Free Sugar Consumption Research Articles

Liking for Sweet Taste, Sweet Food Intakes, and Sugar Intakes

Background/Objectives: Sweet taste preferences are currently targeted to aid with reducing free sugar intakes, but associations between sweet taste liking, sweet food intakes, and sugar intakes are not well established. Methods: UK consumers (n = 179) who were consuming >5% of total energy intakes from free sugars provided several laboratory measures of sweet taste liking, laboratory test meal measures of sweet food choice and sugar intakes, and 3-day food diary measures of free-living free sugar and total sugar intakes. Liking measures included liking for a 1 M sucrose solution, and pleasantness, desire to eat, and sweet taste intensity ratings for seven foods of a range of sweet taste intensities in a taste test. Results: Wide individual differences in sweet taste liking, in liking for a high sweet taste intensity, and in the relationships between sweet taste intensity and sweet taste liking were found. The majority of participants confirmed high liking and increasing liking for increasingly sweet tastes, but differing patterns of responses were also found. Higher liking for sweet foods was associated with increased sweet food selection and consumption at the test meal, and to some degree with free sugar and total sugar consumption in this restricted scenario. However, we found no associations between sweet taste liking, regardless of measure, and either free-living free sugar or total sugar intakes. Conclusions: These findings cast doubt on assumptions that sweet taste preferences are high for all and that these high sweet taste preferences drive high free sugar intakes.

Healthy home food environment is associated with usual consumption of free sugar in children

Healthy home food environment is associated with usual consumption of free sugar in children

Is too much sugar bitter? The impacts of sugars on health.

This paper reviews the associations between sugars consumption and non-communicable diseases. Systematic reviews demonstrate associations between sugars intake and dental caries, weight gain, type 2 diabetes and cardiovascular diseases. Children consuming more sugar-sweetened beverages (SSBs) are 1.55 times more likely to be overweight. In adults, higher consumption of SSBs is associated with a 27% higher relative risk of developing type 2 diabetes. In adults, greater free sugar consumption was positively associated with total CVD (HR 1.07; 95% CI: 1.03-1.10), ischaemic heart disease (HR 1.06; 95%CI: 1.02,1.10), and stroke (HR 1.10, 95% CI: 1.04, 1.17). Those consuming sugars higher than the recommended level of 10% of total energy are more likely to develop dental caries; 42 out of 50 studies involving children and 5 out of 5 in adults reported at least one positive association between sugars and caries. Reduction in sugars consumption requires a myriad of interventions to reduce supply and demand at national and global levels, fiscal policies, alongside high-quality research and promoting environments to reduce the burden of NCDs.

Effects of a 4-week free-sugar avoidance during periodontal therapy: An explorative randomized controlled clinical trial.

This study investigated the effect of a 4-week free-sugar avoidance on periodontal parameters during periodontal therapy. Twenty-one patients with untreated periodontitis and daily free-sugar intake were allocated to a sugar avoidance group (SAG) and a control group (CG). The SAG received a 45-min dietary consultation and was instructed to avoid free sugars during the following 4 weeks after subgingival instrumentation, while the CG continued with their regular diet. Bleeding on probing (BOP), plaque control record, body weight (BW), visceral fat (FATv), and a food frequency questionnaire (FFQ) were collected at baseline (T1), 4 weeks (T2), and 8 weeks (T3) after subgingival instrumentation. The main outcome parameter BOP was significantly reduced at T2 by 40.3% ± 15.54 in the SAG and 34% ± 12.47 in the CG (intra-p value both <0.001, inter-p value 0.361). A linear regression analysis of changes at patient level adjusted for age and FATv revealed a significant group difference for BOP (regression coefficient = -6.8; p = 0.019). Significant reductions were observed in BW, FATv and mean daily intake of free sugars (-14.4g/day), and a significant increase of vitamin C derived from fruits (75.89mg/day) at T2 in the SAG only. This study may indicate additional beneficial effects of a sugar avoidance on periodontal and metabolic parameters, and nutritional intake during periodontal therapy. German Clinical Trials Register (DRKS00026699). The current widespread free-sugar consumption is linked to an increasing incidence of chronic non-communicable diseases. Data indicate a relationship between sugar intake and a higher prevalence of periodontitis and increased gingival inflammation. This study showed that free-sugar avoidance after periodontal therapy had additional beneficial effects on periodontal and metabolic parameters in 10 test and 11 control patients. After 4 weeks of avoiding free sugars like sweets, processed white flour, juice, and so forth, periodontal bleeding was significantly reduced in both groups (-40.3% test group, -34% control group). Further regression analysis revealed a significant difference between groups favoring the intervention. Additionally, body weight and visceral fat were significantly reduced in the intervention group, only. To avoid sugar, patients were allowed to replace it with whole fruit, which led to increased levels of micronutrients such as vitamin C. Therefore, free-sugar avoidance may be of therapeutic benefit in addition to periodontal therapy. Further research is needed to investigate this effect in larger cohorts.

