Babies, soft drinks and snacks: a concern in low- and middle-income countries?

Abstract

Undernutrition in infants and young children is a global health priority while overweight is an emerging issue. Small-scale studies in low- and middle-income countries have demonstrated consumption of sugary and savoury snack foods and soft drinks by young children. We assessed the proportion of children 6-23 months of age consuming sugary snack foods in 18 countries in Asia and Africa using data from selected Demographic and Health Surveys and household expenditures on soft drinks and biscuits using data from four Living Standards Measurement Studies (LSMS). Consumption of sugary snack foods increased with the child's age and household wealth, and was generally higher in urban vs. rural areas. In one-third of countries, >20% of infants 6-8 months consumed sugary snacks. Up to 75% of Asian children and 46% of African children consumed these foods in the second year of life. The proportion of children consuming sugary snack foods was generally higher than the proportion consuming fortified infant cereals, eggs or fruit. Household per capita daily expenditures on soft drinks ranged from $0.03 to $0.11 in three countries for which LSMS data were available, and from $0.01 to $0.04 on biscuits in two LSMS. Future surveys should include quantitative data on the purchase and consumption of snack foods by infants and young children, using consistent definitions and methods for identifying and categorising snack foods across surveys. Researchers should assess associations between snack food consumption and stunting and overweight, and characterise household, maternal and child characteristics associated with snack food consumption.

Keywords: child feeding; child public health; complementary feeding; complementary foods; infant and child nutrition; low-income countries.

Figure 1

Percentage of children 6–23 months of age who consumed selected types of foods during the day or night preceding the interview.^a () Sugary foods, () infant formula, () fortified infant cereals, () eggs, () vitamin A‐rich fruits. ^aThe percentage of children who consumed sugary foods differed from the percentage who consumed other foods at P < 0.001 except for Madagascar for fruit (P = 0.01), Maldives for infant formula (P = 0.01) and fortified infant cereal (P = 0.004), Swaziland for fruit (P = 0.03), Timor‐Lester for eggs (P = 0.04), Uganda (2010) for fruit (P = 0.32) and Zimbabwe for eggs (P = 0.05).

Figure 2

Percentage of children 6–23 months of age who consumed any sugary foods during the day or night preceding the interview, by age category (Demographic and Health Survey).^a () 6–8 months, () 9–11 months, () 12–23 months. ^aThe percentage of children who consumed sugary foods differed significantly between ages 6–8 months and 12–23 months at P < 0.001 except for Sierra Leone (P = 0.002).

Figure 3

Percentage of children 6–23 months of age who consumed any sugary foods during the day or night preceding the interview, by area of residence (DHS).^a () Urban, () rural. ^aThe percentage of children who consumed any sugary foods differed significantly by urban vs. rural residence at P < 0.001 except for Philippines (P = 0.71) and Swaziland (P = 0.95).

Figure 4

Percentage of children 6–23 months of age who consumed any sugary foods during the day or night preceding the interview, by wealth quintile (DHS).^{a a}Proportions differed significantly between the lowest and highest quintiles at P < 0.001, except for the Maldives (P = 0.08).

Figure 5

Percentage of households purchasing any soft drinks in the previous week in Nigeria (2010–2011), by annual per capita total household expenditure decile.

Figure 6

Per capita weekly expenditure ($) on soft drinks among purchasers by annual per capital total household expenditure decile in Nigeria (2010–2011).