Snack food and beverage consumption and young child nutrition in low‐ and middle‐income countries: A systematic review

Abstract

Although snacks can provide important nutrients for young children during the complementary feeding period, the increasing availability of snack foods and sugar‐sweetened beverages (SSB), often energy‐dense and nutrient‐poor, in low‐ and middle‐income countries (LMIC) is a concern. Such foods may displace consumption of nutritious foods in contexts where diets are often nutritionally inadequate and the burden of childhood malnutrition is high. This systematic review summarizes literature on the contribution of snack food/SSB consumption to total energy intakes (TEI) of children below 23 months of age in LMIC and associations between this consumption and nutritional outcomes. It also identifies areas where further research is needed. A systematic search of Embase, Global Health, and MEDLINE for literature published in January 1990–July 2018 was conducted. This search yielded 8,299 studies, 13 of which met inclusion criteria: Nine studies assessed % TEI from snack foods/SSB, and four studies assessed associations between snack food/SSB consumption and nutritional outcomes. Average % TEI from snack foods/SSB ranged from 13% to 38%. Findings regarding associations with growth were inconclusive, and no studies assessed associations with nutrient intakes. Variation in measurement of consumption and definitions of snack foods and SSB limited study comparisons. Further research is needed to understand how consumption of energy‐dense, nutrient‐poor snack foods and SSB influences undernutrition and overnutrition among young children during the complementary feeding period in settings that are experiencing dietary transitions and the double burden of malnutrition.

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

“…Although other studies found both positive and negative associations of household wealth or socioeconomic status with snack consumption (Anderson et al, ; Gatica et al, ; Huffman et al, ; Monteiro et al, ; Pries, Huffman, Adhikary et al, ), this study found no significant effect, possibly a result of the majority of the sample being of higher wealth status, based on the 2012 IDHS national wealth levels. Commercial snack food and SSB consumption were significantly associated with increasing child age and a recent systematic review of the contribution of snack products to diets and nutritional status of children under two years found total energy intake from snack foods and SSB increased with age throughout the complementary period (Pries, Filteau, & Ferguson, ). The inverse associations of BMS and CPCF consumption with consumption of snack foods and/or SSB may reflect different choices caregivers are making on which commercial products to feed as snacks.…”

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

“…Additional regulations should be considered to restrict promotion of BMS for older children, jointpromotion of BMS with commercial snacks, inappropriate promotion of commercial complementary foods and child-targeted advertising of unhealthy commercial snack products. and beverages in regulations controlling inappropriate promotions of foods for young children is increasingly important as consumption becomes more prevalent (Pries, Filteau, & Ferguson, 2019) and habits and taste preferences established in childhood have been linked to long-term eating preferences (Beauchamp & Mennella, 2009;Ventura & Mennella, 2011). Indonesia lacks such regulation, in spite of the growing availability of commercially produced snack foods (Baker & Friel, 2016;Shrimpton & Rokx, 2013).…”

“…The 2010 WHO Set of Recommendations on the Marketing of Foods and Non‐alcoholic Beverages to Children encourages countries to enact policies which reduce children's exposure, directly and indirectly, to marketing of foods with high saturated fat, trans‐fatty acids, free sugars or salt (WHO, ). Inclusion of nutrient‐poor snack foods and beverages in regulations controlling inappropriate promotions of foods for young children is increasingly important as consumption becomes more prevalent (Pries, Filteau, & Ferguson, ) and habits and taste preferences established in childhood have been linked to long‐term eating preferences (Beauchamp & Mennella, ; Ventura & Mennella, ). Indonesia lacks such regulation, in spite of the growing availability of commercially produced snack foods (Baker & Friel, ; Shrimpton & Rokx, ).…”

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

“…Pries, Filteau, and Ferguson () conducted a systematic review of the contribution of snack food and sugar‐sweetened beverages to total energy intakes of children less than 2 years of age in LMIC and the relationship with nutritional outcomes. Among nine studies detailing contribution to energy intakes among children under 24 months in LMIC, total energy intakes from snack foods/beverages ranged from 13% in Peru to 38% in Cambodia.…”