Relationship between energy from added sugars and frequency of added sugars intake in Irish children, teenagers and adults

A WHO report on diet, nutrition and the prevention of chronic diseases recommended that frequency of consumption of foods and/or drinks containing free sugars should be limited to a maximum of four times per d. In addition, they recommended a reduction in the intake of free sugars to a maximum of no more than 10 % of energy intake. These recommendations were developed with the aim of reducing the prevalence of dental caries. The aim of the present study was to establish if there is a quantitative relationship between energy from added sugars and frequency of added sugars intakes in Irish children, teenagers and adults. In addition, the intake of added and total sugars and main contributors to added sugar intakes were examined. Data for the present analysis were based on the North/South Ireland Food Consumption Survey (n1379; aged 18–64 years), the National Children's Food Survey (n594; aged 5–12 years) and the National Teen Food Survey (n441; aged 13–17 years) which used 7 d food diaries to collect food and beverage intake data in representative samples of Irish adults, children and teenagers respectively. Results showed that in adults, frequency of intake of added sugar intake of four times per d corresponded to a mean added sugar intake of 9 %, which was similar to the WHO recommendation. In children and teenagers, a frequency of intake of four times per d corresponded to a mean added sugar intake of 14·6 and 12·4 % respectively and was therefore not in agreement with the WHO recommendation.

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Estimating free and added sugar intakes in New Zealand

10.26686/wgtn.12830840.v1 ◽

2020 ◽

Author(s):

R Kibblewhite ◽

A Nettleton ◽

R McLean ◽

J Haszard ◽

E Fleming ◽

...

Keyword(s):

New Zealand ◽

Energy Intake ◽

Food Composition ◽

World Health ◽

Free Sugar ◽

Nutrition Survey ◽

Added Sugar ◽

Free Sugars ◽

Added Sugars ◽

Sugar Intake

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. The reduction of free or added sugar intake (sugars added to food and drinks as a sweetener) is almost universally recommended to reduce the risk of obesity-related diseases and dental caries. The World Health Organisation recommends intakes of free sugars of less than 10% of energy intake. However, estimating and monitoring intakes at the population level is challenging because free sugars cannot be analytically distinguished from naturally occurring sugars and most national food composition databases do not include data on free or added sugars. We developed free and added sugar estimates for the New Zealand (NZ) food composition database (FOODfiles 2010) by adapting a method developed for Australia. We reanalyzed the 24 h recall dietary data collected for 4721 adults aged 15 years and over participating in the nationally representative 2008/09 New Zealand Adult Nutrition Survey to estimate free and added sugar intakes. The median estimated intake of free and added sugars was 57 and 49 g/day respectively and 42% of adults consumed less than 10% of their energy intake from free sugars. This approach provides more direct estimates of the free and added sugar contents of New Zealand foods than previously available and will enable monitoring of adherence to free sugar intake guidelines in future.

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Estimating free and added sugar intakes in New Zealand

10.26686/wgtn.12830840 ◽

2020 ◽

Author(s):

R Kibblewhite ◽

A Nettleton ◽

R McLean ◽

J Haszard ◽

E Fleming ◽

...

Keyword(s):

New Zealand ◽

Energy Intake ◽

Food Composition ◽

World Health ◽

Free Sugar ◽

Nutrition Survey ◽

Added Sugar ◽

Free Sugars ◽

Added Sugars ◽

Sugar Intake

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Energy, Sugars, Iron, and Vitamin B12 Content of Commercial Infant Food Pouches and Other Commercial Infant Foods on the New Zealand Market

Nutrients ◽

10.3390/nu13020657 ◽

2021 ◽

Vol 13 (2) ◽

pp. 657 ◽

Cited By ~ 1

Author(s):

Ioanna Katiforis ◽

Elizabeth A Fleming ◽

Jillian J Haszard ◽

Tiana Hape-Cramond ◽

Rachael W Taylor ◽

...

Keyword(s):