Estimated changes in free sugar consumption one year after the UK soft drinks industry levy came into force: controlled interrupted time series analysis of the National Diet and Nutrition Survey (2011–2019)

BackgroundThe UK soft drinks industry levy (SDIL) was announced in March 2016 and implemented in April 2018, encouraging manufacturers to reduce the sugar content of soft drinks. This is the...

Free sugar intake is associated with reduced proportion of circulating invariant natural killer T cells among women experiencing overweight and obesity.

Higher prevalence of obesity has been observed among women compared to men, which can be explained partly by the higher consumption of sweets and physical inactivity. Obesity can alter immune cell infiltration, and therefore increase the susceptibility to develop chronic inflammation and metabolic disorders. In this study, we aimed to explore the association between free sugar intake and other unhealthy lifestyle habits in relation to the proportion of circulating iNKT cells among women with healthy weight and women experiencing overweight and obesity. A cross-sectional study was conducted on 51 Saudi women > 18 years, wherein their daily free sugar intake was assessed using the validated Food Frequency Questionnaire. Data on smoking status, physical activity, and supplement use were also collected. Anthropometric data including height, weight, waist circumference were objectively measured from each participants. The proportion of circulating iNKT cells was determined using flow cytometry. Smoking, physical activity, supplement use, and weight status were not associated with proportion of circulating iNKT cells. Significant association was found between proportion of circulating iNKT cells and total free sugar intake and free sugar intake coming from solid food sources only among women experiencing overweight and obesity (Beta: -0.10: Standard Error: 0.04 [95% Confidence Interval: -0.18 to -0.01], p= 0.034) and (Beta: -0.15: Standard Error: 0.05 [95% Confidence Interval: -0.25 to -0.05], p= 0.005), respectively. Excessive free sugar consumption may alter iNKT cells and consequently increase the risk for chronic inflammation and metabolic disorders.

Parental Reports of Children's Dental Pain Experience and Associated Factors among Brazilian Children.

Exploring children's dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their child's oral hygiene practices, free sugar consumption, and dental history. The questionnaire was created using Google Forms and was disseminated to parents/caregivers via E-mail and/or WhatsApp©. Descriptive and Poisson regression analyses were performed (p < 0.05). Children's dental pain experience was reported by 20.3% of the parents. The authoritative parenting style was predominant. The child's mean age at the first consumption of sugar was 1.38 (±0.64) years, and 40.3% of the children had high-free sugar consumption. The mean age for the first dental appointment was 2.26 (±1.31) years, and 24.3% of the children never went to a dental appointment. The prevalence of dental pain experience was higher in children who attended their first dental appointment later (PR: 1.02; CI 95%: 1.01-1.03) and among those with high-free sugar consumption (PR: 1.90; CI 95%: 1.21-3.00). High sugar consumption and delay in the first dental appointment may increase the likelihood that children will experience dental pain.

Sources of free sugar in the diet of Saudi children.

Data concerning sources of free sugar (FS) in the diet of Saudi children are limited. Identification of the top sources of FS would permit to develop tailored interventions that aid in meeting the recommendations of the World Health Organization for FS (≤ 25 g/day). This study aimed to investigate sources of FS in children's diet. A cross-sectional data of healthy children ages between 6 and 12 years who reside in Saudi Arabia were gathered from their mothers using online platforms (WhatsApp, Facebook, and X) (n = 424; 210 boys and 214 girls). An interview was conducted through the phone with the mother and her child to collect data pertaining FS intake using a validated food frequency questionnaire. The primary sources of FS were Sweetened Beverages, followed by Sugars, Sweet Bakery Products, Other Desserts, and Candies, of which the added sugar consisted mostly of its total sugar. The consumption of FS coming from solid food sources for the highest quartile of children almost doubled the amount of FS coming from liquid food sources. Compared to boys, girls in the top quartile of FS intake consumed significantly higher amounts of solid sugars (p = 0.030). Only the intake of FS coming from Sweetened Beverages was associated negatively with age of children (p = 0.032). Public health interventions should emphasize the necessity of reducing the consumption of the top sources of FS to practically achieve the recommendations of FS intake.

A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries.

To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.

Association between added sugar consumption in foods and beverages and body mass index among adolescents in university southern Thailand: a cross-sectional study.

