28 results on '"Pries, Alissa M."'
Search Results
2. Unhealthy Snack Food and Beverage Consumption Is Associated with Lower Dietary Adequacy and Length-for-Age z-Scores among 12–23-Month-Olds in Kathmandu Valley, Nepal
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Pries, Alissa M, Rehman, Andrea M, Filteau, Suzanne, Sharma, Nisha, Upadhyay, Atul, and Ferguson, Elaine L
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- 2019
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3. Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries.
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Pries, Alissa M., Bassetti, Eleonora, White, Jessica M., Mulder, Anzélle, Threapleton, Diane, and Blankenship, Jessica
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SNACK foods , *HUMAN growth , *CANDY , *CHILD nutrition , *NUTRITIONAL assessment , *NUTRITIONAL value , *FOOD consumption , *CHILD development , *INFANTS , *CROSS-sectional method , *NUTRITIONAL requirements , *BENCHMARKING (Management) , *LABELS , *PACKAGED foods , *DIETARY sucrose , *SWEETENERS , *INFANT nutrition , *PEARSON correlation (Statistics) , *RESEARCH funding , *CHILDREN'S health , *CHI-squared test , *DESCRIPTIVE statistics , *DATA analysis software , *DIETARY sodium - Abstract
Ensuring consumption of nutrient‐dense, safe and appropriate complementary foods among older infants and young children (IYC) 6–36 months of age is critical for enabling optimal growth and development. The ubiquitous availability of and high demand for commercially packaged snack foods has culminated in a growing trend of snack food products specifically produced and promoted for older IYC. Commercially produced complementary foods (CPCF) that are finger foods/snacks often contain added sugars, excessive sodium content and high total sugar content, making them inappropriate for this young population. This study benchmarked the nutrient composition and labelling practices of CPCF finger foods/snacks available for purchase in seven countries in Southeast Asia. The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. Of the total 606 products identified, 8.2% were automatically categorized as not suitable because they were confectionery items. Of the remaining 556 products assessed, over 85% failed to meet all nutrient composition requirements, with the presence of added sugars/sweeteners and excessive sodium and total sugar contents the primary reasons for failure. Products also demonstrated concerning labelling practices, with all of the products (98.6%) displaying an inappropriate claim on the label. These findings reveal major concerns with the nutrient composition and labelling practices of CPCF finger foods/snacks in the SEA region and should serve as an alarm bell for regulatory action. National binding legal measures, such as mandatory standards for composition and labelling are urgently needed. Key messages: CPCF finger foods/snacks made up 18‐45% of CPCF products across the seven countries, indicating a normalization of commercially packaged, processed snacks products in older IYC diets.Over 85% of products failed to meet all nutrient composition requirements. Three‐quarters contained added sugars/sweeteners, half high total sugar, and half excessive levels of sodium, indicating that most products are not nutritionally appropriate for this young age group.No CPCF finger foods/snacks met all labelling requirements and most displayed inappropriate claims. With nearly all products containing excessive levels of total sugar, added sugar or sodium, use of persuasive claims on these products is alarming. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Benchmarking the nutrient composition and labelling practices of dry or instant cereals for older infants and young children across seven Southeast Asian countries.
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Bassetti, Eleonora, Blankenship, Jessica, White, Jessica M., Sweet, Lara, Threapleton, Diane, and Pries, Alissa M.
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FOOD labeling ,CHILD nutrition ,NUTRITIONAL value ,ENRICHED foods ,BENCHMARKING (Management) ,DESCRIPTIVE statistics ,RESEARCH funding ,GRAIN ,MICRONUTRIENTS ,ELEMENTAL diet ,NUTRITION policy - Abstract
In Southeast Asia, the increasing availability of commercially produced complementary foods (CPCF), including dry or instant cereals (CPCF cereals), has been noted, however, concerns exist around their nutrient profile and labelling practices. This 2021 study assessed the nutrient composition, labelling practices, and micronutrient content of CPCF cereals sold in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Vietnam), and Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older infants and young children. Micronutrient content of fortified CPCF cereals was assessed against fortification levels specified in the Codex Alimentarius guideline for formulated complementary foods. Of the 484 products assessed, 184 (38.0%) met all nutrient composition requirements. Around one‐third of CPCF cereals contained added sugars and/or sweeteners (37.2%) and high levels of sodium (28.9%). None of the CPCF cereals met all labelling requirements, primarily due to the presence of inappropriate claims on the labels. Most fortified CPCF cereals contained adequate amounts of critical micronutrients, such as calcium, iron, zinc, vitamin A, and vitamin D. However, rates of fortification varied across the seven countries, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. To support the appropriate promotion of CPCF in the region, Southeast Asian countries need to strengthen and enforce national binding legal measures, including national standards for the composition, labelling, and fortification of CPCF cereals. Key messages: Despite most commercially produced complementary foods (CPCF) cereals available in Southeast Asia met the majority of nutrient composition requirements, a considerable number of products contained added sugars/sweeteners (37.2%) and high levels of sodium (28.9%). Regulations that prohibit the use of added sugars/sweeteners and establish an upper limit for sodium in CPCF cereals are a policy priority in the region.None of the 484 CPCF cereals studied met all labelling requirements. Inappropriate claims were the most common. Three‐quarters of the products failed to meet labelling requirements on the protection and promotion of breastfeeding. National regulations on labelling must be strengthened and enforced to protect against inappropriate marketing of CPCF.Approximately two‐thirds or more of fortified CPCF cereals contained adequate amounts of micronutrients critical for older infants and young children (IYC), such as calcium, iron, zinc, vitamin A and vitamin D. Nonetheless, the fortification of CPCF cereals varied greatly by country, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. This is a missed opportunity to provide essential micronutrients to older IYC in contexts where nutrient‐poor diets are common. Future policies that stipulate mandatory minimum micronutrient levels for CPCF cereals are recommended for the region. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Benchmarking the nutrient composition and labelling practices of commercially produced ready‐to‐eat purées and meals for older infants and young children across seven Southeast Asian countries.
