Appropriate snacks provided between meals could allow babies and toddlers to replenish energy and nutrition, and stay hydrated. Yet, the addition of salt and sugar to foods for infants and young children has been an international concern. For example, the Hong Kong Department of Health (DH), the Chinese Nutrition Society (CNS), and health and healthcare authorities in the United States (US) and the United Kingdom (UK) all agreed that salt should not be added to foods for infants under 1 year old; while the US and the UK also respectively stated that young children under the ages of 2 and 4 should not consume foods and beverages containing added sugar. However, the Consumer Council surveyed 37 samples of snacks on the market labelled as suitable for infants and young children, and found that their ingredients did not comply with the recommendations of different overseas healthcare organisations. Nearly 80% of the samples that were labelled as suitable for infants and young children under 24 months listed sources of free sugars in their ingredient lists, such as added sugars and concentrated fruit juice, which did not meet the recommendations in the US and the UK that foods with added sugar should not be consumed by children under 2. Apart from that, surprisingly, more than 50% of the samples with declared sugar content were found to be “high-sugar” foods. Although the remaining 12 samples indicated their sources of free sugars, such as sugar or concentrated fruit juice, no sugar content was found, so consumers have no way to know if they were high in sugar. In addition, 30% of the samples contained added salt, which parents should avoid feeding to infants under the age of 1, while 1 sample was even a “high-sodium” food. Parents should pay attention to the ingredients and nutrition labels when purchasing snacks for infants and young children.
The Council reminds consumers that taste preferences are established in infancy and early childhood. The consumption of “strong-tasting” foods that are too sweet or too salty may result in a preference for strong-flavoured foods in adulthood. Snacks that are high in sugar and sodium generally contain empty calories, i.e. they are high in calories but have very low nutritional value. Excessive intake of sodium over a long period of time could easily lead to the loss of calcium through urine, which affects bone growth, whereas excessive intake of sugar could increase the risk of tooth decay and obesity, as well as the chance of developing chronic diseases such as cardiovascular diseases, high blood pressure and diabetes later in life. According to the regulations in Hong Kong, prepackaged foods that are labelled as intended for infants and young children under 36 months are not required to indicate their sugar content on the nutrition label. The Council recommends that the Government establish sugar and sodium content standards for related foods so as to safeguard the health of infants and young children.
The Council collected 37 samples of prepackaged baby snacks from major retail stores, and reviewed the sugar and sodium contents on their ingredients lists and nutrition labels. The survey covered 7 samples of rice crackers, 5 samples of puffs, 6 samples of “egg bolo biscuits”, 13 samples of other cereal snacks, and 6 samples of yoghurt melts, priced from $12.9 to $74.9 per pack.
Many baby snacks on the market are not only bite-sized but are also advertised as containing healthy ingredients such as vegetables, fruits, and yoghurt, attracting parents to buy them. However, 29 samples indicated sources of free sugars such as added sugar and concentrated fruit juice on their ingredient lists, while the minimum age for consumption of these samples was under 24 months. This did not meet the recommendation by relevant health institutions in the US and the UK that children under the age of 2 should not consume foods and beverages with added sugar. 25 samples either indicated the absolute numbers of sugar content on the nutrition label or original packaging, or had the manufacturers provide the information. Their sugar content ranged from 0g to 80.0g per 100g. If consumed by serving size, 1 serving would incur an intake of 0g to 8.3g of sugar.
Among the 25 samples with sugar content provided, 13 samples (52%) exceeded the “high-sugar” reference level set by the Centre for Food Safety for general food (15g per 100g for consumption by persons 36 months old or above). The highest sugar content was a yoghurt melt snack. Taking a 1-year-old young child with a daily energy requirement of 800 kcal as an example, consuming 25g (equivalent to about 1.3 packets) of this yoghurt melt sample a day will exceed the daily limit of free sugars intake as recommended by the World Health Organization. Although the recommended serving size of snacks for infants and young children is generally small so the sugar intake per serving is not high either, regular consumption of high-sugar snacks can easily develop a preference for sweets in infants and young children.
It is worth noting that although egg bolo biscuits and yoghurt melts are small in size, their sugar content should not be underestimated. The sugar contents of the 2 egg bolo biscuit samples with declared sugar content and all 6 yoghurt melt samples were the highest among all the samples with declared sugar content, containing more than 30g per 100g. For the remaining 4 egg bolo biscuit samples which did not provide information on their sugar content, sugar was listed second on the lists of ingredients, indicating that the sugar content was likely to be quite high. In addition, 1 raisin biscuit sample, despite claiming on its packaging to have no added sugar or salt, stated on its ingredient list that it contained 11% concentrated grape juice, which is a source of free sugars.
Besides, according to the Food and Drugs (Composition and Labelling) Regulations, prepackaged foods that are labelled as intended for infants and young children under 36 months old are not required to provide their sugar content on the nutrition label. It was found that 12 samples listed sources of free sugars, such as sugar or concentrated fruit juice, on the list of ingredients. Although the sugar content was not stated, the sources of free sugars were among the top 3 on the ingredient lists, indicating that the free sugars content might be quite high.
In addition, infants and young children could take in sodium from breast milk and natural foods to maintain normal body functions. The Hong Kong DH, CNS, as well as the UK and the US all agree that salt should not be added to foods for infants under the age of 1. However, 12 samples were added with salt, with declared sodium contents ranging from 111mg to 900mg per 100g. Among them, the minimum age for consumption of 11 samples was under 1 year old, which failed to meet the recommendation put forward by different overseas organisations that salt should not be added to foods for infants and young children under the age of 1.
The Codex Alimentarius Commission stipulates that the sodium content of rusks and biscuits for infants and young children should not exceed 100mg per 100 kcal. However, the rice cracker sample with the highest sodium content exceeded the relevant limit by 1.4 times and also reached the “high-sodium” reference level for general food. If consumed by serving size, 1 serving (4g) of the rice cracker would result in a sodium intake of 36mg. Although this does not affect health under normal consumption, frequent eating of high-sodium foods would also cause infants and young children to prefer salty foods and should therefore be avoided as much as possible.
When purchasing snacks for infants and young children, consumers may refer to the following recommendations:
- Read the ingredient information and nutrition labels on the food packaging carefully, and choose snacks with no added sugar or are low in sugar. Pay attention to the units on the nutrition labels, as conversion may be needed in order to compare the energy and nutrient intake per serving of different products;
- Food products claiming to be free of added sugar may still contain free sugars such as fruit juice concentrate. Avoid selecting products with free sugars sources listed higher up on the list of ingredients, or of a higher percentage;
- Select foods rich in dietary fibre, calcium, iron, and vitamin D;
- Snack times should be at least 1.5 hours away from the main meals so as not to spoil the appetite for main meals. Snack portions should account for no more than 10% of the total daily energy and nutrient intake;
- Do not reward young children with strong-flavoured snacks so as to prevent the development of picky eating habits, which affect their health.
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