New Zealand ◽

Vitamin B12 ◽

Nutritional Quality ◽

Infant Food ◽

Food Groups ◽

Cross Sectional Survey ◽

Free Sugars ◽

Total Sugars ◽

Added Sugars ◽

Infant Foods

There has been an important shift in the New Zealand infant food market over the past decade, with the majority of complementary foods now sold in “pouches”. Along with the increasing market share of commercial infant food pouches internationally, there have been growing concerns about their nutritional quality. However, research examining the nutritional quality of these pouches compared to other forms of commercial infant foods in New Zealand has not been undertaken. Nor have any studies reported the free sugars or added sugars content of these foods. To address this knowledge gap, a cross-sectional survey of infant foods sold in New Zealand supermarkets was conducted in 2019–2020. Recipes and nutrient lines were developed for the 266 foods identified (133 food pouches). The energy, iron, vitamin B12, total sugars, free sugars, and added sugars content of infant food pouches and other forms of commercial infant foods per 100 g were compared, both within food groups and by age group. Infant food pouches contained similar median amounts of energy, iron, and vitamin B12 to other forms of commercial infant foods but contained considerably more total sugars (8.4 g/100 g vs. 2.3 g/100 g). However, median free sugars and added sugars content was very low across all food groups except for “dairy” and “sweet snacks”. All “dry cereals” were fortified with iron whereas none of the infant food pouches were. Therefore, consuming food pouches to the exclusion of other commercial infant foods may place infants at risk of iron deficiency if they do not receive sufficient iron from other sources.

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Objective Biomarkers for Total Added Sugar Intake – Are We on a Wild Goose Chase?

Advances in Nutrition ◽

10.1093/advances/nmaa093 ◽

2020 ◽

Vol 11 (6) ◽

pp. 1429-1436

Author(s):

Jimmy Chun Yu Louie

Keyword(s):

Human Physiology ◽

Current Knowledge ◽

Dietary Assessment ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Adverse Health Outcomes ◽

Dietary Assessment Methods ◽

Nutritional Sciences ◽

Wild Goose

ABSTRACT Misreporting of added sugar intake has been the major criticism of studies linking high added sugar consumption to adverse health outcomes. Despite the advancement in dietary assessment methodologies, the bias introduced by self-reporting can never be completely eliminated. The search for an objective biomarker for total added sugar intake has therefore been a topic of interest. In this article, the reasons this search may be a wild goose chase will be outlined and discussed. The limitations and inability of the 2 candidate biomarkers, namely urinary sucrose and fructose and δ¹³C isotope, which are based on the 2 only possible ways (i.e., difference in metabolism and plant sources) to identify added sugar based on current knowledge in human physiology and food and nutritional sciences, are discussed in detail. Validation studies have shown that these 2 candidate biomarkers are unlikely to be suitable for use as a predictive or calibration biomarker for total added sugar intake. Unless advancement in our understanding in human physiology and food and nutritional sciences leads to new potential ways to distinguish between naturally occurring and added sugars, it is extremely unlikely that any accurate objective added sugar biomarker could be found. It may be time to stop the futile effort in searching for such a biomarker, and resources may be better spent on further improving and innovating dietary assessment methods to minimize the bias introduced by self-reporting.

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Added Sugar Intake and Risk of Falling Among Older People: The Seniors-ENRICA Cohort Study

Gerontology & Geriatrics: Research ◽

10.26420/gerontolgeriatrres.2021.1056 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Ballesteros JM ◽

◽

Struijk E ◽

Machado-Fragua MD ◽

Ortolá R ◽

...

Keyword(s):

Older People ◽

Chronic Diseases ◽

Risk Of Falling ◽

Added Sugar ◽

Cox Models ◽

Added Sugars ◽

Sugar Intake ◽

Vitamin Intake ◽

Injurious Falls ◽

Prospective Association

Background: Added sugar intake is a key contributor to the development of several chronic diseases. We aimed to investigate the prospective association between added sugar intake and the risk of falling among older men and women. Methods: We analyzed data from 2,154 Spanish adults aged ≥65 years from the Seniors-ENRICA cohort. Baseline food consumption was collected in 2008-2010 with a validated diet history, in which 155 foods were identified to contain added sugar. The occurrence of falls was ascertained up to 2015. Analyses were conducted with Cox models adjusted for potential confounders, including nutritional status, chronic diseases and sleeping medication. Results: Over 7.2y of follow-up, 605 participants experienced ≥1 fall and 527 suffered injurious falls. The hazard ratios (95% confidence interval) for ≥1 fall across quintiles of added sugar intake were: 1.0, 1.09 (0.83-1.42), 1.07 (0.82-1.40), 1.15 (0.88-1.52), and 1.48 (1.12-1.96); p-trend 0.03. The corresponding figures for injurious falls were: 1.0, 1.17 (0.88-1.56), 1.06 (0.79- 1.41), 1.13 (0.84-1.52), and 1.40 (1.03-1.90); p-trend 0.10. These associations did not vary over strata of age, protein, calcium or vitamin intake, diet quality, physical activity or alcohol consumption. No differences were found when solid and liquid sources of added sugars were examined separately. Conclusions: Intake of added sugars was associated with a higher risk of falling in older people. This adds to the evidence to support interventions to reduce added sugar intake.

