Contenido de nutrientes críticos en sucedáneos de leche materna comercializada en Perú.
DOI:
https://doi.org/10.12873/451gartnerPalabras clave:
Sustitutos de la leche humana, Fórmulas Infantiles, Etiquetado de Alimentos, Azúcares, Sodio, Grasas, Ácidos Grasos transResumen
Introducción: La lactancia materna exclusiva (LME) es vital para el desarrollo infantil, pero su práctica ha disminuido. En Perú, aunque se promueve la LME, los sucedáneos de leche materna (SLM) han ganado terreno. La normativa sobre advertencias de nutrientes críticos sigue siendo debatida, impactando la salud infantil. Objetivo: Analizar el contenido de nutrientes críticos en SLM dirigidos a niños menores de 2 años, expendidos en Lima Metropolitana. Materiales y Métodos: Estudio transversal en 27 SLM. La recolección de datos se realizó de enero a junio del 2023 en establecimientos farmacéuticos, centros de abasto, hospitales y centros comerciales, a fin de verificar mediante un registro fotográfico la coincidencia entre la lista de cotejo y el etiquetado nutricional. Los datos fueron exportados al software estadístico JASP versión 0.17.2.1. Se presentó el contenido de sodio, azúcar total, grasas saturadas y grasas trans en 100 g del producto en polvo, en 100 ml del producto bebible y en 100 ml del producto reconstituido, y se comparó con los parámetros de nutrientes críticos establecidos para Perú. Resultados: En el total de SLM evaluados, el valor de azúcar es el que resalta, con una mediana de 7,50 g/100 ml de producto reconstituido. El SLM con la mediana más elevada de azúcar total (7,8 g/100 ml) fue procedente de Estados Unidos. En el año 2021 se registró el pico más alto de entrega de registros sanitarios (40,74%). Conclusiones: Los SLM superaron los niveles permitidos de azúcar en la totalidad de los productos en 2019, y en la gran mayoría de los de 2020 y 2021, por lo que deberían incluir una advertencia nutricional.
Referencias
Rodríguez D, Barrera M, Tibanquiza L, Montenegro A. Immunological benefits of breast milk. RECIAMUC. Ecuador: 2019; 4 (1): 93 - 104. https://www.reciamuc.com/index.php/RECIAMUC/article/view/440/635
Martin C, Ling P, Blackburn G. Review of Infant Feeding: key features of breast milk and infant formula. Nutrients 2016; 8 (5): 279. https://doi.org/10.3390/nu8050279
Melnik C, Stremmel W, Weiskirchen, Swen Malte J, Schmitz G. Exosome-Derived MicroRNAs of Human Milk and Their Effects on Infant Health and Development. Biomolecules. 2021; 11 (6): 851. https://doi.org/10.3390/biom11060851
Ministry of Health of Peru Regulation on Infant Feeding - Supreme Decree No 009-2006 SA. 2019 http://bvs.minsa.gob.pe/local/MINSA/4922.pdf
Food and Agriculture Organization. Codex Stan 72-1981. Standard for infant formula and formulas for special medical purposes intended for infants. 2007. Food and Agriculture Organization of the United Nations fao.org/fao-who-codexalimentarius/sh-proxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXS%2B72-1981%252FCXS_072e.pdf
World Health Organization (WHO). How the marketing of formula milk influences our decisions on infant feeding. 2022 https://iris.who.int/bitstream/handle/10665/352098/9789240044609-eng.pdf?sequence=1
National Institute of Statistics and Informatics Peru: Demographic and Family Health Survey - ENDES 2022. 2023 https://cdn.www.gob.pe/uploads/document/file/4570183/Resumen%3A%20Perú.%20Encuesta%20Demográfica%20y%20de%20Salud%20Familiar%20-%20ENDES%202022.pdf?v=1684342928
The official gazette El Peruano. Legal norms: Law promoting healthy nutrition for children and adolescents. Lima: 2013 https://cdn.www.gob.pe/uploads/document/file/2182647/PDF%20de%20la%20Ley%20de%20promoción%20de%20la%20alimentación%20saludable%20para%20niños%2C%20niñas%20y%20adolescentes..pdf
Pan American Health Organization. Front-of-Package Labeling as a Policy Tool for the Prevention of Noncommunicable Diseases in the Americas. 2020 https://iris.paho.org/bitstream/handle/10665.2/53013/OPSNMHRF200033_spa.pdf?sequence=5&isAllowed=y
