Prevalence and Determinants of Unhealthy Food and Beverage Consumption Among Children Aged 6–23 Months in Mekelle, Northern Ethiopia

Abstract

International health authorities, including the World Health Organization, advise against infant consumption of unhealthy foods and beverages (UFB)—products high in sugar, salt, and unhealthy fats but low in micronutrients. Despite global evidence of rising UFB consumption among children, data from post-conflict, low-income settings like Mekelle remain limited. This cross-sectional study assessed UFB consumption among 567 children aged 6–23 months in three randomly selected health facilities in Mekelle, northern Ethiopia, following the 2020–2022 war. Caregiver-reported 24-h recall revealed that 71.8% of children consumed at least one UFB, with sugar-sweetened beverages being most common (62.9%), followed by sweets (41.8%), soft drinks (18.2%), and fried foods (9.2%). UFB consumption increased with age, peaking at 81.1% among 18- to 23-month-olds. Compared to children aged 6–11 months, those aged 12–17 months (Adjusted Odds Ratio (AOR): 2.3, 95% CI: 1.46–3.64, p < 0.001) and 18–23 months (AOR = 4.14, 95% CI: 2.36–7.26, p < 0.001) had significantly higher odds of UFB consumption. Children from high-income households were 51% less likely to consume UFBs than those from low-income households (AOR 0.49, 95% CI: 0.28–0.87, p = 0.014). Birth order influenced intake, with third/later-born children nearly four times more likely to consume UFBs than first-borns (AOR: 3.78, 95% CI: 1.19–11.98, p = 0.024). Larger household sizes showed protective effects, with four-member (AOR: 0.31, 95% CI: 0.10–0.96, p = 0.04) and five- to eight-member households (AOR: 0.28, 95% CI: 0.09–0.87, p = 0.028) having lower consumption than smaller households. The high UFB consumption in postwar Mekelle poses public health risks, particularly among older children and those from low-income households. Targeted nutrition education, stricter UFB regulation, and improved access to healthy foods are essential to address this issue and promote healthier feeding practices.