Abstract

 Introduction: Mothers are the main responsibles in the process of selecting and purchasing foods for their children. Objectives: Describe the purchasing attitude of mothers in response to the demand for ultra-processed foods by children between 8 and 12 years of age. For this, it was proposed: i) Characterize the ultra-processed foods that children request according to their mothers, ii) Identify the factors considered when purchasing the foods requested by their children, iii) Evaluate their perception of the influence of advertising in their children's demand for food, and iv) Describe their attitude towards the behavior of children during purchases of ultra-processed foods. Methodology: Non-experimental, cross-sectional, and descriptive quantitative study. An online survey was designed that allowed reaching the participation of 126 mothers of 153 children. Data were analyzed using univariate descriptive analysis techniques. Results: Sweet and salty cookies, desserts and ice creams, and sugary drinks were the products most requested by children. Mothers mainly considered price and nutritional quality when purchasing these foods. In addition, 83.3% of mothers stated that food advertising influences their children's demands. At the insistence of the children, more than 50% of the mothers occasionally agreed to purchase, although 73.8% had no difficulties refusing the requests. Conclusion: The purchasing attitude of mothers mediates between the demands of their children and their own decisions, establishing limits regarding certain foods requested.

Resumen

Introducción: Las madres son las principales mediadoras en el proceso de selección y compra de alimentos para sus hijos. Objetivos: Describir la actitud de compra de madres frente a la demanda de alimentos ultraprocesados por parte de niños de entre 8 y 12 años. Para ello, se propuso: i) Caracterizar los alimentos ultraprocesados que los niños solicitan según las madres, ii) Identificar los factores considerados al momento de adquirir los alimentos solicitados por los hijos, iii) Evaluar su percepción sobre la influencia de la publicidad alimentaria en la demanda de alimentos de sus hijos, y iv) Describir su actitud frente al comportamiento de los niños durante las compras de alimentos ultraprocesados. Metodología: Estudio cuantitativo no experimental, transversal y descriptivo. Se diseñó una encuesta en línea que permitió alcanzar la participación de 126 madres de 153 niños. Los datos se analizaron mediante técnicas de análisis descriptivo univariable. Resultados: Las galletitas dulces y saladas, postres y helados, y bebidas azucaradas fueron los productos más solicitados por los niños. Las madres consideraron principalmente el precio y la calidad nutricional al adquirir estos alimentos. Además, el 83,3% de las madres afirmaron que la publicidad alimentaria influye en la demanda de sus hijos. Ante la insistencia de los niños, más del 50% de las madres ocasionalmente accedían a la compra, aunque el 73,8% no presentaba dificultades para negarse a los pedidos. Conclusión: La actitud de compra de las madres media entre las demandas de sus hijos y sus propias decisiones, estableciendo límites respecto a ciertos alimentos solicitados.

Resumo

 Introdução: As mães são as principais mediadoras no processo de seleção e compra de alimentos para seus filhos. Objetivos: Descrever a atitude de compra das mães frente à demanda por alimentos ultraprocessados por crianças de 8 a 12 anos. Para isso, propôs-se: i) Caracterizar os alimentos ultraprocessados que as crianças solicitam de acordo com suas mães, ii)) Identificar os fatores considerados na compra dos alimentos solicitados por seus filhos, iii) Avaliar sua percepção sobre a influência da publicidade na demanda de alimentos de seus filhos; e iv) Descrever sua atitude em relação ao comportamento dos filhos durante a compra de alimentos ultraprocessados. Metodologia: Estudo quantitativo não experimental, transversal e descritivo. Foi desenhado um inquérito online que permitiu chegar à participação de 126 mães de 153 crianças. Os dados foram analisados por meio de técnicas de análise descritiva univariada. Resultados: Biscoitos doces e salgados, sobremesas e sorvetes e bebidas açucaradas foram os produtos mais solicitados pelas crianças. As mães consideraram principalmente o preço e a qualidade nutricional na compra desses alimentos. Além disso, 83,3% das mães afirmaram que a propaganda de alimentos influencia na demanda dos filhos. Por insistência dos filhos, mais de 50% das mães ocasionalmente concordavam em comprar, embora 73,8% não tivessem dificuldade em recusar os pedidos. Conclusão: A atitude de compra das mães faz a mediação entre as demandas dos filhos e suas próprias decisões, estabelecendo limites quanto a determinados alimentos solicitados.

