Association between parents' awareness of advertising warnings (octagons) and the consumption of ultra-processed foods by their children attending an early childhood education institution in Lima, 2025

Introduction: Front-of-package warning labels (octagons) constitute a public health strategy aimed at promoting healthier food choices; however, their impact on ultra-processed food consumption in the pediatric population remains limited and depends on parents’ level of understanding. Objective: To determine the association between parental knowledge of front-of-package warning labels (exposure variable) and ultra-processed food consumption in their children (outcome variable) attending an early childhood educational institution in Lima, Peru. Methods: An observational, analytical, cross-sectional study was conducted among 96 parents of children aged 2 to 6 years. Knowledge was classified into four levels (no knowledge, low, medium, high) using a validated questionnaire. Ultra-processed food consumption was assessed using a food frequency questionnaire and categorized as recommended (<28 points) and non-recommended (≥28 points). Crude and adjusted binary logistic regression models were applied, adjusting for age, sex, and body mass index-for-age. Results: The mean age of the children was 3.69 ± 0.85 years, and 85.4% had normal weight status. In the bi-variate analysis, an association was observed between parental knowledge and ultra-processed food consumption (p = 0.03). However, in the adjusted model, this association lost statistical significance (p = 0.372). Child age was inversely associated with non-recommended consumption (OR = 0.52; 95% CI: 0.29–0.94; p = 0.030). Conclusion: Parental knowledge of front-of-package warning labels was associated with ultra-processed food consumption in preschool children; however, this relationship did not remain significant after adjustment for covariates, suggesting the influence of multiple determinants on children’s dietary habits.