Profiling of commercially produced complementary foods in three Southeast Asian and four West African contexts

Background and objectives: Commercially produced complementary foods (CPCFs) for infants and young children vary widely in quality, with some containing high levels of added salt or sugar. In 2019, the WHO Regional Office for Europe published a nutrient profiling model for CPCFs (WHO Europe CPCF NPM) for Member States to use to restrict inappropriate promotion of CPCF products in their countries. The WHO Europe CPCF NPM is one of the first NPMs developed specifically for CPCF products and its application to markets in other regions is a first step in enabling the validation and use of nutrient profiling for CPCFs globally. This study piloted the WHO Europe CPCF NPM in three South-East Asian and four West African contexts to assess the nutritional suitability of CPCFs in regions where markets for these products are rapidly expanding. Methods: CPCF products were purchased in Cambodia (n=68), the Philippines (n=211), and Indonesia (n=211). Secondary datasets of CPCF label information were purchased for Burkina Faso (n=20), Cameroon (n=52), Ghana (n=127) and Nigeria (n=109). Using product label information, nutrient composition and content of CPCF were assessed against the WHO Europe CPCF NPM. Results: The majority of CPCFs sold in both Southeast Asia and West Africa performed poorly in the WHO Europe CPCF NPM. Only 1.9% of products in Cameroon, 4.4% in Cambodia, 10.0% in Indonesia, 10.0% in Burkina Faso, 15.8% in Ghana, 20.2% in Nigeria, and 37.0% in the Philippines complied with WHO Europe NPM nutrient composition requirements. The presence of added sugar and sweeteners were particularly problematic. Fifteen percent of CPCF in Burkina Faso, 16.2% in Cambodia, 21.1% in Nigeria, 27.0% in Indonesia, 30.8% in Cameroon, 37.0% in Ghana, and 58.8% in the Philippines contained total sugar content levels that would require a 'high sugar' warning. Conclusions: Most of the analyzed 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. It is crucial to introduce new policies, regulations, and product standards to limit the promotion of inappropriate CPCF in the South-East Asia and West Africa regions.