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Bassetti, Eleonora, Blankenship, Jessica, White, Jessica M., Mulder, Anzélle, Threapleton, Diane, and Pries, Alissa M.
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FOOD labeling ,NUTRITIONAL value ,INFANTS ,CROSS-sectional method ,NUTRITIONAL requirements ,PACKAGED foods ,BENCHMARKING (Management) ,DIETARY sucrose ,MEDICAL protocols ,DESCRIPTIVE statistics ,RESEARCH funding ,PHYSICIAN practice patterns ,DATA analysis software - Abstract
Commercially produced complementary foods (CPCF), including ready‐to‐eat CPCF purées and meals, are gaining popularity among caregivers of older infants and young children (IYC) as a convenient alternative to home‐prepared foods in low and middle‐income countries. However, there is growing concern regarding the suitability of these products for older IYC, as they can contain high levels of sugar and/or sodium. Given the rapidly evolving market in Southeast Asia, it is crucial to monitor the appropriate composition and promotion of CPCF in the region. This study examined the nutrient composition and labelling practices of CPCF purées and meals sold in 2021 in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Viet Nam), Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. The proportion of CPCF purées and meals that would require a high sugar front‐of‐pack warning based on the percentage energy from total sugar was also determined. Of the 459 CPCF purées/meals assessed, only 37.7% of the products met all nutrient composition requirements and none met all labelling requirements. In addition, most CPCF purées and meals were identified as having high total sugar content. To ensure that older IYC consume appropriate CPCF products, Southeast Asian countries need to implement and enforce regulations concerning the nutrient composition and labelling practices of CPCF purées and meals. Key messages: Only one‐third of CPCF purées/meals were identified as nutritionally suitable for promotion for older IYC, with performance varying by sub‐category, and over three‐quarters of products contained high levels of total sugar.None of the CPCF purées/meals presented fully appropriate labelling practices, with the use of inappropriate claims the most prevalent issue. Further, one‐third of products recommended an age of introduction of less than 6 months.To ensure that CPCF purées/meals sold in Southeast Asia have appropriate nutrient composition and labelling practices, it is essential that national standards are in accordance with global guidance and enforced. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Accuracy of declared nutrient content on labels of commercial complementary food products in Cambodia, Indonesia and Senegal.
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Champeny, Mary, Yuen‐Esco, Katelyn, Juniza, Eva, Sy, Ndeye Y., Kane, Rosenette, Badham, Jane, Mulder, Anzélle, and Pries, Alissa M.
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FOOD labeling ,CHILD nutrition ,NUTRITIONAL value ,ENRICHED foods ,CROSS-sectional method ,SATURATED fatty acids ,BABY foods ,PUBLIC health ,NUTRITIONAL requirements ,CALCIUM compounds ,ZINC compounds ,COMMERCIAL product evaluation ,CARBOHYDRATES ,DESCRIPTIVE statistics ,RESEARCH funding ,METROPOLITAN areas ,MICRONUTRIENTS ,DATA analysis software ,DIETARY sodium ,IRON compounds - Abstract
Commercially produced complementary foods (CPCF) have the potential to fill nutritional gaps in the diets of older infants and young children. This study evaluated the accuracy of nutrient declarations on labels of 43 commonly available CPCF in three peri‐urban/urban locations: Khsach Kandal district, Cambodia (n = 11); Bandung, Indonesia (n = 11) and Guédiawaye and Dakar departments, Senegal (n = 21). Label values (LV) from product nutrient declarations were compared to analytical values (AV) derived from laboratory nutrient analysis for macronutrients (carbohydrate, protein and total fat), nutrients of public health concern (saturated fat, total sugar and sodium), and micronutrients of interest (calcium, iron and zinc). European Union guidance for nutrition label accuracy was used to set tolerance ranges for each nutrient LV relative to AV. LV were missing for one or more nutrients in 88.4% (n = 38) of the CPCF products and no CPCF met EU tolerance thresholds for all nine nutrients assessed. Over half of products with LV for key micronutrients (55.6%, n = 10/18) and macronutrients (54.8%, n = 23/42) met tolerances for LV accuracy. Eighty‐five percent (n = 11/13) of products with LV for nutrients of public health concern were determined to be accurate. Nutrient content claims for iron