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Added sugars: consumption and associated factors among adults and the elderly. São Paulo, Brazil

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2012000200003 ◽

2012 ◽

Vol 15 (2) ◽

pp. 256-264 ◽

Cited By ~ 8

Author(s):

Milena Baptista Bueno ◽

Dirce Maria Lobo Marchioni ◽

Chester Luis Galvão César ◽

Regina Mara Fisberg

Keyword(s):

Soft Drink ◽

Linear Regression Analysis ◽

The Elderly ◽

Sao Paulo ◽

Socioeconomic Level ◽

São Paulo ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Factors Associated

OBJECTIVE: To investigate added sugar intake, main dietary sources and factors associated with excessive intake of added sugar. METHODS: A population-based household survey was carried out in São Paulo, the largest city in Brazil. Cluster sampling was performed and the study sample comprised 689 adults and 622 elderly individuals. Dietary intake was estimated based on a 24-hour food recall. Usual nutrient intake was estimated by correcting for the within-person variance of intake using the Iowa State University (ISU) method. Linear regression analysis was conducted to identify factors associated with added sugar intake. RESULTS: Average of energy intake (EI) from added sugars was 9.1% (95% CI: 8.9%; 9.4%) among adults and 8.4% (95% CI: 8.2%; 8.7%) among the elderly (p < 0.05). Average added sugar intake (% EI) was higher among women than among men (p < 0.05). Soft drink was the main source of added sugar among adults, while table sugar was the main source of added sugar among the elderly. Added sugar intake increased with age among adults. Moreover, higher socioeconomic level was associated with added sugar intake in the same group. CONCLUSIONS: Added sugar intake is higher among younger adults of higher socioeconomic level. Soft drink and table sugar accounted for more than 50% of the sugar consumed.

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Consumption of added sugars and development of metabolic syndrome components among a sample of youth at risk of obesity

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2013-0456 ◽

2014 ◽

Vol 39 (4) ◽

pp. 512-512 ◽

Cited By ~ 12

Author(s):

JiaWei Wang

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Glucose Tolerance ◽

Fat Mass ◽

Diet Quality ◽

Healthy Eating Index ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake

Previous evidence showed controversial links between added sugar intake, diet quality, and increasing prevalence of metabolic syndrome (MetS) components (abdominal adiposity, dysglycemia, elevated blood pressure, reduced high-density lipoprotein cholesterol (HDL-C), and hypertriglyceridemia) in youth, and most studied only its liquid source of sugar-sweetened beverages (SSB). To better understand the extent of the detrimental effects of added sugars from both liquid and solid sources to diets in terms of nutrient and food intake and metabolic consequences in children, 3 studies were undertaken to (i) quantify the associations of added sugar intake with overall diet quality and adiposity indicators; (ii) assess whether excess weight and glucose tolerance status modifies the associations between consumption of added sugars and MetS components; and (iii) evaluate whether consumption of added sugars predicts the development of MetS components over time. Data for these studies were obtained from the Quebec Adiposity and Lifestyle Investigation in Youth cohort. Caucasian children (8 to 10 years at baseline, N = 630) with at least 1 obese biological parent were recruited from 1040 Quebec primary schools and followed-up 2 years later (N = 564). Dietary intake, including added sugars (liquid vs. solid) and Canadian Healthy Eating Index (HEI-C) was assessed in three 24-h recalls at baseline. Adiposity indicators included measured height and weight for body mass index (BMI), BMI z score, waist circumference (WC), and fat mass (by dual-energy X-ray absorptiometry). Plasma glucose and insulin were measured at fasting and by oral glucose tolerance tests to calculate the homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda IS index (Matsuda-ISI). Systolic blood pressure (SBP), concentration of triglycerides and HDL-C were measured by standard instruments. Multivariate linear regression models were used, adjusting for age, sex, pubertal status (by Tanner stage), energy intake, fat mass, and physical activity (by 7-day accelerometer). The main findings include the following: (i) Higher consumption of added sugars from SSB or solid sources was associated with lower nutrient density and lower HEI-C. Positive associations with adiposity indicators were observed with consumption of added sugars from liquid sources only. (ii) Higher SSB consumption was associated with higher HOMA-IR and higher SBP among overweight children (≥85th BMI percentile), as well as higher SBP and higher WC among children with impaired glucose tolerance. These associations with metabolic indicators were not observed among children whose BMI was below 85th percentile. (iii) No association with added sugar intake was observed for 2-year changes in adiposity, but higher consumption of added sugars from liquid sources was associated with higher fasting glucose, higher fasting insulin, higher HOMA-IR, and lower Matsuda-ISI. In conclusion, this thesis suggested that consumption of added sugars from both solid and liquid sources was associated with a lower overall diet quality, but only added sugars from liquid sources was associated with adiposity indicators. Cross-sectional links with higher levels of SSB intake and MetS components were more evident among overweight/obese and glucose-intolerant children. Consumption of added sugars from liquid sources was not associated with changes in adiposity over 2 years, but was clearly associated with development of impaired glucose homeostasis and insulin resistance. This thesis presents further evidence on the nutritional and metabolic consequences of consuming added sugar from liquid and solid sources.

