Relationships between children's sugar consumption at home and their food choices and consumption at school lunch.

Sugar intake in infancy in early childhood is an area of investigation with surprisingly few studies, with most of the research done in adults. The aim of this study was to determine whether early vs. late introduction of solid foods and commercially prepared (CP) vs. parents choice (PC) of solid foods affects sugar intake. Based on adult data, we hypothesized that children with high sugar intakes will compensate their total calorie intake with lower fat; high sugar will be weakly correlated with high lean mass, and a high early sugar intake will result in a high intake later. Term infants (n=175) were recruited prior to 3 mo and randomly assigned to receive: 1) CP from 3-12 mo 2) CP from 6-12 mo 3) PC from 3-12 mo or 4) PC from 6-12 mo. Body composition, anthropometrics and 3-d diet records (Univ of Mn Nutrient Database) were completed at 3, 6, 12 and 24 mo. At 12 mo, total sugar intake was greater in late vs. early group when adjusted for weight (84.0 + 2.5g vs. 75.7 + 2.4g, p=0.02), but this effect did not persist to 24 mo. There was no difference in total sugar intake between CP and PC at either 12 or 24 mo (both p≥.05). At 12 and 24 mo, total sugar intake was correlated with total fat intake (both p≤.001) even when adjusted for weight. Total sugar intake at 12 and 24 mo was correlated with lean mass (p=.9 and p=.06). Additionally, 24 mo sugar intake/kg was positively correlated with total sugar intake/kg at 12 mo, p≤.001. Unlike adult data that shows a calorie compensation effect (an inverse relationship between consumption of calories from sugar and fat) the 12 and 24 mo data show positive correlations between high sugar and high fat intake. In addition, there was no correlation between sugar intake and lean mass at 12 or 24 mo. High sugar intake/kg at 12 mo is positively correlated with high sugar intake/kg at 24 mo suggesting a developing pattern of sweet preference. Infants developing a sweet preference may “pattern” their eating habits for later in the toddler years for sugar and fat intake.

BackgroundAdolescents consume too much sugar and not enough fruit and vegetables. The school food and drink environment offers an opportunity to improve adolescents’ food choices, as the school day can...

Introduction: Children choose sweet, energy dense foods in preference to more nutritious options. Despite being aware about healthy food, mothers regularly purchase, prepare and allow their children to eat unhealthy food. Aims: To explore the association between the knowledge of mothers of preschool children about making food choices and oral health of their children and to assess the association with their children's sugar consumption and caries status. Materials and Methods: A cross-sectional study was conducted on 358 mother and child pairs from preschools and Anganwadi centers in the Vikarabad town of Ranga Reddy district in Telangana using simple random sampling. Data were collected using a questionnaire filled by their mothers who gathered their views on choices about food; a 3-day diet chart and clinical assessment of the children's caries status. Chi-square, t-test and ANOVA were used. Results: Majority of mothers were motivated by their child's preferences (51%), availability and accessibility of food products (19%) and affordability (15%) when making food choices for their children. Though, mothers had a favorable knowledge regarding food choices for their children and about oral health, it was not found to be associated with caries status of their children. However, the association between the sweet scores of the children and their caries status was significant. Conclusion:Though the mothers had favorable knowledge about providing healthy foods to their children, it did not reflect in their behavior when choosing foods. Higher sugar consumption of the children was associated with more dental caries.

Presented in: Poster Session Sunday, May 3, 1998, Poster number 145 † 617 Sugar intake in infancy in early childhood is an area of investigation with surprisingly few studies, with most of the research done in adults. The aim of this study was to determine whether early vs. late introduction of solid foods and commercially prepared (CP) vs. parents choice (PC) of solid foods affects sugar intake. Based on adult data, we hypothesized that children with high sugar intakes will compensate their total calorie intake with lower fat; high sugar will be weakly correlated with high lean mass, and a high early sugar intake will result in a high intake later.

