Efficacy of an Intervention in the Nutritional Status and Consumption of Ultra-Processed Foods in Children With Obesity Treated in Primary Health Care in Brazil

Introduction: Effective childhood obesity management requires multicomponent interventions in Primary Health Care (PHC), engaging families, communities, and healthcare professionals to foster healthier behaviors. Objective: This study evaluated the effect of a controlled intervention on the nutritional status and ultra-processed food (UPF) consumption of children with obesity receiving PHC services. Methods: A randomized clinical trial was conducted with children from PHC units in Betim, Minas Gerais, Brazil. Twenty units were randomly selected and allocated into control (CG) and intervention groups (IG). Children aged 6–10 years with obesity (z-score ≥ + 2 for BMI/age) were included. The estimated sample size was 47 per group, considering 20% loss. The IG received monthly activities with four weekly sessions (≥ 26 contact hours) and five consultations. The CG followed a similar protocol with up to 9 contact hours. Sociodemographic, nutritional, and UPF consumption data were collected through a questionnaire covering 11 food groups. Intention-to-treat analysis compared mean UPF consumption, BMI/age z-score, and BMI (kg/m²) within and between groups post-intervention. Results: The intervention significantly reduced UPF consumption in IG at visit 3 [95% CI: -0.95 (-1.87; -0.04)], visit 4 [95% CI: -1.35 (-2.215; -0.49)], and visit 5 [95% CI: -0.94 (-1.83; -0.05)]. No significant differences were found for BMI or BMI/age z-score (p > 0.05). Conclusion: The intervention effectively reduced UPF con-sumption. Although no BMI/age reduction was observed, it contributed to weight maintenance and should be considered in PHC childhood obesity strategies.