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Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa246 ◽

2020 ◽

Vol 112 (5) ◽

pp. 1267-1279 ◽

Cited By ~ 1

Author(s):

Charlotte Debras ◽

Eloi Chazelas ◽

Bernard Srour ◽

Emmanuelle Kesse-Guyot ◽

Chantal Julia ◽

...

Keyword(s):

Risk Factor ◽

Weight Gain ◽

Cancer Risk ◽

Current Debate ◽

Cancer Etiology ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Sugary Drinks

ABSTRACT Background Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar–cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. Objective The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. Methods In total, 101,279 participants aged >18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009–2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants’ usual consumption for >3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results Total sugar intake was associated with higher overall cancer risk (n = 2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend = 0.02). Breast cancer risks were increased (n = 783 cases; HRQ4vs.Q1 = 1.51; 95% CI: 1.14, 2.00; Ptrend = 0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose, sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend ≤ 0.01). Conclusions These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.

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Total Sugar Intake and Macro and Micronutrients in Children Aged 6–8 Years: The ANIVA Study

Nutrients ◽

10.3390/nu12020349 ◽

2020 ◽

Vol 12 (2) ◽

pp. 349

Author(s):

María Morales-Suarez-Varela ◽

Isabel Peraita-Costa ◽

Agustín Llopis-Morales ◽

Yolanda Picó ◽

Maira Bes-Rastrollo ◽

...

Keyword(s):

Body Fat ◽

Nutrient Intake ◽

Parental Education ◽

Pediatric Population ◽

Caloric Intake ◽

Total Sugar ◽

Total Sugars ◽

Sugar Intake ◽

Food And Beverage ◽

Z Scores

The objective of this study was to study the association between total sugar intake (TSI) levels of children aged 6–8 years old, nutrient intake and anthropometry. Food and beverage intakes were collected by a prospective three-day recall questionnaire. The 2237 children were distributed into three groups according to TSI percentiles. Mean TSI was 93.77 ± 25.72 g/day, 22%–25% of total caloric intake, with boys presenting an intake of 96.24 ± 24.34 g/day and girls 91.38 ± 26.78 g/day. Greater TSI was associated with higher body fat, parental education, energy intake, nutrients/1000 kcal, and lower weight z-scores, BMI z-scores, waist circumferences, and hip circumferences. Weight, height, and waist circumference had the highest R2 while body fat had the lowest. The percentage of total energy derived (%E) from protein decreased as the %E from TSI increased, while the opposite was true for carbohydrates and saccharides, while for fiber intake, the medium groups presented the highest intake/1000 kcal. For the remaining macronutrients studied, intake/1000 kcal decreased when the %E from TSI increased. Calcium, iodine, magnesium, vitamin B2, folate, and vitamin C intake increased as the %E from TSI increased, while the opposite was true for vitamin B12. Fiber, ω-6 PUFA, iodine, folate, vitamin D, and vitamin E intakes were insufficient across most of the sample. TSI levels in children were identified to exceed adult recommendations. It is not clear what the effect of up to an average of 21% of energy coming from total sugars has on childhood obesity and further research is needed in the pediatric population, however, opportunities exist to improve sugar intake patterns.

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Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents

Children ◽

10.3390/children8080676 ◽

2021 ◽

Vol 8 (8) ◽

pp. 676

Author(s):

Emmanuella Magriplis ◽

George Michas ◽

Evgenia Petridi ◽

George P. Chrousos ◽

Eleftheria Roma ◽

...

Keyword(s):

Total Energy ◽

Children And Adolescents ◽

Age Groups ◽

Significant Proportion ◽

Dietary Intakes ◽

Food Groups ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Sweetened Beverages

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor was sugar-sweetened beverages (20.6%). Being overweight or obese was 2.57 (p = 0.002) and 1.77 (p = 0.047) times more likely for intakes ≥10% of total energy from added sugars compared to less <10%, when accounting for food groups and macronutrient intakes, respectively. The predicted probability of becoming obese was also significant with higher total and added-sugar consumption. We conclude that high consumption of added sugars increased the probability for overweight/obesity among youth, irrespectively of other dietary or macronutrient intakes.

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