The official gazette El Peruano. Supreme Decree that modifies the Regulation of Law No 30021, Law on the Promotion of Healthy Nutrition for Children and Adolescents, and the Manual of Advertising Warnings. Lima: 2019. https://busquedas.elperuano.pe/normaslegales/decreto-supremo-que-modifica-el-reglamento-de-la-ley-no-3002-decreto-supremo-n-015-2019-sa-177961 5-4/
Food and Agriculture Organization. Codex Stan 146-1985. General Standard for the Labeling of and claims for prepackaged foods for special dietary uses. https://www.fao.org/3/W8612S/W8612s03.htm
The official gazette El Peruano. Ministerial Resolution No 526-2022/MINSA. Lima: 2022. https://busquedas.elperuano.pe/dispositivo/NL/2087682-1
Congress of the Republic of Peru Pre-draft opinion on bill 1941/2021-CR, which proposes the law that regulates the production and commercialization of special dietary foods for vulnerable populations. Lima: 2021. https://www.congreso.gob.pe/Docs/comisiones2022/Salud/files/dictamenes/pre_dictamen_1941_alimentos_especiales_11.10.22.pdf
Te Morenga L, Howatson A, Jones R, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J Clin Nutr. 2014; 100:65-79. https://pubmed.ncbi.nlm.nih.gov/24808490/
Pan American Health Organization. Shake less salt more health - Technical guide to reduce salt consumption. 2019 https://iris.paho.org/bitstream/handle/10665.2/38586/9789275319956_spa.pdf?sequence=1&isAllowed=y
The Ministry of Public Health and Social Welfare of Paraguay Children are at risk of suffering complications due to excessive salt consumption. 2018 https://www.mspbs.gov.py/portal/14419/nintildeos-corren-riesgo-de-sufrir-complicaciones-por-consumo-excesivo-de-sal.html
Ros G. The importance of fat in the diet of a child aged 6 to 12 months. Anales. 2007; 20(1): 69 - 90. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjDz-fFzsGDAxUUHLkGHa7dDm8QFnoECAsQAw&url=https%3A%2F%2Fdialnet.unirioja.es%2Fdescarga%2Farticulo%2F2973202.pdf&usg=AOvVaw35ibJ_6sHDkT2WRKVOEAoh&opi=89978449
Cortés E, Aguilar M, Rizo M, Gil V, Hidalgo M. Trans fatty acids in the nutrition of children with neurological disorders Nutr. Hosp. 2013; 28 (3): 1140 - 1144. https://scielo.isciii.es/pdf/nh/v28n4/23original14.pdf
Moreno Villares JM, Collado MC, L arqué E, Leis Trabazo MR, Sáenz de Pipaon M, Moreno Aznar LA. The first 1000 days: an opportunity to reduce the burden of noncommunicable diseases. Nutr Hosp 2019;36(1):218-232. https://dx.doi.org/10.20960/nh.02453
Mamani V., Salvatierra R., Flores M.., Espinoza R..Increase in health registrations of breast milk substitutes in Peru during the COVID-19 pandemic. An. Fac. med.. 2022; 83(3): 251 - 253 http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832022000300251
Ministry of Health Peru - General Directorate of Health Consultation of Food Health Records http://www.digesa.minsa.gob.pe/Expedientes/Consulta_Registro_Sanitario.aspx
Ministry of Health Peru. Procedure guide for fortification of breast milk or pasteurized human milk. Lima https://www.inmp.gob.pe/uploads/file/Revistas/Neo2023/procedimiento/8_GUÍA%20DE%20PROCEDIMIENTO%20DE%20FORTIFICACIÓN%20DE%20LECHE%20MATERNA%20O%20LECHE%20HUMANA%20PASTEURIZADA.pdf
The official Gazette El Peruano. Legal norms: Approve the Manual of Advertising Warnings within the framework of Law No 30021. Lima: 2018 https://busquedas.elperuano.pe/download/url/aprueban-manual-de-advertencias-publicitarias-en-el-marco-de-decreto-supremo-n-012-2018-sa-1660606-1
Mamaní V, Dominguez C, Moreno A, Silva V, Bustamante A. Evaluation of processed and ultra-processed foods: An analysis before the implementation of front-of-package labeling in Peru Rev. chil. nutr. 2021; 48(3): 355-365. https://www.scielo.cl/pdf/rchnut/v48n3/0717-7518-rchnut-48-03-0355.pdf
