Prevalence, patterns, and factors associated with early childhood cariogenic diet exposure in Kenya

Early childhood exposure to cariogenic foods and drinks is a key modifiable risk factor for early childhood caries, yet national-level surveillance of dietary risk in children under two years remains limited in Kenya. This study assessed the prevalence, patterns, and factors associated with cariogenic diet exposure among young children in Kenya.We analyzed nationally representative data from the 2022 Kenya Demographic and Health Survey. A total of 7,459 children aged below two years were included in the analysis. Cariogenic diet exposure was defined as consumption of any sugar-containing foods or drinks in the previous day or night. Weighted prevalence estimates were calculated overall and by age group. Bivariate analyses assessed associations with child, maternal, household, and feeding characteristics. Multivariable logistic regression models were fitted using a hierarchical stepwise approach to identify factors associated with exposure.Overall, 21% of children under two years were exposed to a cariogenic diet. Exposure increased markedly with age, from 3.3% among infants < 6 months to 20.2% among those aged 6 to 11 months and 31.2% among children aged 12 to 23 months. The most consumed cariogenic items were sweetened tea or coffee, sweetened milk, and fried or sugary snacks. In the fully adjusted model, older child age was the strongest predictor of cariogenic diet exposure (12-23 months vs. < 6 months: OR = 27.96; 95% CI: 19.44-40.23). Compared with no maternal education, primary (OR = 1.81; 95% CI 1.30-2.53) and secondary (OR = 1.49; 95% CI 1.01-2.20) education were associated with higher odds of exposure. Children in the richest wealth bracket had two times higher odds of exposure compared with those in the poorest bracket (OR = 2.00; 95% CI 1.26-3.18), while continued breastfeeding was protective (OR = 0.57; 95% CI: 0.43-0.75).One in five Kenyan children under two years old is exposed to a cariogenic diet. Early introduction of sugar-containing foods and drinks highlights missed opportunities for prevention during complementary feeding. Integrating oral-health promotion and sugar-avoidance messaging into existing maternal, child health, and nutrition services could strengthen early childhood caries prevention and support Kenya's national oral health goals. In addition, regulating the marketing and availability of sugar-rich foods can help create healthier food environments for young children.