Introduction

The demographic, epidemiological, social and economic transformations that took place over the last years have had a profound impact in the diet, lifestyle and health status of the population. Urban populatons have experienced significant changes in diet and physical activity levels, have adopted sedentary lifestyles, and their diet is centered around ultra-processed foods, which are high in sugars, saturated fats, and sodium ^{(1, 2)} .

Based on the NOVA classification system, which groups foods based on the amount of processing involved in their production, ultra-processed foods are industrial formulae produced using substances obtained or derived from foods, which include additives and undergo a series of industrial processes. Due to their negative impact on health, Food Guidelines for the population of Argentina ⁽³⁾ they are considered "foods for optional consumption", and limiting their consumption is recommended, in order to enjoy a healthy diet.

The second national survey on nutrition and health ⁽⁴⁾ has reported high amounts of ultra-processed foods consumption (including carbonated drinks, pastries, snacks and candy) in children. The excessive consumption of these produts is associated with greater risks of developing chronic non-transmissible diseases. In Argentina, 41.1% percent of children and adolescents aged between 5 and 17 present with excess malnutrition ⁽⁴⁾. Thus, prevention efforts should focus on children ⁽⁶⁾, since childhood is a crucial stage in the formation of diet and lifestyle habits ⁽¹⁾.

Advertising also plays a major role in determining food preferences, acquisition requests and consumption habits of children ⁽⁷⁾. In Argentina, 21.5 of adults responsible for children bewteen 2 and 12 years of age declared having bought some product because their chilren had seen it being advertisde ⁽⁴⁾ . Among all channels through which chidlren are exposed to advertising, television is still the most widealy used means for promoting products with low nutritional value ^{(7, 8)}

Eating habits, preferences and strong dislikes are closely linked to family and context ⁽⁹⁾. Caregivers play a key role in the dietary choices of children, establishing limits and molding their behaviors and attitudes towards food ^{(10, 11)} . During childhood, although not exclusively during childhood, it is mainly mothers that assume the responsibility of planning and preparing meals ^{(10, 12)} , and play a key role in shopping decisions ⁽¹³⁾ . This responsibility of feeding is a cultural expectation on the practice of motherhood, which is shared across social classes and is transmitted intergenerationally. Fathers participate in [], but they usually play a secondary role ⁽¹²⁾, but they generally [] established by mothers ⁽¹³⁾ .

Decisions made by mothers when selecting food for their children is influenced by several factors ⁽¹⁹⁾. Moreovers, mothers can adopt different stances towards the acquisition of foods, from giving in to the demands of their children to avoiding taking them to the supermarket to bypass requests. They can also negotiate the consumption of certain foods or refusing to buy certain products ⁽¹⁴⁾ . In this sense, it is important to note that attitudes are an acquired predispositions with powerful motivational loads, which lead people to behave in positive or negative ways before specific products. These attitudes are determined mainly by prior experience with the product, comments made by others, and exposure to advertisement ⁽¹⁵⁾ .

In this context, the present work's goal was to describe mother's shopping choices when faced with their children's demand for ultra-processed foods, including children aged between eight and twelve years-old in Entre Ríos, Argentina. With this aim, the following specific goals were set: i) To describe the products requested by children, ii) to identify factors considering by mothers when deciding whether to acquire the products, iii) to evaluate their perception of the influence of advertising on their children's demands for ultra-processed foods, iv) and to describe their attitudes and reactions to the behavior of their children when buying ultra-processed foods.

Methods

Study Design and Population

A quantitative, cross-sectional non-experimental descriptive study was conducted. The target population was mother and children aged between 8 and 12 years-old, given evidence shows they are the main responisbles for their children's diet ^{(10, 14)}. Moreover, chilren in that age range are in a stage midways between childhood and adolescence, during which their diatary habits can influence their food preferences in later stages of life.

The sample is conformed by a total of 126 mothers and a total of 153 children of both sexes aged 8 to 12 years-old, all residents of Basavilbaso, Entre Ríos, Argentina. Participants were selected by non-probabilistic sampling and were recruited using social networks during June 2022.  

Data Collection

We used a self.administered semi-structured survey which was completed online using Google Forms. We provided a concise explanation on the properties of ultra-processed foods, with the aim of avoiding erroneous interpretations that could introduce bias in the results obtained.