Excessive consumption of added sugar is an essential contributing factor to weight gain in adolescence, leading to non-communicable diseases. The aim of this study was to evaluate the added sugar consumption in foods and beverages and determine the association between free sugar consumption and BMI status. This cross-sectional study was conducted among 280 adolescents in university (18-22 years) recruited from undergraduate students at different schools. The information was acquired using a 24-hour dietary recall questionnaire. Adjusted binary logistic regression analysis was used to assess the associations between added sugar consumption in foods and beverages and nutritional status. Half of the participants had a BMI status in the normal range (51.8%). A large percentage of adolescents had eaten staple food only two times and did not have breakfast (49%). Additionally, most of the student did not eat a snack or drink beverages (57.7%). Consumption of vegetables, fruit, meat, and milk was higher in obese subjects than other groups. The results showed that adolescents consumed more added sugar (79.2%) than is recommended by the WHO. The majority of added sugar consumption were beverages (46.5%). The findings revealed that added sugar consumption among undergraduate students did not differ significantly depending on BMI. This study indicated that added sugar consumption in university students exceeded the WHO recommendation, although there was no discernible difference in BMI status. The results would be useful for further study and may help dietitians provide appropriate nutrition education or campaigns to reduce added sugar consumption in Thai and Southeast Asia university students.

Effect of 100% Orange Juice and a Volume-Matched Sugar-Sweetened Drink on Subjective Appetite, Food Intake, and Glycemic Response in Adults.

Dietary recommendations to reduce the consumption of free sugars often group 100% fruit juice with other sugar-containing beverages. The objective of this study was to determine the effect of consuming 100% orange juice compared to an orange drink on next-meal food intake (FI), glycemic response, average appetite, emotions, and sensory characteristics in normal-weight adults. Thirty-six normal-weight adults (age: 26.8 ± 0.9 years) consumed, in random order and at least 5 days apart, three 240 mL test beverages as follows: (a) 100% orange juice, (b) orange drink, or (c) water. Subjective sweetness and pleasantness were determined immediately after test beverage consumption. Glycemic response, average appetite, and subjective emotions were measured every 15 min for 60 min. Food intake was determined at a pizza lunch 60 min later. Rest-of-day glycemic response and energy intake (EI) were determined using a continuous glucose monitor and food record, respectively. Lunch FI (p = 0.054) and total EI (p = 0.01) were both lower after 100% orange juice compared with the orange drink. Caloric compensation was 84% after 100% orange juice and -25% after the orange drink (p = 0.047). Average appetite was not significantly different between the test beverages (p > 0.05). Blood glucose iAUC adjusted for available carbohydrate was lower after 100% orange juice compared with the orange drink (p < 0.001). Rest-of-day blood glucose concentrations were lower after 100% orange juice compared with the orange drink (p = 0.03) and water control (p < 0.001). In conclusion, consumption of 100% orange juice as a preload resulted in higher caloric compensation, lower total daily EI, and lower blood glucose concentrations compared to the orange drink.

European experience of healthy eating: strategies and practices

The expediency of studying the European experience in solving modern problems of healthy nutrition is substantiated. Healthy nutrition strategies in various European countries: Finland, Switzerland, Spain, and Germany were analyzed. It was determined that each of the countries has principles and special experiences, formed by certain historical, traditional, and other characteristics. The graphic form was chosen to demonstrate healthy eating recommendations for all segments of the population. Nutrition monitoring of the population of European countries identified individual characteristics typical for European countries, which in turn formed special food pyramids. The basic elements of the World Health Organization's three-level food pyramid are provided and recommendations for reducing the consumption of fats and free sugars contained in the diet are applied. One of the main focuses of the study was the analysis of the peculiarities of the formation of food pyramids in the leading European countries, the unique characteristics of each of these pyramids were described. The key differences in the qualitative filling of the pyramids levels of different countries are listed and construed, in particular, in the context of the World Health Organisation recommendations on healthy nutrition. The experience of European restaurants, which position themselves in the healthy food segment according to developed general and special criteria, is analyzed. The developed author's criteria allow a systematic and unified comparative analysis of the key healthy eating aspects and trends for the modern population through the prism of researching the specific features of European healthy eating restaurants. It has been established that vegetarianism and veganism are mostly understood by European institutions as healthy food. The conducted analysis of restaurant establishments made it possible to create a list of components of healthy nutrition for the European population.

