Factors Associated with Sweetened Beverage Consumption Patterns and Behaviors among Elementary School Students in Indonesia: A Systematic Literature Review

Abstract

Sugar-sweetened beverages (SSB) are drinks with added free sugars or caloric sweeteners introduced by manufacturers or vendors, such as carbonated soft drinks, sweetened packaged tea or coffee, packaged fruit-flavored drinks, energy drinks, and instant powdered drinks. This term differs from the broader "minuman manis" (sweet beverages) construct used in the 2023 Indonesia Health Survey (SKI), which also includes home-prepared sweetened drinks. SSB consumption among children is a public health concern because exposure during school age may shape long-term dietary patterns. This study aimed to identify, map, and synthesize factors related to patterns and behavior of SSB consumption among primary school students in Indonesia. A Systematic Literature Review following PRISMA 2020 covered publications from January 2020 to 22 August 2026 through four search pathways: PubMed/PMC-indexed discovery (12 records), GARUDA and SINTA-indexed national journal portals (11 records), publisher/DOI and scholarly-web discovery (13 records), and institutional repositories (5 records), yielding 41 records in total. After 13 duplicates were removed, 28 records were screened, 10 full texts were assessed for eligibility, and 5 studies were included in the narrative synthesis. Findings were mapped using the Social-Ecological Model (SEM) and study quality was assessed with JBI critical appraisal checklists appropriate to each design. The most direct evidence highlighted the school food environment, particularly availability and easy access to unhealthy beverages through canteens and nearby vendors, as the factor most consistently related to SSB consumption patterns. Individual factors such as taste preference, consumption patterns, and pocket money, as well as the home food environment, were also reported, although much of this evidence was contextual because four of the five primary studies used overweight or obesity, rather than SSB consumption, as the primary outcome. Interventions should prioritize healthier school food environments, improved drinking-water access, student education, and family engagement, while future longitudinal, multilevel studies should treat SSB consumption as the primary outcome.