appeared on 19 (44.2%) of the 43 products. Of the products which made an iron content claim, 26.3% had inaccurate LV with the majority of these containing less iron than declared. Regulatory action is needed to ensure that CPCF labelling communicates complete and accurate nutrient content information that enables caregivers to make informed decisions for feeding older infants and young children. Key messages: None of the 43 commercially produced complementary food (CPCF) products assessed met tolerance thresholds for nutrient label value accuracy, either because of missing nutrient label information or discrepancies with laboratory derived analytical values.The proportion of accurate nutrient label values for individual nutrients ranged from 54.2% (n = 13/24) for calcium to 94.7% (n = 36/38) for sodium.While infant cereals generally had high proportions of accurate label values for the nine nutrients assessed, fewer than half of snacks/finger foods (e.g. rusks/biscuits) had accurate label values for protein and calcium and only a third were accurate for zinc.Nutrient content claims were prevalent across the 43 CPCF products, which can create a 'health halo' (the perception that something is healthy without direct evidence) for these products. However, over half of products with nutrient content claims for iron and calcium were found to contain lower levels of these micronutrients when compared to analytical values. These products were found to overstate iron content and calcium content by a median of 4.71 mg per 100 g product and 101.7 mg per 100 g product, respectively.Nutrient content claims and nutrient declarations should be regulated and monitored by national authorities to ensure accurate labelling of CPCF. Manufacturers of CPCF have a responsibility to provide consumers with correct product information and should be accountable for the content of CPCF nutrient declarations. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Consumption of commercially produced snack foods and sugar‐sweetened beverages during the complementary feeding period in four African and Asian urban contexts
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Pries, Alissa M., Huffman, Sandra L., Champeny, Mary, Adhikary, Indu, Benjamin, Margaret, Coly, Aminata Ndeye, Diop, El Hadji Issakha, Mengkheang, Khin, Sy, Ndèye Yaga, Dhungel, Shrid, Feeley, Alison, Vitta, Bineti, and Zehner, Elizabeth
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- 2017
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8. Nutrient Profiles of Commercially Produced Complementary Foods Available in Burkina Faso, Cameroon, Ghana, Nigeria and Senegal.
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Khosravi, Asha, Bassetti, Eleonora, Yuen-Esco, Katelyn, Sy, Ndeye Yaga, Kane, Rosenette, Sweet, Lara, Zehner, Elizabeth, and Pries, Alissa M.
- Abstract
The nutritional quality of commercially produced complementary food (CPCF) varies widely, with CPCF in high-income settings often containing excessive levels of sugar and sodium. Little is known about the nutritional quality of CPCF available in the West Africa region, despite their potential to improve the nutrition of infants and young children (IYC). This study evaluated the nutritional quality of CPCF available in five West African countries using the WHO Europe nutrient profiling model (NPM) and assessed their suitability for IYC based on label information. The proportion that would necessitate a "high sugar" warning was also determined, and the micronutrient (iron, calcium, and zinc) content was assessed against IYC-recommended nutrient intakes. Of the 666 products assessed, only 15.9% were classified as nutritionally suitable for promotion for IYC. The presence of added sugar and excessive sodium levels were the most common reasons for a product to fail the nutrient profiling assessment. Dry/instant cereals contributed the highest percentage of recommended nutrient intake (RNI) per serving. This highlights the need for policies to improve the nutritional quality of CPCF in West Africa, including labeling standards and the use of front-of-pack warning signs to promote product reformulation and clearly communicate nutritional quality to caregivers. [ABSTRACT FROM AUTHOR]
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- 2023
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9. High consumption of unhealthy commercial foods and beverages tracks across the complementary feeding period in rural/peri-urban Cambodia.
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Hinnouho, Guy-Marino, Ferguson, Elaine L., MacDougall, Amy, Kroeun, Hou, Sophonneary, Prak, Chea, Mary, and Pries, Alissa M.
