High proportions of children under 3 years of age consume commercially produced snack foods and sugar‐sweetened beverages in Bandung City, Indonesia

Abstract

Child undernutrition continues to be a national concern in Indonesia, whereas childhood overweight/obesity rises. Economic development has led to wide availability of highly processed foods and beverages, with growing evidence that children are consuming commercial snack products during the critical complementary feeding period. This study assessed the prevalence and patterns of consumption of commercially produced snack foods and sugar‐sweetened beverages among Indonesian children. A cross‐sectional survey was conducted with 495 mothers of children aged 6–35 months living in Bandung City, Indonesia. Among all children, 81.6% consumed a commercial snack food and 40.0% consumed a sugar‐sweetened beverage in the day preceding the interview. At 6–11 months, 46.5% of children consumed a snack food and 2.0% consumed a sugar‐sweetened beverage. Snack foods were consumed 3 or more times a day by 60.0% of children 24–35 months of age. Sweet biscuits and savory snacks were the most commonly consumed snack foods; sweetened milks and sweetened teas were the most common beverages. Maternal education, child age, and consumption of a commercially produced complementary food were associated with snack food consumption. Factors associated with sugar‐sweetened beverage consumption were child age and consumption of a commercially produced complementary food or breastmilk substitute. These findings reflect a high presence of processed, high‐sugar/salt commercial snack products in the diets of children 6–35 months. National attention should focus on interventions to reduce reliance on processed snack products and increase consumption of nutrient‐rich, locally available foods during the complementary feeding period.

Promotions of breastmilk substitutes, commercial complementary foods and commercial snack products commonly fed to young children are frequently found in points‐of‐sale in Bandung City, Indonesia

“…The most prevalent caregiver‐targeted promotion was for sweetened milks (22.3%), which is also troubling as a recent multi‐country study on the perception of beverage healthiness found that Indonesian participants perceived flavoured, sweetened milk to be healthier than other sugar‐sweetened beverages (Thomson et al, ). With prevalent consumption of unhealthy commercial snack products by young children in Indonesia (Green et al, ), and rising rates of child overweight/obesity (MOH, ; Rachmi, Li, & Baur, ), promotions for these products could have a significant impact on the health and well‐being of children in Indonesia. The Indonesian government should consider passing and enforcing food industry regulations related to caregiver‐ and child‐targeted promotion of commercial snack foods to reduce the impact of unhealthy snacking among children.…”

“…Small stores were sampled for their proximity to public sector health facilities offering child health services (WHO & UNICEF, ). The 33 facilities were identified in coordination with the Bandung City Health Office in preparation for a survey with mothers of young children (Green et al, ). Using Google Maps and Google Street View, four small stores in closest proximity to each health facility were listed.…”

“…Complementary foods are often introduced too early (BPS, BKKBN, Kemenkes, & ICF International, ; Muslimatun & Wiradnyani, ), and a number of studies have documented micronutrient deficiencies among children in the complementary feeding period (Diana et al, ; Fahmida & Santika, ; Muslimatun & Wiradnyani, ; Santika, Februhartanty, & Ariawan, ). There is also growing evidence that commercial snack foods, with high levels of salt, sugar and fat, are becoming increasingly common in diets of infants and young Indonesian children (Green et al, ; Imanningsih, Jahari, Permaesih, Chan, & Amarra, ; Purwestri et al, ; Sekiyama, Roosita, & Ohtsuka, ; White et al, ), potentially displacing breastmilk and other nutrient‐rich foods (Pries et al, ). A study in Central Java found that stunted children 6–59 months had significantly higher snack consumption than non‐stunted children in the last 24 hr (Purwestri et al, ).…”

Marketing and infant and young child feeding in rapidly evolving food environments

“…Green et al () report on consumption patterns among 495 children 6–35 months of age interviewed as part of a cross‐sectional survey in Bandung City. Consumption of commercial infant and young child feeding products was prevalent, with 49.5% and 37.4% of children having consumed a BMS or commercially produced complementary food in the previous day.…”

Commercially produced complementary foods in Bandung City, Indonesia, are often reported to be iron fortified but with less than recommended amounts or suboptimal forms of iron

“…This study was conducted as a substudy of an assessment of availability and promotions of CPCF in Bandung City, Indonesia, in 2017 (Green et al, ). CPCF were defined as foods recommended for children less than 3 years of age with a label or package that recommends an age of introduction less than 3 years on the label and/or uses the term “baby” or words referring to a child's age to describe the food (e.g., “baby food”), not including infant formula or other breastmilk substitutes (WHO, ).…”