Abstract
Objectives
Consumption of sugar sweetened beverages (SSB) is associated with childhood obesity and other negative health conditions. Feeding SSB to infants and young children (IYC) under 2 years may displace consumption of breastmilk and nutrient rich foods critical for optimal growth and development. The World Health Organization (WHO) recommends avoiding added sugar (e.g. SSB) for IYC under 2 years. We sought to describe the variety of homemade and commercial SSB as well as breastmilk and beverages without added sugar fed to IYC aged 4–23 months living in a low-income, populous peri-urban area of Lima, Peru.
Methods
A cross-sectional survey was conducted with 181 households with IYC aged 4–23 months. A list of common local homemade and commercial beverages was used to investigate what caregivers had fed to the child in the past 24 h.
Results
A total of 93.9% of caregivers reported feeding at least one beverage to their child other than breastmilk in the past 24 h. This included a variety of homemade SSB (73.5%), commercial SSB (18.2%) and homemade beverages without added sugar (70.2%). A high percentage (83.4%) of children were also breastfed.
Conclusions for Practice
Our findings suggest that interventions to address feeding homemade SSB to IYC within households are needed to support WHO recommendations and complement current commercial SSB policy regulations in Peru.
Significance
What is already known on this subject? sugar sweetened beverages (SSB) are widely available, nutrient-poor and contribute to childhood obesity and other negative health outcomes. Little is known about homemade SSB fed to IYC under 2 years in Peru.
What this study adds? in peri-urban Peru, prevalent feeding practices include breastfeeding as well as giving a variety of homemade SSB to IYC. In addition to recent policy level interventions aimed at reducing consumption of commercial SSB in Peru and Latin America generally, household level interventions to address feeding homemade SSB to IYC are needed.
This is a preview of subscription content, log in via an institution to check access.
Data Availability
The data that support the findings of this study are available from the corresponding author, [RCR], upon reasonable request.
Code Availability
Not applicable.
References
Afeiche, M. C., Villalpando-Carrión, S., Reidy, K. C., Fries, L. R., & Eldridge, A. L. (2018). Many infants and young children are not compliant with Mexican and international complementary feeding recommendations for milk and other beverages. Nutrients. https://doi.org/10.3390/nu10040466
Alviso-Orellana, C., Estrada-Tejada, D., Carrillo-Larco, R. M., & Bernabé-Ortiz, A. (2018). Sweetened beverages, snacks and overweight: Findings from the young lives cohort study in Peru. Public Health Nutrition, 21(9), 1627–1633. https://doi.org/10.1017/s1368980018000320
Bentley, M. E., & Nulty, A. K. (2020). When does it all begin: What, when, and how young children are fed. Nestle Nutrition Institue Workshop Series, 93, 15–24. https://doi.org/10.1159/000503353
Bergallo, P., Castagnari, V., Fernández, A., & Mejía, R. (2018). Regulatory initiatives to reduce sugar-sweetened beverages (SSBs) in Latin America. PLoS ONE, 13(10), e0205694. https://doi.org/10.1371/journal.pone.0205694
Bernabe-Ortiz, A., Mendoza-Quispe, D., Jimenez, M. M., Ugaz, M. E., & Rojas-Davila, C. E. (2023). Quantifying the childhood and adolescent overnutrition attributable to specific risk factors: The young lives study in Peru. Pediatric Obesity. https://doi.org/10.1111/ijpo.13002
Bleich, S. N., & Vercammen, K. A. (2018). The negative impact of sugar-sweetened beverages on children’s health: An update of the literature. BMC Obesity, 5, 6. https://doi.org/10.1186/s40608-017-0178-9
Busse, P., & Bernabé-Ortiz, A. (2018). Self-regulation of the Peruvian food industry: Health message cues in the context of food and beverage advertisements. Public Health, 159, 1–3. https://doi.org/10.1016/j.puhe.2018.03.003