Before conducting the survey, we carried out a pilot test with a reduced group of ten mothers who were not part of the sample, but met inclusion criteria. This pilot was conducted with the purpose of checking if questions were understood correctly, and to detect errors in wording. These women were selected among those close to the research team who willingly participated in the study. They received a link to the questionnaire via whatsapp, and they were asked to complete it as if they were participating in the study. Once all of them completed the questionnaire, answers were minutely revised and they were contacted again using WhatsApp in order to obtain feedback on whether questions were clear and what they thought they meant.

All these steps made it possible to conduct the necessary adjustments and to design the final questionnaire. Finally, in order to collect the data, we made an open call on social media (Instagram, Facebook and Whatsapp), sharing a link to the questionnaire only with women who were interested in participating in the study and met inclusion criteria.

Ethical Considerations

The study was conducted in accordance with the principles of the Helsinki Declaration. Participants were informed in written about the aims of the study and provided their informed consent in electronic form in order to participate anonymously as volunteers.

Data Analysis

Our statistical analysis was performed using IBM® SPSS Statistics, version 28 (IBM Corp., Armonk, New York, USA). For our descriptive analysis, we summarized the data in percentages, averages and standard deviations.

Results

Results revealed that 79.4% of mothers had only one child aged 8 to 12, with an average age of 9.7 ± 1.5 años, while the remaining 19% had two children within the target age range. We found both sexes were evenly represented, with 52.3% mothers having female sex children and 47.7% having male sex children.

Figure 1 shows the top ultra-processed foods requested by children, showing sweet cookies were the most commonly mentioned products (19.7%), followed by ice-cream and puddings (18.1%), and sodas or soft drinks (15.5).

Figura N° 1. Ultra-processed foods requested by children, according to mothers.

When buying buying this type of foods, price (24,4%) and nutritional value (23,6%) were the main factors considered by mothers when making decisions. Moreover, they stated that the preferences of their children (19,6%) and family (19,1%) are considered when choosing purchases.

As regards the influence of advertising in the demand for ultra-processed foods, most participants (83.3%) agreed that their children's requests were affected by advertisements. They further commented that children were exposed to advertisements mainly in television (46.7%) and social media (38.9%).

More than 60% stated that they rarely or never take their children to stores or commerces (Fig. 2). Despite the low frequency, 80.4% of mothers mentioned that, when they do take their children with them, their children ask mainly for sweet beberages and candy. However, 73.8% refused to buy these products, due to their low nutritional value, and their high sugar and/or fat content.

Figure 2. Frequency with which mothers take their children with them when purchasing foods, according to mothers.

Lastly, mothers report that insistence (35.6%) is the most commonly adopted behavior when requesting ultra processed foods (Table 1), and this behavior intensifies when in front of the product (69%).

Results also showed that 50% of mothers report that, facing their children's insistence, they sometimes give up and grant requests (Figure 3). However, most (73,8%) reported that they do not experience issues when refusing to heed their children's demands, even when facing insistence.

Figura N° 3. Frequency with which mothers give in to demands for ultraprocessed foods when facing insistence.

Discussion

The present work made it possible to obtain valuable information on their mothers attitudes towards demands for ultra-processed foods from children aged 8 to 12 years old, residing in Basavilbaso, Entre Ríos, Argentina.

First, mothers' reports show that children request for a wide variety of ultra-processed foods, among which cookies and crackers, puddings and icecream, and carbonated drinks. This suggests that mothers perceive their children as active consumers of this kind of ultra-processed food ⁽¹⁴⁾. Moreover, it shows that children have high autonomy in choosing their food, despite mothers being the ones making food purchase last-instance decisions ⁽¹⁴⁾. Preference for this type of ultra-processed foods might be attributed to early exposure to sweets ⁽¹⁶⁾ and food experiences lived during the first five years of life ⁽¹⁰⁾. Moreover, ENNyS 2 backs up this conclusion, reporting higher rates of ultra-processed food consumption in children and adolescents in comparison to adults ⁽⁴⁾, supporting the claim that sweets are a habitual component in the diet of young children ⁽¹⁷⁾.

It is important to consider that the demand for ultra-processed foods can be influenced by the availability of foods in their school environment. One study conducted by Britos et al.⁽¹⁸⁾   revealed that almost half of all discretional calories consumed by children come from foods consumed in a school cafeteria or nearby stores, with cookies and carbonated drinks being the main product categories in the diet of schoolchildren. Moreover, some family members, such as grandparents, may influence the demand for ultraprocessed foods in children by offering foods that are not considered healthy ⁽¹³⁾.

