Fat Parents, Stunted Kids Mark Popularity of Cheap Junk Food

When a woman with a fat aluminum kettle on her back enters a working-class neighborhood, children swarm around to share spoonfuls of the thick, syrupy porridge scooped from the vat.

This treat called bubur sumsum Jawa -- rice flour mixed with sweet coconut milk and sugar -- sells for about 10 cents a bowl, creating a local favorite cheap enough for many poor families in Indonesia’s sprawling capital.

Indonesia has its share of McDonald’s and KFCs, but far more ubiquitous and affordable are cheap street foods like the sweet porridge and chiki-chiki, this country’s catch phrase for packaged junk food. As families abandon the countryside for cities, the abundance of this poor-quality food has grown.

One result, global health experts say, is the paradox of underweight children with fat parents.

Dr. Benjamin Caballero first noticed overweight mothers with thin, stunted children a few years ago in a Brazilian clinic. After looking closer, he found that the problem was more widespread in developing Asian nations undergoing economic transition with a high number of people migrating to cities.

A survey published in the International Journal of Obesity within the past year examined seven countries for underweight-overweight households. The two with the highest prevalence of such families are in Asia: Kyrgyzstan with 13% and Indonesia with 11%, a finding based on data from several years ago and adjusted for household size.

These countries are still relatively poor, but incomes are growing enough for parents to give children a few cents a day, which they spend on preservative-filled processed foods lacking vital nutrients that children need to grow properly. Adults who eat the junk merely get fat.

Caballero, director of the Center for Human Nutrition at Johns Hopkins University’s Bloomberg School of Public Health, wrote of the phenomenon in a recent commentary in the New England Journal of Medicine.

“A lot of the globalization of food markets [has] resulted in the introduction of many processed foods in these countries in transition, which has changed the eating habits of people,” he said in an interview.

Families who once grew their own fruits and vegetables now must buy everything in the city, where cheap street food abounds. That change, along with more mothers working outside the home (and cooking less), and families watching TV instead of working in the fields, is leading to these so-called “dual-burden” households, Caballero wrote in the medical journal.

Changes in eating habits are visible on Jakarta’s busy streets and in its outlying neighborhoods as children like 7-year-old Raras come home from school and beg their parents for change to buy chiki-chiki -- potato chips, candy, fried cassava, cookies.

“My kids prefer to eat that type of food every day,” said Raras’ mother, Nining, who like many Indonesians uses only one name. “I tried to forbid my kids from buying that kind of food, but I cannot.”

Nining, who is chubby by Indonesian standards, said her average-sized daughter began eating chiki-chiki when she was 2 and is now addicted to it.

An Indonesian nutritionist says the majority of families she sees are still underweight, although she’s starting to see more fat children with fat parents in wealthier families.

“In the lower-income families, usually the mother or father [is] quite skinny and the children become undernourished or stunted -- not growing tall or not enough weight,” said Uken Soetrisno, of the government Board of Research and Development of Nutrition and Food.

And while the majority of households may not have overweight and underweight members, Caballero said he has received letters from health experts all over the world who see the phenomenon.

He fears that the problem will progress to a new phase as these countries gain more wealth -- producing overweight families, as is the trend in many Latin American countries.

To address the dual-burden issue, Caballero recommends that governments recognize the phenomenon and devise intervention plans targeting both underweight and overweight households.

Key prevention for both could include encouraging breast-feeding, improving nutrition among women of child-bearing age and educating communities about the importance of prenatal nutrition.