Abstract
Background: The evidence regarding the association between added sugar (AS) intake and obesity remains inconsistent. The aim of this study was to investigate the association between changes in the percentage of energy intake from AS (EAS%) and changes in body weight in a cohort study of older Australians during 15 years of follow-up. In addition, associations were assessed according to whether EAS% intake was provided from beverage or non-beverage sources.Methods: Data were analyzed from the participants of the Blue Mountains Eye Study Cohort. Dietary data were collected at baseline (1992–94) and three five-yearly intervals using a 145-item food frequency questionnaire. Participants' body weight was measured at each time point. Five-yearly changes in EAS% intake and body weight were calculated (n = 1,713 at baseline). A generalized estimating equation (GEE) model was used to examine the relationship between the overall five-yearly changes in EAS% intake and body weight, adjusted for dietary and lifestyle variables.Results: In each time interval, the EAS% intake decreased by ~5% in the lowest quartile (Q1) and increased by ~5% in the highest quartile (Q4). The mean (SD) body weight change in Q1 and Q4 were 1.24 (8.10) kg and 1.57 (7.50) kg (first time interval), 0.08 (6.86) kg and −0.19 (5.63) kg (second time interval), and −1.22 (5.16) kg and −0.37 (5.47) kg (third time interval), respectively. In GEE analyses, the overall five-yearly change in EAS% intake was not significantly associated with body weight change (Ptrend = 0.837). Furthermore, no significant associations were observed between changes in EAS% intake from either beverage or non-beverage sources and changes in body weight (Ptrend for beverage sources = 0.621 and Ptrend for non-beverage sources = 0.626).Conclusion: The findings of this older Australian cohort do not support the association between changes in EAS% intake and body weight, regardless of AS food sources (beverage or non-beverage).
Highlights
Obesity is a major public health issue in all age groups, including the elderly
This is similar to the World Health Organization free sugar definition where all monosaccharaides and disaccharides added to foods and sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates are considered in the free sugar definition [11]
Participants in quartile 1 had higher EAS% intakes and body mass index (BMI) compared to those in quartile 4. Their EAS% intakes from beverage and non-beverage sources were higher than other participants
Summary
Obesity is a major public health issue in all age groups, including the elderly. Several physical and mental health complications (e.g., cardiovascular disease and depression) are associated with obesity in this population [1]. Diets high in energy-dense foods have been linked to obesity [7], and added sugar (AS) has been identified as a major component in many energy-dense foods [8]. Honey and concentrated fruit juices used as an ingredient in the multi-ingredient foods are considered to be AS [10] This is similar to the World Health Organization free sugar definition where all monosaccharaides and disaccharides added to foods (by the manufacturer, cook, or consumer) and sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates are considered in the free sugar definition [11]. The aim of this study was to investigate the association between changes in the percentage of energy intake from AS (EAS%) and changes in body weight in a cohort study of older Australians during 15 years of follow-up. Associations were assessed according to whether EAS% intake was provided from beverage or non-beverage sources
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