Contribution of sugar sweetened beverages to caloric and vitamin c dietary intake and nutritional status of school children aged 10-13 years in Westlands, Nairobi

Abstract

Consumption of sugar sweetened beverages (SSBs) among school children is becoming increasingly common in Kenya today. Some of the beverages are attractive to parents and guardians of the children because they contain nutritional label claims, which are not necessarily authenticated. Vitamin C is among the nutrients that are very commonly claimed to be present in these beverages. Excessive and prolonged consumption of the beverages is likely to result in positive energy balance, leading to overweight and possibly obesity in the children. The present study was therefore designed to investigate the contribution of SSBs to dietary intake of calories and vitamin C, and nutritional status of school children in Westlands Division of Nairobi. A cross sectional survey involving 202 children, 91 males and III females selected from the three categories of public primary schools A, B, C, was carried out. The children were selected proportionately from the three categories of school with 96 from category A, 30 from Band 76 from C. A structured previously pre-tested questionnaire was administered to the children. A food frequency, a 24-hour recall and focus group discussion were also carried out. A rapid market appraisal was carried out and samples of selected SSBs were analysed for sugar content as °Brix and vitamin C as reduced ascorbic acid. Anthropometric measurements were taken as a measure of nutritional status. The households in which the children lived comprised of 557c females and 459'c males, which was slightly in variance with the national census. Category C had the highest proportion of professional parents. Categories B and A parents were mainly from middle and lower socioeconomic families. On the nutritional status based on the height-for-age Z scores, 91.6% of the children were within the normal range, while 6.9% were moderately stunted and 1.5% severely stunted. Category A had the highest stunting at 12.57('. The market appraisal revealed 50 different brands in three forms: ready to drink, concentrated and solid powders. Ready to drink beverages were the commonest among the children, consumed at an average of 347ml daily. The mean caloric intake was I37.4Kcals. Some SSBs contained very low levels of calories suggesting they are sweetened with non-nutritive sweeteners. The mean intake for males was higher than for the females although on average females consumed more than males. About 70% of SSBs analysed had no vitamin C. The SSBs that contained vitamin C had a mean of 9.2mg equivalent of 33.5% RDA. Only 11.5% of the SSBs had nutrition label information, of which 41.6% had claim of containing vitamin C. Majority (87.6%) of the school children consumed SSBs every day in school. Quencher'f was the most widely consumed by 76.4% of the children. The mean (I 37.4kcals) intake of calories from SSBs was equivalent to 6.5% and 7.7% of the RDA for males and females respectively. Up to 64% of children consumed more than the minimum amount (120kcals) likely to cause overweight when consumed daily for a period of four years. Television and peer influence were commonest in influencing the choice beverage. This study concludes that consumption of SSBs is high among the three categories of schools and could lead to overweight. Vitamin C is not present in many SSBs even where the labels indicate so. Therefore, SSBs contribute significantly to the caloric and vitamin C dietary intake of school children.