Dietary Intakes, Sources, and Determinants of Total and Free Sugar Consumption Among Lebanese Children and Adolescents: Findings from a National Study

Abstract Objectives To determine the intake levels and main sources of total sugars (TS) and free sugars (FS) among Lebanese children and adolescents and to investigate the determinants of high FS consumption. Methods In a national cross-sectional survey, data on socio-demographic, anthropometric, and lifestyle characteristics of Lebanese children and adolescents (5–18 years-old) were collected (n = 1133). Dietary intake (24-hr recall) was analyzed using Nutri Pro software to determine average daily energy intake in kilocalories (kcal/d), TS and FS in grams (g/d) and as % of total energy intake (% kcal/d). FS content of foods was defined as 100% of added sugars for non-fruit juice sources and 100% of TS for fruit juice and drinks. Independent t -tests were used to compare mean daily intakes of TS and FS by sex and age groups. Logistic regressions were conducted to explore determinants of high FS intake (>10% kcal/d), as per the World Health Organization recommendations. Results Children and adolescents consumed, on average, 1899.9 ± 25.2 kcal/d of which 17 ± 0.2% kcal/d from TS and 16 ± 0.2% kcal/d from FS. Percentage of children and adolescents having high FS consumption was 62%. Main contributors to TS and FS were sweetened beverages, biscuits/chocolates, and syrups, jams and honey. Per consumer basis, intakes of FS from all food groups were significantly higher in older boys and girls than younger ones, except for candies, ice cream and fresh fruit juices. Multiple logistic regression showed children with higher paternal educational level and highest household monthly income had significantly lower odds of high FS intake (OR = 0.79, 95% CI: 0.64, 0.96 and OR = 0.70, 95% CI: 0.58, 0.83, respectively). Children meeting physical activity recommendations had higher odds of high FS compared to their counterparts (OR = 1.12, 95% CI: 1.003, 1.23). Conclusions High proportion of Lebanese children and adolescents exceeded upper limits for FS intake. Findings highlight the need for developing culture-specific interventions aimed at reducing the intake of TS and FS among adolescents, particularly those from low-income families, to curb rising obesity rates. Funding Sources This project was funded by the Lebanese National Council for Scientific Research and the University Research Board at the American University of Beirut.

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Food consumption of sugarcane workers' families in the Brazilian Northeast

Revista de Nutrição ◽

10.1590/1415-52732015000200006 ◽

2015 ◽

Vol 28 (2) ◽

pp. 175-184

Author(s):

Vanessa Messias Muniz ◽

Débora Silva Cavalcanti ◽

Nayalla Morais de Lima ◽

Mônica Maria Osório

Keyword(s):

Food Intake ◽

Total Energy ◽

Energy Intake ◽

Family Members ◽

Age Groups ◽

Total Energy Intake ◽

Dietary Intakes ◽

Food Groups ◽

Micronutrient Intake ◽

Brazilian Northeast

OBJECTIVE: To analyze the food intake of sugarcane workers' family members. METHODS: The food intake of 159 family members of sugarcane workers from Gameleira, Pernambuco, Brazilian Northeast, was investigated by directly weighing the foods on three non-consecutive days. The percent risk of inadequate macro- and micronutrient intakes was analyzed according to the Reference Dietary Intakes. The macronutrients were analyzed in relation to acceptable distribution intervals. The energy consumed from the various food groups was expressed as a ratio of the total energy intake. RESULTS: The median intake of carbohydrates and proteins remained above the Estimated Average Requirement, and all age groups presented a low risk of inadequate carbohydrate and protein intakes. The median intakes of riboflavin, niacin, thiamin, and iron remained above the Estimated Average Requirement for all age groups, but children aged 1-3 years presented a high percent risk of inadequate iron intake. All age groups presented high percent risk of inadequate zinc, calcium, vitamin A, and vitamin C intakes. Grains and derivatives had a greater participation in the total energy intake, especially in men aged 19-30 years. The group "milk and dairy products" had a greater participation in the diet of children aged 1-3 years. CONCLUSION: The low percent risk of inadequate carbohydrate and protein intakes in all age groups was opposed to the high risk of inadequate mineral and vitamin intakes, making the population vulnerable to nutritional disorders caused by excess macronutrient intake and inadequate micronutrient intake.

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Breakfast eating among Brazilian adolescents: Analysis of the National Dietary Survey 2008-2009

Revista de Nutrição ◽

10.1590/1678-98652017000400006 ◽

2017 ◽

Vol 30 (4) ◽

pp. 463-476 ◽

Cited By ~ 4

Author(s):

Luana Silva MONTEIRO ◽

Amanda de Moura SOUZA ◽

Bruna Kulik HASSAN ◽

Camilla Chermont Prochnik ESTIMA ◽

Rosely SICHIERI ◽

...