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STATISTICS ,INFANT development ,CAREGIVERS ,CONFIDENCE intervals ,CONVENIENCE foods ,ANALYSIS of variance ,FOOD consumption ,INFANTS ,TELEPHONES ,ANTHROPOMETRY ,NUTRITIONAL requirements ,REGRESSION analysis ,GOVERNMENT policy ,QUESTIONNAIRES ,REPEATED measures design ,CHI-squared test ,STATISTICAL hypothesis testing ,FACTOR analysis ,STATISTICAL sampling ,LOGISTIC regression analysis ,DATA analysis ,SENSITIVITY & specificity (Statistics) ,DATA analysis software ,RURAL population ,LONGITUDINAL method ,POISSON distribution ,CHILDREN - Abstract
Consumption of unhealthy commercial foods and beverages (UCFB) is common among infants and young children living in low- and middle-income countries. Such foods can displace other nutritious foods, however, there is limited evidence on how this consumption tracks across time. This study assessed and tracked UCFB consumption of children living in rural/peri-urban Cambodia during the complementary feeding period, identified UCFB consumption patterns of these children, and explored the association between UCFB consumption and growth. A 6-month longitudinal cohort study was implemented among 567 caregivers of children aged 10-14 months at recruitment. UCFB consumption was estimated each month via a telephone-administered 7-day food frequency questionnaire, and UCFB consumption patterns were identified based on changes in this frequency of consumption over time. The majority of children either maintained (45.7%, n = 246) or developed (43.5%, n = 234) an unhealthy consumption pattern and only 10.8% (n = 58) of children maintained/transitioned into a healthy consumption pattern. High consumers of UCFB at 10-14 months had a 4.7 (CI: 4.7 [3.1-7.2]) times odds of being high consumers of UCFB at 15-19 months (p < 0.001). There was a trend of lower length- for-age z-scores (LAZ) among children maintaining or developing an unhealthy consumption pattern (~-0. SD LAZ) compared to children maintaining/transitioning into a healthy consumption pattern, however, this association was not statistically significant. Findings indicate that high UCFB consumption begins during infancy and tracks into early childhood. National policies and programmes centred on early interventions addressing the use of UCFB for infant and young child feeding are needed. [ABSTRACT FROM AUTHOR]
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- 2023
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10. Prevalence of Front-of-Pack Warning Signs among Commercial Complementary Foods in Seven High and Upper Middle-Income Countries.
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Bassetti, Eleonora, Khosravi, Asha, and Pries, Alissa M.
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Front-of-pack nutrition labelling (FOPNL) can provide a mechanism for communicating the nutritional quality of commercially produced complementary foods (CPCF) to caregivers. To better understand the role FOPNL may provide for CPCF, this study aimed to evaluate CPCFs against national and global FOPNL systems to determine the proportion that would warrant warning or traffic light signs for high levels of concerning nutrients. A cross-sectional assessment was conducted to evaluate the levels of selected nutrients in CPCF available in Australia (n = 266), Brazil (n = 41), Chile (n = 73), Mexico (n = 164), the United States (n = 562), the United Arab Emirates (n = 135), and the United Kingdom (n = 643). The analysis was based on national FOPNL systems and the WHO Regional Office for Europe CPCF nutrient profiling model's 'high sugar' FOPNL warning. A substantial proportion of CPCFs contained excessive levels of total sugar, total fat or saturated fat that would warrant a red/amber traffic light or warning sign on product labels. Additionally, the high prevalence of added sugars and sweeteners identified in CPCFs was concerning. Based on these findings, the use of FOPNL among CPCFs could be beneficial to communicate the nutritional quality of these products to caregivers and trigger the reformulation of CPCFs with inappropriate nutrient profiles. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding
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Pries, Alissa M., Huffman, Sandra L., Mengkheang, Khin, Kroeun, Hou, Champeny, Mary, Roberts, Margarette, and Zehner, Elizabeth
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- 2016
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12. Promotion and consumption of commercially produced foods among children: situation analysis in an urban setting in Senegal
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Feeley, Alison B., Ndeye Coly, Aminata, Sy Gueye, Ndeye Yaga, Diop, Elhadji Issakha, Pries, Alissa M., Champeny, Mary, Zehner, Elizabeth R., and Huffman, Sandra L.
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- 2016
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13. High use of commercial food products among infants and young children and promotions for these products in Cambodia
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Pries, Alissa M., Huffman, Sandra L., Mengkheang, Khin, Kroeun, Hou, Champeny, Mary, Roberts, Margarette, and Zehner, Elizabeth
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- 2016
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14. Infant and young child feeding practices among children under 2 years of age and maternal exposure to infant and young child feeding messages and promotions in Dar es Salaam, Tanzania
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Vitta, Bineti S., Benjamin, Margaret, Pries, Alissa M., Champeny, Mary, Zehner, Elizabeth, and Huffman, Sandra L.
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- 2016
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15. High consumption of commercial food products among children less than 24 months of age and product promotion in Kathmandu Valley, Nepal
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Pries, Alissa M., Huffman, Sandra L., Adhikary, Indu, Upreti, Senendra Raj, Dhungel, Shrid, Champeny, Mary, and Zehner, Elizabeth
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- 2016
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16. Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal
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Pries, Alissa M., Huffman, Sandra L., Adhikary, Indu, Upreti, Senendra Raj, Dhungel, Shrid, Champeny, Mary, and Zehner, Elizabeth
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- 2016
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17. Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia and the Philippines.
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Bassetti, Eleonora, Zehner, Elizabeth, Mayhew, Susannah H, Nasser, Nadine, Mulder, Anzélle, Badham, Jane, Sweet, Lara, Crossley, Rachel, and Pries, Alissa M
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CAPITAL cities ,NUTRITIONAL requirements ,LABEL design ,SUGAR - Abstract
Objective: To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts. Design: Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a 'high sugar' warning was also determined. Setting: Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines. Participants: CPCF products purchased in Cambodia (n 68) and Philippines (n 211) in 2020, and Indonesia (n 211) in 2017. Results: Only 4·4 % of products in Cambodia, 10·0 % of products in Indonesia and 37·0 % of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen per cent of CPCF in Cambodia, 27·0 % in Indonesia and 58·8 % in the Philippines contained total sugar content levels that would require a 'high sugar' warning. Conclusions: Most of the analysed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Sugar content and nutrient content claims of growing‐up milks in Indonesia.
