Abstract
Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to “healthy” foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6–<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6–<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well.
Highlights
The childhood obesity pandemic being currently observed in most developed and developing countries urges the identification of effective strategies for its prevention and treatment [1]
The novel research question of this study is to investigate in the large European cohort of children participating to the IDEFICS survey, both cross-sectionally and prospectively, whether the habit to add sugar to milk and/or fruit is associated to adiposity indexes and/or to the quality of the diet, as assessed by a healthy diet score
We describe below the measurements were detailed description of the anthropometric measurements in the IDEFICS study, including and considered in the present analysis
Summary
The childhood obesity pandemic being currently observed in most developed and developing countries urges the identification of effective strategies for its prevention and treatment [1]. As free sugar or sugar-sweetened beverages (SSB), significantly contributes to total energy intake, and, possibly, to increased body weight [2]. Recent data on the European children participating to the Identification and Prevention of Dietary-and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) study indicate that the mean total intake is still high [9], in the light of the WHO Guidelines for sugars intake released in 2015 [3]. The evidence about sugar intake in European countries has been recently reviewed by Azaïs-Braesco et al [10], confirming the high intake of total and added sugars in Europe, especially in children, and identifying sweet products and beverages as the major contributors to added sugar intakes. The authors highlighted the many limitations in the interpretation of the available data, which is mainly due to important items, such as dietary data collection, food composition tables, or estimation of added sugars [10], not considering the varying definition of sugars used in different context [11]
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