Keyword(s):

Energy Intake ◽

Fruit Juice ◽

Northern Region ◽

Food Groups ◽

Food Record ◽

Daily Energy Intake ◽

Processed Meats ◽

Daily Energy ◽

Breakfast Eating ◽

Income Quartile

ABSTRACT Objective: To characterize breakfast eating among Brazilian adolescents. Methods: Food intake was estimated based on a 1-day food record of adolescents aged 10-19 years, according to the first National Diet Survey (2008-2009). Breakfast was considered as the first meal of the day eaten between 4 and 11 am. Results: Ninety-three percent of adolescents reported eating breakfast. This meal contributed to 17.7% of the daily energy intake. The most commonly consumed food groups were: coffee and tea, breads, butter/margarine, milk, cakes and cookies, packaged snacks, corn-based dishes, cheese, processed meats, and fruit juice. In the Northern region there was a higher frequency of coffee and tea and roots and tubers intake and lower frequency of milk intake than that in the other regions in the country. In the Northeastern region, the intake of corn and eggs was high; in the Southern region, there was high intake of processed meats and fruits. Adolescents from families in the first income quartile reported higher intake of coffee and tea, packaged snacks, corn, and roots and tubers intake, and lower intake of milk and dairy products. Adolescents from families in the highest income quartile reported higher intake of milk, fruit juice, cheese, and sugar-added beverages. Conclusion: In Brazil, the contribution of breakfast to daily energy intake among adolescents is low. The nutritional quality of breakfast improved with increased income. The three most frequently consumed items were coffee and tea, breads, and butter/margarine.

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Underreporting of energy intake among Japanese women aged 18–20 years and its association with reported nutrient and food group intakes

Public Health Nutrition ◽

10.1079/phn2004635 ◽

2004 ◽

Vol 7 (7) ◽

pp. 911-917 ◽

Cited By ~ 39

Author(s):

Hitomi Okubo ◽

Satoshi Sasaki

Keyword(s):

Metabolic Rate ◽

Energy Intake ◽

Basal Metabolic Rate ◽

Food Group ◽

Young Female ◽

Dietary Intakes ◽

Food Groups ◽

Female Population ◽

Reporting Accuracy ◽

Diet History Questionnaire

AbstractObjectives:To evaluate the ratio of energy intake to basal metabolic rate (EI/BMR) among young female Japanese adults, and to compare the lifestyle and dietary characteristics between relatively low and high reporters.Design:Dietary intakes were assessed over a 1-month period with a validated, self-administered, diet history questionnaire, and lifestyle variables were assessed by a second questionnaire designed for this survey. The ratio of EI/BMR was calculated from reported energy intake and estimated basal metabolic rate.Subjects:In total, 1889 female Japanese university students aged 18–20 years who were enrolled in dietetics courses.Results:Ninety-five per cent of the subjects were classified into a non-obese group (body mass index (BMI) <25 kg m−2; mean±standard deviation (SD): 20.8±2.6 kg m−2). EI/BMR was 1.43±0.40 (mean±SD). Sixty-eight per cent of the subjects showed an EI/BMR level below the possibly balanced value of 1.56, 37% showed EI/BMR below the minimum survival value of 1.27 and 2% of the subjects showed EI/BMR exceeding the maximum value for a sustainable lifestyle of 2.4. BMI, body weight and BMR decreased significantly with the increase in EI/BMR (P<0.001). The percentage of energy from carbohydrate was significantly higher, whereas those from fat and protein were significantly lower, among the lower EI/BMR groups. As for food groups, a significantly declining trend from the lowest to the highest EI/BMR groups was observed for cereals.Conclusion:Underreporting, rather than overreporting, of energy intake was predominant in this relatively lean Japanese female population. BMI was the most important factor affecting the reporting accuracy of energy intake.

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What Do Ontario Children Eat for Breakfast? Food Group, Energy and Macronutrient Intake

Canadian Journal of Dietetic Practice and Research ◽

10.3148/64.1.2003.28 ◽

2003 ◽

Vol 64 (1) ◽

pp. 28-30 ◽

Cited By ~ 7

Author(s):

Michelle Hooper ◽

Susan Evers

Keyword(s):

Energy Intake ◽

Low Income ◽

Household Income ◽

Demographic Data ◽

Food Group ◽

Macronutrient Intake ◽

Food Groups ◽

Prevention Project ◽

Breakfast Food ◽

24 Hour Recall

This study included 305 children living in Ontario in 1993. Our objective was to determine the proportion of daily energy and macronutrient intake consumed at breakfast, and the major food groups contributing to this meal. Demographic data were obtained in a parent interview that was part of the prevention project Better Beginnings, Better Futures. A single 24-hour recall among parents indicated that breakfast provided a mean of 1,230 (± 607) kJ. Although only 4.9% (n=15) of children ate nothing at breakfast, 26.9% had <837 kJ. Many (59.7%) had a mid-morning snack; however, children who consumed <837 kJ at breakfast were not more likely to have a snack than were those who had a greater energy intake. The major sources of energy were foods from the milk (27.4%), cereals (22.1%), and breads (14.1%) groups. Energy intake at breakfast was no different in children whose household income was at or above the low-income cutoff than in children whose household income was below the cutoff. While few children missed breakfast, many needed more energy at this meal, and non-economic as well as economic influences on breakfast consumption need to be identified.