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Pries, Alissa M., Mulder, Anzélle, Badham, Jane, Sweet, Lara, Yuen, Katelyn, and Zehner, Elizabeth
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KRUSKAL-Wallis Test , *FOOD labeling , *BEVERAGES , *NUTRITIONAL value , *CROSS-sectional method , *INGESTION , *MILK , *CARBOHYDRATES , *DESCRIPTIVE statistics , *DATA analysis software - Abstract
'Growing‐up milks' (GUMs)—breast‐milk substitutes targeted for young children (aged 12–36 months)—are commonly consumed in Indonesia. The World Health Assembly has stated that GUMs are not necessary for proper growth and development, and recently, the American Academy of Pediatrics declared that such products are not recommended for young children due to their common use of sweeteners. To contribute to the evidence base on the composition of GUMs and their appropriateness for young child diets, this cross‐sectional study documented the declared sugar content and presence of nutrient content claims of 99 GUMs newly launched in Indonesia between January 2017 and May 2019. Sugar content was evaluated against the draft 2018 Codex Alimentarius Standard for Follow‐Up Formula guidance on sugar content and the United Kingdom Food Standard Agency's front‐of‐pack (UK FSA FOP) colour coding system for sugar. Almost all (97%) GUMs contained one or more added sugars. None of the products were fully compliant with all three sugar content recommendations in the draft Codex standard. Seventy‐one per cent of GUMs were determined to have high sugar content according to the UK FSA FOP system. Nutrient content claims were found on 97% of GUMs. Median total sugar content was 7.3 g per 100 ml, similar to sugar content levels in sugar‐sweetened beverages. Many GUMs available in Indonesia claim to offer nutritional benefits; however, the current levels of sugar content in GUMs are a serious concern and are inappropriate for inclusion in the diets of young children. [ABSTRACT FROM AUTHOR]
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- 2021
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19. Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal
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Champeny, Mary, Pries, Alissa M., Hou, Kroeun, Adhikary, Indu, Zehner, Elizabeth, and Huffman, Sandra L.
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Adult ,Male ,breast milk substitutes ,breastfeeding ,Attitude of Health Personnel ,education ,Mothers ,Supplement Articles ,Hospitals, Maternity ,Birthing Centers ,Young Adult ,breastfeeding initiation ,Nepal ,Advertising ,Pregnancy ,Risk Factors ,Humans ,infant feeding behaviour ,Milk, Human ,digestive, oral, and skin physiology ,Infant, Newborn ,infant formula ,Marketing and Consumption of Commercial Foods Fed to Young Children in Low and Middle‐income Countries. Guest Editors: Elizabeth Zehner and Mary Champeny. Publication of this supplement was supported by the Bill & Melinda Gates Foundation ,stomatognathic diseases ,Breast Feeding ,Cross-Sectional Studies ,Socioeconomic Factors ,Supplement Article ,Female ,infant feeding decisions ,Milk Substitutes ,Cambodia - Abstract
Introducing breast milk substitutes (BMS) in the first days after birth can increase infant morbidity and reduce duration and exclusivity of breastfeeding. This study assessed determinants of BMS feeding among newborns in delivery facilities in Phnom Penh, Cambodia, and Kathmandu Valley, Nepal. Cross‐sectional surveys were conducted among mothers upon discharge from health facilities after delivery: 304 mothers in Kathmandu Valley and 306 mothers in Phnom Penh participated. On the basis of a conceptual framework for prelacteal feeding, multivariable logistic regression was used to identify factors associated with BMS feeding prior to facility discharge. In both Phnom Penh and Kathmandu Valley, feeds of BMS were reported by over half of mothers (56.9% and 55.9%, respectively). Receiving a health professional's recommendation to use BMS increased the odds of BMS feeding in both Kathmandu Valley and Phnom Penh (odds ratio: 24.87; confidence interval [6.05, 102.29]; odds ratio: 2.42; CI [1.20, 4.91], respectively). In Kathmandu Valley, recommendations from friends/family and caesarean delivery were also associated with BMS use among mothers. Early initiation of breastfeeding and higher parity were protective against the use of BMS in Kathmandu Valley. Breastfeeding support from a health professional lowered the odds of BMS feeding among newborns. Exposure to BMS promotions outside the health system was prevalent in Phnom Penh (84.6%) and Kathmandu Valley (27.0%) but was not associated with BMS feeds among newborns. Establishment of successful breastfeeding should be prioritized before discharging mothers from delivery facilities, and health professionals should be equipped to support and encourage breastfeeding among all new mothers.
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- 2019
20. Snack food and beverage consumption and young child nutrition in low‐ and middle‐income countries: A systematic review
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Pries, Alissa M., Filteau, Suzanne, and Ferguson, Elaine L.