Mental health problems are highly prevalent in childhood and adolescence and may be associated with nutritional intake. It has recently been shown that a high percentage of infants and children consume large amounts of free sugars. In this paper, we analyse the relationship between free sugar consumption at 12 and 30 months and the risk of developing psychological problems at 30 months in a community sample of 86 children evaluated longitudinally. Socio-family and anthropometric data, and the amount of free sugars consumed were collected at both ages. At 30 months, the Child Behavior Checklist 1.5–5 was administered to parents and an interview was conducted to identify psychological disorders in accordance with DC: 0–3’s classification. We report a relationship between high free sugar consumption at 30 months and the concurrent presence of sleeping problems, ADHD and anxiety symptoms. However, no significant association was observed between free sugar consumption at 12 months and the subsequent development of psychological problems. Early detection of emotional and behavioural manifestations and high sugar consumption in children may help to prevent the persistence of psychological problems.

“I Control What I Eat and I’m Sensible with What I Eat, Apart from School” – A Qualitative Study of Adolescents’ Food Choices and the School Environment

Research is limited on added sugars in school meals and children’s dietary intakes after the 2015–2020 Dietary Guidelines for Americans (DGA) recommended that added sugars be limited to less than 10% of total calories. This analysis uses data from the School Nutrition and Meal Cost Study (SNMCS) to examine levels of added sugars in: (1) school meals and (2) children’s dietary intakes at breakfast, lunch, and over 24 h on school days. SNMCS data were collected in the 2014–2015 school year after updated nutrition standards for school meals were implemented. Most schools exceeded the DGA limit for added sugars at breakfast (92%), while 69% exceeded the limit at lunch. The leading source of added sugars in school meals (both breakfasts and lunches) was flavored skim milk. More than 62% of children consumed breakfasts that exceeded the DGA limit, and almost half (47%) consumed lunches that exceeded the limit. Leading sources of added sugars in the breakfasts consumed by children were sweetened cold cereals and condiments and toppings; leading sources of added sugars in children’s lunches were flavored skim milk and cake. Over 24 h, 63% of children exceeded the DGA limit. These findings show that school meals and children’s dietary intakes are high in added sugars relative to the DGA limit and provide insights into the types of foods that should be targeted in order to decrease levels of added sugars.

Oral microbiome transplantation (OMT) has the potential to serve as a therapeutic approach for managing dental caries; however, it is essential to identify suitable donors. The aim of this study was to analyse the relationship between dietary (i.e., energy, water, carbohydrate and sugar intake), saliva quality (i.e., saliva flow rate and salivary pH), and clinical factors (i.e., past caries experience and fluoride exposure) on the oral microbiome composition of potential OMT donors. For this cross-sectional study, a comprehensive dental examination was conducted for 93 healthy, caries-free adults (aged 18–85 years) without systemic or oral disease. All participants completed questionnaires on food frequency and socio-economic, lifestyle, and behavioural factors. Supragingival plaque samples were collected, and bacterial 16S rRNA genes were amplified, sequenced, and assigned to bacterial taxa. Stimulated saliva samples were collected for salivary flow rate and pH measurements. Constrained partial ordination analysis revealed that dietary factors, such as carbohydrate and sugar intake, had strong directional influences on microbial composition, while salivary factors like flow rate and pH showed opposing effects. Correlation analysis linked high sugar intake and reduced salivary pH to increased Streptococcus abundance. Differential abundance analysis identified significantly higher abundance of Streptococcus species among low water and high carbohydrate and sugar consumers. In mediation analysis, sugar consumption was directly and indirectly linked to reduced salivary pH, with Streptococcus showing a significant negative mediation effect (mean: -0.198; 95% CI: -0.387 to -0.010). High carbohydrate and sugar intake significantly influenced alpha diversity metrics (p < 0.05). Beta diversity permutational multivariate ANOVA revealed that covariates explained 11.45–12.52% of microbial variation (p < 0.05). This study emphasises that OMT donors with diverse oral microbiomes, low sugar and carbohydrate intake, and reduced levels of acidogenic taxa, such as Streptococcus, which significantly mediate salivary pH reduction, may be preferred for caries prevention.