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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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Breastfeeding Duration in a Low-Income Sample Is Associated With Child Diet Quality at Age Three

Journal of Human Lactation ◽

10.1177/0890334420903029 ◽

2020 ◽

pp. 089033442090302 ◽

Cited By ~ 1

Author(s):

Nancy S. Weinfield ◽

Christine Borger ◽

Alice Ann Gola

Keyword(s):

At Risk ◽

Diet Quality ◽

Low Income ◽

Child Outcomes ◽

Feeding Practices ◽

Breastfeeding Duration ◽

National Study ◽

Food Groups ◽

Populations At Risk ◽

Child Age

Background: Little research has focused on breastfeeding and diet quality, particularly in low-income populations at risk for shorter breastfeeding duration and poorer diet quality. Research Aim: The aim of this study was to examine the association between breastfeeding duration and later diet quality in a low-income population. Methods: For this longitudinal prospective cohort study we conducted a secondary analysis of data from the Infant and Toddler Feeding Practices Study-2, a national study of infant feeding practices and child outcomes. Study infants were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children by 2.5 months of age and followed until 36 months ( N = 1,223). We examined the association between breastfeeding duration until 13 months of age, and child diet quality derived from a 24-hour dietary recall with a usual intake adjustment at child age 36 months. Multiple regression analyses were used to examine the association of breastfeeding duration with overall diet quality, as measured by the Heathy Eating Index 2015, and with consumption of specific food groups. Results: Longer breastfeeding duration during infancy was associated with better diet quality at child age 36 months after controlling for key socio-demographic variables. In follow-up analyses, the origin of the association was narrowed to greater consumption of mature/dried beans and peas. Conclusions: Longer breastfeeding duration in infancy was associated with better diet quality at 36 months, in a population at risk for shorter breastfeeding duration and poorer diet quality. Breastfeeding was particularly associated with children’s consumption of mature/dried beans and peas. Clinical Trial Registration: This study is registered at clinicaltrials.gov as Feeding My Baby—A National WIC Study, NCT02031978

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Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016

Nutrients ◽

10.3390/nu12010020 ◽

2019 ◽

Vol 12 (1) ◽

pp. 20 ◽

Cited By ~ 2

Author(s):

Ines Perrar ◽

Alena M. Schadow ◽

Sarah Schmitting ◽

Anette E. Buyken ◽

Ute Alexy

Keyword(s):

Children And Adolescents ◽

Linear Trend ◽

Total Sample ◽

Free Sugar ◽

Food Groups ◽

Linear Quadratic ◽

Added Sugars ◽

Dietary Records ◽

Age Trends ◽

German Children

Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.

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Influence of ultra-processed foods on prevalence of inadequacy in Portuguese adults and elderly

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.438 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Costa de Miranda ◽

F Rauber ◽

M Moraes ◽

S Rodrigues ◽

R Bertazzi Levy

Keyword(s):

Energy Intake ◽

Saturated Fat ◽

World Health ◽

Free Sugar ◽

Processed Foods ◽

Processed Food ◽

Energy Contribution ◽

Daily Energy Intake ◽

Free Sugars ◽

Daily Energy

Abstract Background Ultra-processed foods (UPF) consumption has been widely associated with low diet quality. We aim to investigate its energy contribution and influence on prevalence of nutrient inadequacy in Portugal. Methods Cross-sectional representative study involving 3102 adults and 750 elderly enrolled in the 2015-2016 National Food, Nutrition and Physical Activity Survey. Dietary intake was assessed by two non-consecutive 24h recalls. Food items were classified according to the NOVA system. Total energy intake and energy contribution provided by UPF group were determined. Inadequate intake was evaluated across quintiles (Q) of UPF consumption by adjusted Poisson regressions. We adjusted the usual intake estimate by Multiple Source Method and considered the World Health Organization (WHO) recommendations. Results UPF contributed with 24% and 16% of daily energy intake in adults (1904 kcal/day) and elderly (1603 kcal/day), respectively. In both age groups, practically all individuals had inadequate intake of sodium, while about a half or more of population had inadequate intake of fibre and potassium. As the dietary share of UPF increased, the prevalence of inadequacy of free sugars (PR = 1.53 for adults and 1.56 for elderly) and saturated fat (PR = 1.18 and 1.15, respectively) increased significantly. In adults, this same trend was also seen for fibre (PR = 1.03) and potassium (PR = 1.12). Particularly relevant was the increase in prevalence of inadequacy of free sugar from 10.5% (Q1) to 67.6% (Q5) in adults and 5.8% (Q1) to 41.8% (Q5) in elderly. Prevalence of inadequacy of saturated fat raised from 27.3% (Q1) to 68.9% (Q5) in adults and 29.4% (Q1) to 46.8% (Q5) in elderly. Conclusions Effective strategies are needed to reduce UPF consumption among Portuguese adults and elderly in order to prevent them from diet-related non-communicable diseases. Funding FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR); POCI-01-0145-FEDER-032090. Key messages Ultra-processed food contributes with 24% and 16% of daily energy intake in Portuguese adults and elderly. As the ultra-processed food consumption increases, the prevalence of inadequacy of free sugars and saturated fat increases for both, while inadequacy of fiber and potassium also increases for adults.