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double burden ,nutrition ,digestive, oral, and skin physiology ,Supplement Article ,Supplement Articles ,Marketing and Consumption of Commercial Foods Fed to Young Children in Low and Middle‐income Countries. Guest Editors: Elizabeth Zehner and Mary Champeny. Publication of this supplement was supported by the Bill & Melinda Gates Foundation ,complementary feeding ,low‐ and middle‐income countries ,snacks ,sugar‐sweetened beverages - 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.
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- 2019
21. Breastfeeding and breastmilk substitute use and feeding motivations among mothers in Bandung City, Indonesia.
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Green, Mackenzie, Pries, Alissa M., Hadihardjono, Dian N., Izwardy, Doddy, Zehner, Elizabeth, and Moran, Victoria Hall
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BREASTFEEDING & psychology , *INFANT formulas , *CROSS-sectional method , *SOCIAL norms , *MOTIVATION (Psychology) , *SOCIAL factors , *INTERVIEWING , *MOTHERHOOD , *PARENTING , *INFANT nutrition , *MARKETING , *RESEARCH funding , *QUESTIONNAIRES , *EMPLOYMENT , *CLUSTER analysis (Statistics) , *STATISTICAL sampling , *DATA analysis software - Abstract
Suboptimal breastfeeding is common in Indonesia, with only half of infants 0–5 months of age exclusively breastfed and feeding of breastmilk substitutes (BMS) highly prevalent among infants and toddlers. Various factors influence these feeding practices, including social norms, limited health system support and BMS manufacturer marketing practices. This cross‐sectional survey aimed to identify the prevalence of breastfeeding and BMS feeding among children aged 0–35 months, explore socio‐demographic characteristics and motivating factors associated with these feeding behaviours and identify the prevalence of mothers' exposure to BMS promotions. Indonesian mothers of children <3 years of age (n = 595) were interviewed in Bandung City health facilities using structured questionnaires. Although all children were ever breastfed, half of children across all age groups received BMS in the previous day. Maternal employment outside the home and insufficient breastmilk production were associated with BMS use. The most important motivational factors for feeding BMS were perceived benefits for growth, intelligence and immunity. Despite Indonesian legislation restricting some BMS marketing, 93% of mothers reported observing a BMS promotion outside the health system, with television, social media and newspapers as the most common sources. Half of mothers (43%) reported observing a BMS promotion within the health system, and half (46%) reported receiving recommendations from health workers to use BMS. Such high prevalence of BMS marketing may be influencing caregivers' feeding choices; stronger national legislation and implementation of laws are needed to ensure mothers' ability to make feeding choices free from manufacturer influence. [ABSTRACT FROM AUTHOR]
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- 2021
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22. Exploratory Analysis of Nutritional Quality and Metrics of Snack Consumption among Nepali Children during the Complementary Feeding Period.
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Pries, Alissa M., Ferguson, Elaine L., Sharma, Nisha, Upadhyay, Atul, and Filteau, Suzanne
- Abstract
The World Health Organization recommends feeding snacks between meals to young children. This study explored nutritional quality of snacks consumed between meals and consumption metrics (% total energy intakes (%TEI) and amount of kcal from snacks) to understand correlations with dietary outcomes (total energy intakes and dietary adequacy) and body-mass-index-for-age z-scores (BMIZ). Data used were 24-h dietary recalls and anthropometric measurements among a representative sample (n = 679) of one-year-olds in Nepal. Nepali meal patterns for young children were identified through formative research and all foods/beverages consumed outside of meals were categorized as snacks. A nutrient profiling model was used to categorize snacks as healthy or unhealthy, based on positive and negative nutrient content. Snacks consumed between meals provided half of all energy consumed, and were associated with increased energy and nutrient intakes. The positive effect of snacks between meals on dietary adequacy was greater when these snacks were healthy, while increasing %TEI from unhealthy snacks consumed between meals was negatively associated with dietary adequacy. Consumption of snacks between meals was not associated with mean BMIZ among the children. These findings indicate that the provision of and nutritional quality of snacks are important considerations to communicate to caregivers. Discouragement of unhealthy, nutrient-poor snacks is critical for complementary feeding dietary guidelines in contexts experiencing nutrition transition. [ABSTRACT FROM AUTHOR]
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- 2019
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23. Commercial Snack Food and Beverage Consumption Prevalence among Children 6–59 Months in West Africa.
- Author
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Nordhagen, Stella, Pries, Alissa M., and Dissieka, Romance
- Abstract
Consumption of commercial snack food and beverage products among infants, young, and school-aged children may have negative effects on child nutritional outcomes, as these foods are typically dense in energy but not in micronutrients. However, there is limited information available about the consumption of such snacks in low-income settings, particularly in Africa. We contribute to filling this gap using data from 11,537 children aged 6–59.9 months from four West African countries (i.e., Burkina Faso, Cote d'Ivoire, Mali, and Niger). We estimated the prevalence of commercial snack food and drink consumption and explored variations within the sample by age group, urban or rural residence, household wealth status, and caregiver educational attainment. The results show that 25.7% of children in Niger, 31.5% in Burkina Faso, 42.9% in Mali, and 45.4% in Cote d'Ivoire ate at least one commercial snack food or beverage in the prior 24 h. Consumption prevalence was significantly higher in urban areas than rural areas, among older children (ages 2–5 y) than those in the complementary feeding period (6–23.9 months), and among children in wealthier households. These relationships were confirmed via logistic regression. Our results confirm the widespread consumption of commercial snack foods and drinks by young children in West Africa, a finding with relevance for nutrition policy and programming. [ABSTRACT FROM AUTHOR]
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- 2019
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24. Energy intake from unhealthy snack food/beverage among 12‐23‐month‐old children in urban Nepal.