Pries A, Mulder A, Badham J, Sweet L, Yuen K, Zehner E. Sugar content and nutrient content claims of growing-up milk in Indonesia. Matern Child Nutr. 2021; 17 (4): 1 - 11. https://doi.org/10.1111/mcn.13186
Food and Agriculture Organization. Codex Alimentarius. Guidelines on Nutrition Labeling CXG - 2 1985. https://www.fao.org/fao-who-codexalimentarius/sh-proxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXG%2B2-1985%252FCXG_002s.pdf
The official Gazette El Peruano. Legal norms: Supreme decree approving the regulation of Law No 30021, the law promoting healthy eating. Lima: 2017 https://busquedas.elperuano.pe/dispositivo/NL/1534348-4
Daga R, Weisstaub G. Octagonal warnings on breast milk substitutes: a tool to promote informed infant feeding. An. Fac. med. 2017 ; 84 (3): 372 - 374. http://dx.doi.org/10.15381/anales.v84i3.25551
Hoteit M, Ibrahim C, Nohra J, Sacre Y, Hanna-Wakim L, Al-Jawaldeh A. Assessment of the Composition of Breastmilk Substitutes. Commercial Complementary Foods, and Commercial Snacks Products Commonly Fed to Infant and Young Children in Lebanon: A call to action. Nutrients . 2023; 15 (5): 1200. https://doi.org/10.3390/nu15051200
World Health Organization. Guidelines: Sugar Intakes for Adults and Children. 2015 https://iris.who.int/bitstream/handle/10665/154587/WHO_NMH_NHD_15.2_spa.pdf?sequence=2
Alfaris N, Alothman Z, Aldayel T, Wabaidur S, Altamimi J. Evaluation and Comparison of the Nutritional and Mineral Content of Milk Formula in the Saudi Arabia Market. Front. Nutr. 2022; 9 : 1 - 8. https://doi.org/10.3389/fnut.2022.851229
World Health Organization. Global report on sodium intake reduction. 2023 https://iris.who.int/bitstream/handle/10665/366393/9789240069985-eng.pdf?sequence=1&isAllowed=y
Ministry of Health of Peru: Dietary guidelines for children under 2 years of age. 2020 https://cdn.www.gob.pe/uploads/document/file/1811895/Gu%C3%ADas%20Alimentarias%20para%20niños%20y%20niñas%20menores%20a%202%20años%20de%20edad.pdf
World Health Organization. Guidelines: Sodium intake for adults and children. 2013 https://iris.who.int/bitstream/handle/10665/85224/WHO_NMH_NHD_13.2_spa.pdf
Baker P, Smith J, Garde A, Grummer-Strawn L, Wood B, Sen G. The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress. Lancet . 2023; 401 : 503 - 524 .https://doi.org/10.1016/S0140-6736(22)01933-X
International Baby Food Action Network (IBFAN) . Peru 2020: Monitoring of the International Code of Marketing of Breast-milk Substitutes and relevant World Health Organization Resolutions and Infant Feeding Regulations during the COVID-19 pandemic. Lima, 2020. http://www.babymilkaction.org/wp-content/uploads/2021/06/Peru%CC%81-IBFAN-Informe-Monitoreo-Establecimientos.pdf.
Ching C, Zambrano P, Nguyen T, Tharaney M, Zafimanjaka M, Mathisen R. Old Tricks, New Opportunities: How Companies Violate the International Code Of Marketing of Marketing of Breat-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health. 2021; 18 (5) : 2381. https://doi.org/10.3390/ijerph18052381
Pan American Health Organization. Infant and young child feeding Chapter Model for textbooks aimed at medical students and other health sciences. 2010 https://www3.paho.org/hq/dmdocuments/2010/IYCF_model_SP_web.pdf
National Institute of Health Technical report: Nutritional status and food consumption of children under 3 years old from the Food and Nutritional Surveillance Survey by Life Stages - VIANEV. 2019 https://cdn.www.gob.pe/uploads/document/file/4527244/Informe%20%20Tecnico%20VIANEV%20niños%20%20menor%203%20años%202019.pdf?v=1693590786
The official gazette El Peruano. Legal norms: Approve regulations that establish the gradual reduction process towards the elimination of trans fats in industrially processed food and non-alcoholic beverages. Lima: 2016 https://busquedas.elperuano.pe/dispositivo/NL/1409585-3
Descargas
Publicado
Número
Sección
Categorías
Licencia
Derechos de autor 2025 Nutrición Clínica y Dietética Hospitalaria
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)