Scond, mothers made it clear that, when buying foods requested by their children, they prioritize price and nutritional value. They also mentioned that the food preferences of children and their families influence shopping decisions. This suggests that, even when there are many other factors influencing food purchases⁽¹⁰⁾, budget is especially relevant for mothers, especially in Argentina, where prices are a significant concern ⁽¹⁹⁾, and mothers become 'smart agents' out of necessity ⁽¹⁵⁾ , in order to acquire the healthiest food at affordable prices ⁽¹⁰⁾. In agreement with these findings, a study conducted by Vázquez et al.⁽¹⁰⁾ revealed that both nutritional content and sensory desirability and cost are the main criteria considered by mothers in Buenos Aires when making decisions about food. Moreover, Ávila-Ortiz et al.⁽²⁰⁾ report that women are the main responsibles for buying food, taking into account the food preferences of their family group, especially children. In general, these results show that mothers play fundamental roles in shopping decisions and their children's diets, and make it clear that the decision-making process involved in food planning is complex ⁽¹⁴⁾.

Morevoer, 8 out of 10 mothers report that advertising clearly influences their children's demand for ultra-processed foods, and state television and social networks are the main media promoting these products, which have low nutrition values. This shows that advertising is able to influence the preferences and shopping decisions made by children ⁽⁷⁾, who demand for the products they see in commercials ⁽⁴⁾. In agreement with these results, the study by Castronuovo et al.⁽¹⁴⁾ found that advertising and promotion campaigns affect the preferences of their children and their requests.

The presence of children at the moment of making purchases influences food choices ⁽²¹⁾. Despite the fact that more than 60% of mothers reported that they rarely or never are accompanied nby their children when shopping, 80.4% mentioned that, when they do, children ask for candy and sodas. However, the fact that 70% of participants report that they refuse to buy these products due to their low nutritional quality shows that, even when food choices begin during the first years of life of children ⁽²⁰⁾, they play key roles in the process of acquiring food ⁽¹⁴⁾, choosing healthier options and teaching their children, so that they are aware of the quality of the food they choose to consume ⁽²²⁾.

Lately, participants showed that insistence is the most commonly adopted request behavior, and insistence intensifies when in the prescence of the product. More than half of mothers reported that, when facing insistence, they occasionally yield. Moreover, most mothers (73.8%) reported not having issues denying their children's requests. This further supports the claim that mothers play key roles in shaping their children's eating habits, helping develop healthy eating habits, and are the ones that ultimately decide which foods to buy or not ⁽¹⁴⁾. In agreement with these results, Castronuovo et al.⁽¹⁴⁾ reported that mothers perceive requests intensify when children are in immediate contact with products, mainly in front of stalls in supermarket or stores.

In conclusion, the findings of this study show that mothers play key roles as providers and the main responsibles for making food decisions. Despite the influcence of advertising on preferences and the insistence of their children when in supermarkets or stores, mothers show clear interest in the nutritional quality of the purchases the make and requests made by their children.

Childhood is a key stage in the development of healthy eating habits that may last into adulthood. In this direction, the attitudes of mothers participating in this study, who played the role of mediating between the demand for foods with low nutritional value and their own shopping decisions, establishing limits to the consumption of certain products, is essential for the heaalthy development and grow of children, as well as for the prevention of non-transmissible chronic diseases over the long and short term.

However, it is crucial to interpret results considering the limitations of this study. The sample was not representative of the population, giiven that the study participants were selected by convencience non-probability sampling. Moreover, we did not collect data on the social and economic context of each participant, which might be a factor determining shopping decisions. The study did not explore the impact of the school environment and other family members in the demand for ultraprocessed foods, and did not consider children's own autonomous choices when choosing food. Consequently, further research should take into account these variables in order to obtain a more complete picture of these issues. It is also important to assess how the implementation of law N° 27.642 for the promotion of healthy diets impacted on the demand for ultraprocessed foods made by children and their mother's reaction to it.

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Recibido: 2023-08-21 Aceptado: 2024-09-25

DOI: http://dx.doi.org/10.31053/1853.0605.v81.n4.42297

 https://creativecommons.org/licenses/by-nc/4.0/

©Universidad Nacional de Córdoba