- Author
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Pries, Alissa M., Sharma, Nisha, Upadhyay, Atul, Rehman, Andrea M., Filteau, Suzanne, and Ferguson, Elaine L.
- Subjects
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ANALYSIS of variance , *CAREGIVERS , *CHI-squared test , *CLUSTER analysis (Statistics) , *CONFIDENCE intervals , *STATISTICAL correlation , *DIET , *FOOD habits , *INGESTION , *METROPOLITAN areas , *MULTIVARIATE analysis , *QUESTIONNAIRES , *RESEARCH funding , *STATISTICAL sampling , *SNACK foods , *STATISTICS , *SURVEYS , *T-test (Statistics) , *LOGISTIC regression analysis , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *MIDDLE-income countries , *LOW-income countries , *ODDS ratio , *KRUSKAL-Wallis Test - Abstract
Unhealthy snack food and beverage (USFB) consumption among young children has been noted in many low‐income and middle‐income countries (LMIC), however, there is a lack of information on the contribution of these foods to children's diets in these contexts. This study describes the nutrient profiles and costs of snacks consumed by young children in Kathmandu Valley, Nepal, and assesses the proportion of total energy intake from nonbreastmilk foods (%TEI‐NBF) contributed by USFB and factors associated with high USFB consumption. A cross‐sectional survey was conducted among 745 randomly sampled primary caregivers of children aged 12–23 months. Of 239 unique snack foods and beverages consumed, 180 (75.3%) were classified as unhealthy based on nutrient profiling, with 158 of these being commercially branded. Median cost/100 kcal of USFB was lower as compared with healthy snacks. Ninety‐one percent of children had consumed a USFB in the previous 24 hr, with these foods contributing a mean %TEI‐NBF of 24.5 ± 0.7 among all children. Biscuits (10.8%), candy/chocolate (3.5%), and savoury snacks (3.4%) provided the largest %TEI‐NBF. Children who were older, female, or from the poorest households had significantly higher odds of high USFB consumption, whereas children whose caregivers were of upper caste/ethnicity or had achieved tertiary education had lower odds of consumption than other children. To reduce USFB consumption, interventions should seek to further understand social/cultural drivers of feeding practices, target disadvantaged populations, and ensure caregivers are fully aware of the nutritional quality of food products they choose for their children. [ABSTRACT FROM AUTHOR]
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- 2019
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25. Prevalence, duration, and content of television advertisements for breast milk substitutes and commercially produced complementary foods in Phnom Penh, Cambodia and Dakar, Senegal.
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Champeny, Mary, Hou, Kroeun, Diop, Elhadji Issakha, Sy Gueye, Ndeye Yaga, Pries, Alissa M., Zehner, Elizabeth, Badham, Jane, and Huffman, Sandra L.
- Subjects
MARKETING laws ,ADVERTISING ,BREAST milk ,FOOD habits ,HEALTH promotion ,INFANT formulas ,INFANT nutrition ,MARKETING ,MASS media ,NUTRITIONAL requirements ,RESEARCH funding ,SALES personnel ,TELEVISION ,WORLD health ,PACKAGED foods ,NUTRITIONAL value - Abstract
Promotion of breast milk substitutes (BMS) and inappropriate marketing of commercially produced complementary foods (CPCF), including through television, can negatively influence infant and young child feeding. The World Health Organization International Code of Marketing of Breast‐milk Substitutes and subsequent relevant World Health Assembly (WHA) resolutions prohibit such advertising and require manufacturers and distributors to comply with its provisions; however, such regulations at national level may vary. Advertisements require Ministry of Health approval in Cambodia but are not regulated in Senegal. Television stations were monitored for 13 months in Phnom Penh and for 3 months in Dakar to assess advertisements for BMS and CPCF. Ten television channels (out of 16) in Phnom Penh and four (out of 20) in Dakar aired advertisements for BMS. Three and five channels, respectively, aired advertisements for CPCF. All BMS advertised in Phnom Penh were for children over 1 year of age. BMS products for children 6+ months of age and 1+ years of age were advertised in Dakar. Average air time for BMS advertisements was 189.5 min per month in Phnom Penh and 29.7 min in Dakar. Air time for CPCF advertisements averaged 3.2 min per month and 13.6 min, respectively. Fewer than half of BMS advertisements and three quarters of CPCF advertisements explicitly stated an age of use for products. Nutrition and health claims were common across BMS advertisements. This study illustrates the need to adopt, regulate, monitor, and enforce legislation prohibiting BMS promotion, as well as to implement regulations to prevent inappropriate promotion of CPCF. [ABSTRACT FROM AUTHOR]
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- 2019
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26. High proportions of children under 3 years of age consume commercially produced snack foods and sugar‐sweetened beverages in Bandung City, Indonesia.