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Association between free sugar intake and nutrient dilution among Japanese children and adolescents: the 2016 National Health and Nutrition Survey, Japan

British Journal Of Nutrition ◽

10.1017/s0007114520003657 ◽

2020 ◽

pp. 1-11

Author(s):

Aya Fujiwara ◽

Emiko Okada ◽

Chika Okada ◽

Mai Matsumoto ◽

Hidemi Takimoto

Keyword(s):

Children And Adolescents ◽

National Health ◽

Weight Status ◽

Free Sugar ◽

Food Groups ◽

Japanese Children ◽

Nutrition Survey ◽

Sugar Intake ◽

Health And Nutrition ◽

Dietary Record

Abstract The influence of free sugar intake on nutrient intake remains unclear in Japanese children and adolescents with relatively low free sugar intake. This cross-sectional study aimed to investigate the relationship between free sugar and selected nutrient intakes using data from the 2016 National Health and Nutrition Survey, Japan, based on the WHO recommendations (<5 % or <10 % of energy (%E)) for free sugar intake. A 1-d weighed dietary record was assessed in Japanese children and adolescents (aged 1–19 years; n 2919). Mean intakes for selected nutrients and food groups were compared according to free sugar intake categories (<2·5 %E, 2·5 to <5 %E, 5 to <10 %E and ≥10 %E) with adjustment for sex, age and weight status. Inverse associations were observed between intakes of free sugars and twenty-one of twenty-four micronutrients assessed, except for vitamins A and C and Ca. Significantly reduced intakes were identified for twenty-two and fourteen micronutrients in the ≥10 %E and 5 to <0 %E categories, respectively, compared with the lower categories. Mean micronutrient intakes at the <2·5 %E category did not differ from those at the 2·5 to <5 %E category. Free sugar intake had positive associations with intakes of sugars and jams, confectioneries, fruit and vegetable juices, and soft drinks and negative associations with intakes of pulses and nuts and vegetables. This study showed that nutrient dilution was associated with higher free sugar intake among Japanese children and adolescents. The findings suggest that the WHO recommendations might help prevent nutrient dilution in Japanese children and adolescents.

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Consumption of Free Sugar Predicts Nutrient Intake of Saudi Children

Frontiers in Nutrition ◽

10.3389/fnut.2021.782853 ◽

2021 ◽

Vol 8 ◽

Author(s):

Walaa Abdullah Mumena

Keyword(s):

Total Energy ◽

Energy Intake ◽

Nutrient Intake ◽

Linear Regression Analysis ◽

Total Energy Intake ◽

World Health ◽

Food Sources ◽

Future Research ◽

Free Sugar ◽

Sugar Intake

Data concerning the association between free sugar intake and nutrient intake in children in the Middle East are not available. This study aimed to explore the association between the consumption of free sugar and nutrient intake among Saudi children. A cross-sectional study included 424 Saudi children ages between 6 and 12 years old and their mothers. An online survey collected sociodemographic data from mothers. Trained data collector personal contacted mothers to arrange for a phone interview in order to collect 24-h dietary recall to assess the dietary intake of children. Only 0.90% of children consumed free sugar within the recent recommendation of the World Health Organization (WHO) of <5% of total energy intake, whereas 10.6% of children consumed free sugar <10% of total energy intake. The percentage of free sugar intake was negatively associated with total energy intake. Multiple linear regression analysis of free sugar consumption and nutrient intake adjusted for children's age and sex indicated that a higher percentage of free sugar intake significantly predicted lower intake of saturated fat, fiber, sodium, potassium, calcium, iron, zinc, and vitamin B12. Excessive intake of free sugar predicted a lower intake of many essential nutrients. Interventions that aim to reduce the intake of free sugar are urgently needed in order to improve diet of growing children. Future research to explore top food sources of free sugar is needed to establish effective interventions that aim to limit free sugar intake among children.

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