tome and Principe. Available online: https:\/\/globalnutritionreport.org\/resources\/nutrition-profiles\/africa\/middle-africa\/sao-tome-and-principe\/."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s12966-022-01389-8","article-title":"Socio-economic difference in purchases of ultra-processed foods in Australia: An analysis of a nationally representative household grocery purchasing panel","volume":"19","author":"Coyle","year":"2022","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.numecd.2019.12.011","article-title":"Association between the price of ultra-processed foods and obesity in Brazil","volume":"30","author":"Passos","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nutres.2017.11.001","article-title":"Methodological considerations and future insights for 24-hour dietary recall assessment in children","volume":"51","author":"Foster","year":"2018","journal-title":"Nutr. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e2014009","DOI":"10.4178\/epih\/e2014009","article-title":"Dietary assessment methods in epidemiologic studies","volume":"36","author":"Shim","year":"2014","journal-title":"Epidemiol. Health"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1093\/aje\/kwac037","article-title":"Can Cross-Sectional Studies Contribute to Causal Inference? It Depends","volume":"192","author":"Savitz","year":"2023","journal-title":"Am. J. Epidemiol."},{"key":"ref_64","first-page":"38","article-title":"Dietary assessment methods: Dietary records","volume":"31","author":"Ortega","year":"2015","journal-title":"Nutr. Hosp."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1089\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:49:25Z","timestamp":1760111365000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,5]]},"references-count":64,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["children11091089"],"URL":"https:\/\/doi.org\/10.3390\/children11091089","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,5]]}}}