Cominato, L., Di Biagio, G. F., Lellis, D., Franco, R. R., Mancini, M. C., & de Melo, M. E. (2018). Obesity prevention: Strategies and challenges in Latin America. Current Obesity Reports, 7(2), 97–104. https://doi.org/10.1007/s13679-018-0311-1
Curi-Quinto, K., Ortiz-Panozo, E., & López de Romaña, D. (2020). Malnutrition in all its forms and socio-economic disparities in children under 5 years of age and women of reproductive age in Peru. Public Health Nutrition, 23(S1), s89–s100. https://doi.org/10.1017/s136898001900315x
Denney, L., Afeiche, M. C., Eldridge, A. L., & Villalpando-Carrión, S. (2017). Food sources of energy and nutrients in infants, toddlers, and young children from the Mexican National health and nutrition survey 2012. Nutrients. https://doi.org/10.3390/nu9050494
Di Cesare, M., Sorić, M., Bovet, P., Miranda, J. J., Bhutta, Z., Stevens, G. A., Avula, L., Andre-Pascal, K., & Bentham, J. (2019). The epidemiological burden of obesity in childhood: A worldwide epidemic requiring urgent action. BMC Medicine, 17(1), 212. https://doi.org/10.1186/s12916-019-1449-8
English, L. K., Obbagy, J. E., Wong, Y. P., Butte, N. F., Dewey, K. G., Fox, M. K., Greer, F. R., Krebs, N. F., Scanlon, K. S., & Stoody, E. E. (2019). Types and amounts of complementary foods and beverages consumed and growth, size, and body composition: A systematic review. American Journal of Clinical Nutrition, 109(Suppl 7), 956s–977s. https://doi.org/10.1093/ajcn/nqy281
Guzman-Vilca, W. C., Yovera-Juarez, E. A., Tarazona-Meza, C., García-Larsen, V., & Carrillo-Larco, R. M. (2022). Sugar-sweetened beverage consumption in adults: Evidence from a national health survey in Peru. Nutrients. https://doi.org/10.3390/nu14030582
Huffman, S. L., Piwoz, E. G., Vosti, S. A., & Dewey, K. G. (2014). Babies, soft drinks and snacks: A concern in low- and middle-income countries? Maternal & Child Nutrition, 10(4), 562–574. https://doi.org/10.1111/mcn.12126
Instituto Nacional de Estadística e Informática (INEI). (2016). Peru encuesta demografica y de salud familiar (ENDES) 2016. Instituto Nacional de Estadística e Informática.
Koplin, J. J., Kerr, J. A., Lodge, C., Garner, C., Dharmage, S. C., Wake, M., & Allen, K. J. (2019). Infant and young child feeding interventions targeting overweight and obesity: A narrative review. Obesity Reviews, 20(Suppl 1), 31–44. https://doi.org/10.1111/obr.12798
Kovalskys, I., Rigotti, A., Koletzko, B., Fisberg, M., Gómez, G., Herrera-Cuenca, M., Sanabria, L. Y. C., García, M. C. Y., Pareja, R. G., Zimberg, I. Z., Arco, A. D., Zonis, L., & Fisberg, R. (2019). Latin American consumption of major food groups: Results from the ELANS study. PLoS ONE, 14(12), e0225101. https://doi.org/10.1371/journal.pone.0225101
Lott M., Callahan E., Welker Duffy E., Story M. & Daniels S. (2019). Healthy beverage consumption in early childhood: Recommendations from key national health and nutrition organizations. Consensus statement. https://healthyeatingresearch.org
Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B. (2013). Sugar-sweetened beverages and weight gain in children and adults: A systematic review and meta-analysis. American Journal of Clinical Nutrition, 98(4), 1084–1102. https://doi.org/10.3945/ajcn.113.058362
Meza-Hernández, M., Villarreal-Zegarra, D., & Saavedra-Garcia, L. (2020). Nutritional quality of food and beverages offered in supermarkets of Lima according to the Peruvian law of healthy eating. Nutrients. https://doi.org/10.3390/nu12051508
Ministerio de Economía y Finanzas. (2018). Supreme decree No. 091-2018-EF: Amending section A of new appendix IV of the consolidated amended text of the law on general sales tax and selective consumption tax. www.gob.pe/institucion/mef/normas-legales/31038-091-2018-ef.