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Green, Mackenzie, Hadihardjono, Dian N., Pries, Alissa M., Izwardy, Doddy, Zehner, Elizabeth, and Huffman, Sandra L.
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BEVERAGES ,CHI-squared test ,CONFIDENCE intervals ,CONVENIENCE foods ,STATISTICAL correlation ,FOOD habits ,INGESTION ,INTERVIEWING ,MOTHERS ,CHILDHOOD obesity ,QUESTIONNAIRES ,RESEARCH funding ,LOGISTIC regression analysis ,DATA analysis ,CONTENT mining ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics ,NUTRITIONAL status ,ODDS ratio ,CLUSTER sampling ,CHILDREN - 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. [ABSTRACT FROM AUTHOR]
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- 2019
- Full Text
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27. Perceptions of commercial snack food and beverages for infant and young child feeding: A mixed‐methods study among caregivers in Kathmandu Valley, Nepal.
- Author
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Sharma, Nisha, Ferguson, Elaine L., Upadhyay, Atul, Zehner, Elizabeth, Filteau, Suzanne, and Pries, Alissa M.
- Subjects
CHILD nutrition ,CLUSTER analysis (Statistics) ,FOCUS groups ,FOOD habits ,INFANT nutrition ,RESEARCH methodology ,METROPOLITAN areas ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,SNACK foods ,JUDGMENT sampling ,THEMATIC analysis ,CAREGIVER attitudes ,CROSS-sectional method - Abstract
Ensuring nutritious complementary feeding is vital for child nutrition. Prior research in Kathmandu Valley found high consumption rates of commercially produced snack foods among young children, which are often energy‐dense/nutrient poor. This mixed‐methods study was conducted to elicit Nepali caregivers' perceptions of commercial snack foods and beverages and factors influencing their use for young child feeding. Seven facilitated focus group discussions (FGD) were conducted with Kathmandu Valley caregivers of children 12–23 months, and a survey of 745 primary caregivers of children 12–23 months of age was then conducted. During the FGD, caregivers reported commonly providing commercial food and beverage products to their children as snacks, and 98.6% of caregivers participating in the survey reported feeding their child such a food in the previous week. Because of processing and packaging, snack foods were not trusted by many FGD participants and considered as "junk foods" and not healthy for children. However, commercial snack foods were consistently ranked highly on convenience, both because of minimal preparation and ease of feeding; 48.5% of all surveyed caregivers reported providing a snack food because of convenience. Other family members' diets or provision of snack foods as treats also influenced children's consumption of these snack foods and beverages. This study indicates that caregivers of young children prefer snack options that are nutrient rich; however, this may conflict with preferences for foods that require minimal preparation and are appealing to young children. Such findings carry programmatic implications for interventions aiming to address children's diet quality in urban Nepal. [ABSTRACT FROM AUTHOR]
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- 2019
- Full Text
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28. High unhealthy food and beverage consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal.
- Author
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Vanderkooy A, Ferguson EL, Sy NY, Kane R, Diagne M, Mbodji A, and Pries AM
- Abstract
Background: High consumption of unhealthy foods and beverages (UFB) during early childhood is cause for concern, with growing evidence from low- and middle-income countries finding associations with poor diet quality and malnutrition. Research from sub-Saharan Africa remains limited, with no studies quantifying the contribution of UFB to total energy intakes among young children or exploring the relationship between such intakes and diet quality or anthropometric outcomes., Objectives: Assess UFB consumption patterns and their contribution to total energy intake from non-breastmilk foods/beverages (TEI-NBF), assess the association between high UFB consumption and dietary/nutrition outcomes, and explore drivers of unhealthy food choice among young children in Guédiawaye Department, Senegal., Methods: We conducted a cross-sectional study of a representative sample of 724 primary caregivers and their 12-35.9-month-old children. The study included a questionnaire, a quantitative four-pass 24-h dietary recall, and anthropometric measurements. The contribution of UFB to TEI-NBF was calculated and terciles generated. Logistic and linear models were used to compare outcomes of high versus low UFB consumption terciles., Results: UFB contributed on average 22.2% of TEI-NBF, averaging 5.9% for the lowest tercile and 39.9% for the highest. Diets of high UFB consumers, as compared to low, were significantly less dense in protein, fiber, and seven of the 11 micronutrients assessed and significantly denser in total fat, saturated fat, and total sugar. No associations were found with anthropometric outcomes. High UFB consumers were older and more likely to be living in food insecurity. The most common drivers of commercial UFB consumption were related to child preference, the use of these products as behavior management tools, treats, or gifts, and the sharing of these products by someone else eating them., Conclusion: High UFB consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal. Addressing high UFB consumption during this critical developmental period should be prioritized in young child nutrition research, programming, and policy development., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Vanderkooy, Ferguson, Sy, Kane, Diagne, Mbodji and Pries.)
- Published
- 2023
- Full Text
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