Patterns of sugar consumption were studied prospectively in a birth cohort of 231 Norwegian children. Information on dietary habits and sugar consumption was collected at the children's ages of 10 months, 18 months, and 2 yr. The results of the factor analyses showed that the children's sugar consumption constituted a separate dimension of dietary habits. Patterns of sugar consumption seemed to be established already during infancy. The children's sugar consumption increased from infancy to the age of 2 yr, and the patterns of sugar consumption also seemed to be maintained throughout the first years of early childhood. Sugar consumption was also analyzed multivariately using indicators of social background and family size as explanatory variables, but the explanatory power of these variables was rather poor and decreasing with age.

Diet diaries are recommended for dentists to monitor children's sugar consumption. Diaries provide multifaceted dietary information, but patients respond better to simpler advice. We explore how dentists integrate information from diet diaries to deliver useable advice to patients. As part of a questionnaire study of general dental practitioners (GDPs) in Northwest England, we asked dentists to specify the advice they would give a hypothetical patient based upon a diet diary case vignette. A sequential mixed method approach was used for data analysis: an initial inductive content analysis (ICA) to develop coding system to capture the complexity of dietary assessment and delivered advice. Using these codes, a quantitative analysis was conducted to examine correspondences between identified dietary problems and advice given. From these correspondences, we inferred how dentists reduced problems to give simple advice. A total of 229 dentists' responses were analysed. ICA on 40 questionnaires identified two distinctive approaches of developing diet advice: a summative (summary of issues into an all-encompassing message) and a selective approach (selection of a main message approach). In the quantitative analysis of all responses, raw frequencies indicated that dentists saw more problems than they advised on and provided highly specific advice on a restricted number of problems (e.g. not eating sugars before bedtime 50.7% or harmful items 42.4%, rather than simply reducing the amount of sugar 9.2%). Binary logistic regression models indicate that dentists provided specific advice that was tailored to the key problems that they identified. Dentists provided specific recommendations to address what they felt were key problems, whilst not intervening to address other problems that they may have felt less pressing.

Restriction of both dietary fat and extrinsic sugars is standard advice for weight reduction. It has been suggested that foods, and diets, that combine high levels of sugars and fat particularly contribute to overconsumption. Weighed dietary data on 1087 men and 1110 women aged 16-64 who took part in the Dietary and Nutritional Survey of British Adults were examined for evidence of this hypothesis. Consumption of the main sugary fatty foods (cakes, biscuits, confectionery and puddings) averaged 12% of energy for men, 14.9% for women. Intake of these foods (as a proportion of total energy) was inversely related to BMI (adjusted for age and smoking). After exclusion of the substantial number who were dieting or unwell or who may have under-reported their intakes, the association remained significant only in men. Consumption of sugary fatty foods showed a positive association with intakes of fibre, a negative association with vegetables and no relationship with percentage of energy from fat. For the investigation of diet composition, men and women were divided into four groups, high or low in extrinsic sugars energy (cut point 15%) and fat energy (cut point 40%). For men consuming high fat diets (> 40% energy) mean BMI was higher in the low sugar group. After exclusion of dieters and unwell, men with low sugar intakes still had a higher mean BMI than men with high sugar intakes. BMI and extrinsic sugars energy were still negatively but weakly correlated (r = -0.10; P < 0.05) after adjusting for age, smoking, energy, fat intake, and dieting/under-reporting. In conclusion, there is little evidence in this cross-sectional survey that either sugary fatty foods, or diets high in sugars, are associated with obesity. Rather, sugars appear to have a weak negative association with BMI that is not totally explained by confounders such as dieting, under-reporting or the inverse correlation between energy from sugars and fat.