Morel, K., Nichols, K., Nong, Y., Charles, N., Price, S., Taveras, E., Goldman, R., & Woo Baidal, J. A. (2019). Parental and provider perceptions of sugar-sweetened beverage interventions in the first 1000 days: A qualitative study. Academic Pediatrics, 19(7), 748–755. https://doi.org/10.1016/j.acap.2019.01.004
Nakhimovsky, S. S., Feigl, A. B., Avila, C., O’Sullivan, G., Macgregor-Skinner, E., & Spranca, M. (2016). Taxes on sugar-sweetened beverages to reduce overweight and obesity in middle-income countries: A systematic review. PLoS ONE, 11(9), e0163358. https://doi.org/10.1371/journal.pone.0163358
Park, S., Pan, L., Sherry, B., & Li, R. (2014). The association of sugar-sweetened beverage intake during infancy with sugar-sweetened beverage intake at 6 years of age. Pediatrics, 134(Suppl 1), S56-62. https://doi.org/10.1542/peds.2014-0646J
Pérez-Escamilla, R., Lutter, C. K., Rabadan-Diehl, C., Rubinstein, A., Calvillo, A., Corvalán, C., & Rivera, J. A. (2017). Prevention of childhood obesity and food policies in Latin America: From research to practice. Obesity Reviews, 18(Suppl 2), 28–38. https://doi.org/10.1111/obr.12574
Popkin, B. M., Corvalan, C., & Grummer-Strawn, L. M. (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet, 395(10217), 65–74. https://doi.org/10.1016/s0140-6736(19)32497-3
Popkin, B. M., & Reardon, T. (2018). Obesity and the food system transformation in Latin America. Obesity Reviews, 19(8), 1028–1064. https://doi.org/10.1111/obr.12694
Pries, A. M., Filteau, S., & Ferguson, E. L. (2019). Snack food and beverage consumption and young child nutrition in low- and middle-income countries: A systematic review. Maternal Child Nutrition, 15(Suppl 4), e12729. https://doi.org/10.1111/mcn.12729
Rodríguez-Ramírez, S., Muñoz-Espinosa, A., Rivera, J. A., González-Castell, D., & González de Cosío, T. (2016). Mexican children under 2 years of age consume food groups high in energy and low in micronutrients. Journal of Nutrition, 146(9), 1916s–1923s. https://doi.org/10.3945/jn.115.220145
Sánchez-Pimienta, T. G., Batis, C., Lutter, C. K., & Rivera, J. A. (2016). Sugar-sweetened beverages are the main sources of added sugar intake in the Mexican population. Journal of Nutrition, 146(9), 1888s–1896s. https://doi.org/10.3945/jn.115.220301
UNICEF. (2019). The state of the world’s children 2019. Children, food and nutrition: Growing well in a changing world. UNICEF.
Vos, M. B., Kaar, J. L., Welsh, J. A., Van Horn, L. V., Feig, D. I., Anderson, C. A. M., Patel, M. J., Munos, J. C., Krebs, N. F., Xanthakos, S. A., & Johnson, R. K. (2017). Added sugars and cardiovascular disease risk in children: A scientific statement from the American Heart Association. Circulation, 135(19), e1017–e1034. https://doi.org/10.1161/cir.0000000000000439
World Health Organization (WHO). (2018). Healthy diet fact sheet N°394. World Health Organization.
World Health Organization (WHO), United Nation’s Childrens Fund (UNICEF). (2021). Indicators for assessing infant and young child feeding practices: Definitions and measurement methods. Licence: CC BYNC-SA 3.0 IGO. WHO and UNICEF.
Ziesmann, A., Kiflen, R., Rubeis, V., Smith, B. T., Maguire on behalf of the TARGet Kids, Birken, C. S., & Anderson, L. N. (2019). The association between early childhood and later childhood sugar-containing beverage intake: A prospective cohort study. Nutrients. https://doi.org/10.3390/nu11102338
Acknowledgements
We gratefully acknowledge the research team who collected the survey data.
Funding
There was no external funding for this study.
Author information
Authors and Affiliations
Contributions
RCR analyzed the data and drafted and revised the manuscript. MEP developed the research questions and designed the study, and edited the manuscript. GB contributed to the study design, oversaw the study and reviewed the manuscript. SM contributed to the analysis and interpretation of the data, literature review and reviewed the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
The study and consent process were approved by the Ethics Committee of the Instituto de Investigación Nutricional, Lima, Peru, No. 349-2014/CEI-IIN.
Informed Consent
Each participant gave consent prior to the study activity.
Consent for Publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Robert, R.C., Penny, M.E., Barbagelatta, G. et al. Feeding Homemade Sugar Sweetened Beverages in Addition to Breastfeeding: Survey Results from Caregivers of Infants and Young Children in Peri-Urban Lima, Peru. Matern Child Health J 27, 2105–2112 (2023). https://doi.org/10.1007/s10995-023-03668-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-023-03668-7