Food classification using daily sugar intake among Indonesian school-aged children

Introduction: The increasing prevalence of diabetes and sugary snacking habits among schoolchildren in Indonesia is driving the need for a comprehensive food classification system, particularly based on sugar intake, with potential implications for sugar traffic light labelling. This study aimed to classify foods according to sugar intake in Indonesian children aged 5 to 9 years. Methods: Using cross-sectional design, the study used secondary data from the 2014 Individual Food Consumption Survey (IFCS), which included 24-hour recalls from 8007 school-aged children (5-9 years). The 1318 food items consumed were aggregated into 61 subgroups and Ward’s hierarchical clustering method (HCWM) was used for classification. Principal component analysis (PCA) and BiPlot visualisation were used to analyse the similarity of the characteristic variables in each food level. Results: Four levels of food groups based on daily sugar intake: Level 1 (low sugar), Level 2 (moderate sugar), Level 3 (high sugar), and Level 4 (very high sugar). Notable items included instant noodles (Level 1), tea/coffee/cocoa drinks (Level 2), soft drinks/fruit drinks (Level 3), and added sugars/sugary milk (Level 4). Level 4 foods had highest sugar content and were among the most frequently consumed items, significantly contributing to daily sugar intake. Conclusion: This classification system highlighted the significant contribution of specific foods to daily sugar intake of school-aged children. Targeted nutrition interventions and strong food labelling policies are essential to reduce consumption of foods high in sugar and promote healthier dietary choices among children.