Consuming sugar-added foods and sweetened beverages is being a familiar habit associated with many diseases. Folk information in Yemen indicates the therapeutic effects of Aloe woodii on some diseases. So, the aim of this study is to evaluate the ameliorated effect of Aloe woodii gel extract on liver lesions in female rats induced by high table sugar intake. This study lasted 11 weeks and was divided into two periods. The first period was for high table sugar supplement, whereas the second was for the treatment by the methanolic extract of Aloe woodii gel. At the end of the experiment, body weights were recorded, blood samples were taken, and liver samples were also taken for the histopathological examination supported by quantitative measurement. Results: There was no remarked change in the body weights between groups, but there was an accumulation of the visceral fat and an elevated of alanine aminotransferase (ALT) level in the sugar group. Histopathological examination of liver tissues in the sugar group revealed many degenerated manners such as vacuolation and/or ballooning of hepatocytes and inflammation. However, the treatment by Aloe woodii gel led to an ameliorate of the histopathological changes, but had no effect on ALT level. Conclusion: High sugar supplement induced high visceral fat accumulation and many lesions in liver tissue, whereas Aloe woodii treatment ameliorated these effects.

(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99–1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88–1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82–1.84) and OR: 0.98 (95% CL: 0.60–1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.

INTRODUCTION: Inflammatory Bowel disease (IBD) management involves a delicate balance between medications, diet, and psychosocial care. Dietary factors like sugar consumption have been associated with disease onset. However, it is unknown how sugar intake complicates the medical regimen necessary to induce and maintain disease remission. We sought to characterize differences in IBD treatment regimens among patients with high and low sugar consumption and if medication patterns exist within subgroups that are in remission. METHODS: Using a longitudinal, prospective natural history of consented IBD patients, we meticulously tracked consented IBD patients at a large tertiary referral hospital. Sugar consumption was prospectively assessed using the 2005 National Health Interview Survey Diet and Questionnaire. Patients completed these questionnaires at routine outpatient appointments. The USDA estimates that the average American consumes 73 grams of added sugars on a daily basis. Patients who consumed above this average figure, were allocated to the high consumption group and those below comprised the low sugar consumption group. The primary outcome, medication use, was approximated using prescription data harvested from the electronic medical records. We focused on standard medications used in the management of IBD. We also conducted subgroup analyses to identify potential subpopulations with treatment patterns. Remission was defined as a score of ≤ 3 on the Harvey-Bradshaw index or ≤4 on the Ulcerative Colitis Activity Index. RESULTS: The study population consisted of 1259 adult IBD patients (70%CD, 30%UC, 57% Female). The median age was 40 years old. The mean sugar consumption of this study cohort was 71 grams. About 66% of patients had low sugar consumption while 34% of patients had high sugar consumption. High sugar consumption was associated with increased anti-TNF medication use, higher combination therapy use, and lower 5-ASA use. Among the subgroup of high sugar consumers, those not in remission used more adalimumab and steroids. Deeper analysis with only patients with Crohn’s Disease (CD), revealed differences in Azathioprine, 5-ASA, and steroid use. CONCLUSION: IBD patients consuming high sugar diets require more immunomodulator, biologic and combination therapy. These data suggest that optimal IBD treatment may benefit from incorporating nutritional counseling for healthy diet with low added sugar.Table 1Table 2Table 3

BackgroundEating too much sugar is associated with many negative health effects. Two brief online interventions were carried out to investigate whether information about the negative consequences of eating high-sugar food vs. positive consequences of eating low-sugar food can change reported appetite, mood, and visual food cue attention. MethodFor Study I, participants (n = 201) were allocated to one of three groups: Two groups were asked to list either the negative consequences of high-sugar consumption (negative focus) or the positive consequences of low-sugar consumption (positive focus). The third group carried out a control task (writing a shopping list). For Study II, 200 participants took part in a quiz with questions focusing on either positive, negative, or neutral consequences of high vs. low sugar consumption. Participants evaluated their appetite and mood before and after all interventions (list, quiz) and additionally completed a visual probe task with images depicting high vs. low-sugar food. ResultsIn Study I, the positive focus increased appetite for low-sugar food. The negative focus reduced participants' positive mood but did not change reported appetite. In Study II, all quiz conditions decreased appetite for high-sugar foods but did not affect mood. None of the interventions influenced visual attention to the food images. ConclusionFocusing on negative consequences of a high-sugar diet is less pleasant and is less effective in changing people's appetite than considering the positive aspects of a low-sugar diet. Thus, future interventions should instead spotlight the positive outcomes of a healthy diet.