Relationship between total free Sugars Consumption and Incidence of Laryngopharyngeal Reflux in Adolescents

Background: Up to date there are still few studies showing the relationship between laryngopharyngeal reflux (LPR) and free sugars consumption in adolescents. We consequently aimed to discover any association of free sugars consumption with LPR in Indonesian adolescents. Methods: This cross-sectional study was conducted on 210 middle school students in Jakarta, Indonesia. Data on age and gender were collected using a questionnaire, while body mass index was determined by anthropometric measurement. Free sugars consumption and LPR were evaluated by means of Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) and Reflux Symptom Index (RSI), respectively. Data were analyzed using Mann-Whitney test at level of significance p &lt;0.05. Results: Median age (min - max) was 16 (15 – 18) years, body mass index 19.8 (15.4 – 27.0) kg/m2, and free sugars consumption 6.7 (1.5 – 70.6) g/day. The prevalence of LPR was 14.3%. There was a statistically significant difference in free sugars consumption of the LPR negative versus the LPR positive groups (p&lt; 0.049). Conclusion: Free sugars consumption was strongly related to laryngopharyngeal reflux incidence. There is a need for a policy on and monitoring of free sugars consumption to decrease its harmful impact on adolescent health. Keywords: free sugars, laryngopharyngeal reflux, adolescents, Indonesia

Determinants of oral health status: an ecological study in Iran

ObjectivesThe aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level.Materials and methodsThe data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05).ResultsMean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01–0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07–0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2–0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 − 0.48) were positively in associated with FT.ConclusionsThe present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.

PRÁCTICAS DE SALUD BUCAL DURANTE LOS PRIMEROS 1000 DÍAS DE VIDA: REVISIÓN DE LA LITERATURA

Objective: To conduct a bibliographic literature review on current good practices in oral health during the first 1000 days of life, encompassing the gestation period and the initial two years of the child. Materials and methods: A scientific literature review was conducted in February and March 2022, utilizing the Pubmed and Scopus databases. The inclusion criteria encompassed original articles and systematic reviews (with or without meta-analysis) published between 2016 and 2022. Search strategies incorporating English keywords derived from MeSH were employed. Additionally, the grey literature was reviewed to define some key concepts. Results: 72 scientific articles, and four references from the grey literature (one clinical practice guide and three reports) were selected. The identified themes were categorized as follows: good oral hygiene practices, good feeding practices for pregnant women and infants, parafunctional habits, and dental visits. Based on the findings, the key recommendations for promoting good oral health practices during this crucial period include the use of fluoride toothpaste for oral hygiene once teeth erupt, avoidance of free sugar consumption, encouragement of breastfeeding over bottle-feeding, and early dental visits before birth. Conclusion: Good oral health practices during the first 1000 days of life significantly impact the child’s oral and general health, necessitating preventive measures starting from gestation, with a focus on oral hygiene and nutrition. The collaborative efforts of a multidisciplinary healthcare team during pregnancy and the initial two years of life are vital for enhancing both oral and general health outcomes for the population.

Protecting children from the harmful impact of food marketing.

A healthy and balanced diet should be promoted already in childhood, a crucial period for the psychophysical development of the individual. In particular, the consumption of free sugars and soft drinks in children and adolescents should not exceed the current WHO recommendations. This trend is very difficult to counter as the preference for sweet flavours is innate and often further reinforced by pre- and post-natal exposure and aggressive marketing. Unfortunately, sugar consumption continues to grow alarmingly due in part to the easy availability of foods and drinks rich in added sugars from vending machines, supermarkets and fast-food restaurants. Recently, the WHO (with the recommendations included in the QR Code below and in the following link: WHO recommends stronger policies to protect children from the harmful impact of food marketing) pointed out how exposure to food marketing affects children's health, eating behaviours and beliefs about food, thus becoming a real threat to public health. Among the proposals made, it is interesting to note the need for national governments to "curb the persuasive power of food marketing" by limiting the use of cartoons and other techniques that appeal to children, such as the inclusion of toys in packaging or advertisements with songs and celebrity endorsements. It is already evident in the literature that an excessive intake of sugar predisposes children to a number of pathological conditions that in the long term may favour the onset not only of carious disease but also obesity, type 2 diabetes mellitus, liver disease, cardiovascular and dysmetabolic diseases. As paediatric dentists, sugar-related dietary excesses are already very obvious to us since it is mainly these that drive young patients to our clinics. In our privileged position, we should therefore increasingly promote knowledge on the possible correlations between excessive sugar consumption and the onset of these diseases, drawing the attention of parents of young patients to all foods that are harmful to their growing children. Therefore, let us welcome these new guidelines promoted by the WHO to protect children and adolescents from the harmful impact of food marketing; and may we not miss the opportunity to share and promote this important battle for future generations!

Evidence pertaining to modifiable risk factors for oral diseases: an umbrella review to Inform oral health messages for Australia.

The aim of this umbrella review was to collate and appraise the evidence base regarding modifiable risk factors for the prevention of oral diseases to inform the update of the Oral Health Messages for Australia. Eleven questions related to modifiable risk factors and dental disease were investigated. Electronic databases (Medline, Embase and PubMed) were searched from January 2010 to October 2022. Systematic reviews evaluating interventions/exposures in healthy subjects from high-income countries, where Westernized practices, oral health promotion and healthcare systems are similar to Australia, were included. Quality appraisal of included systematic reviews was guided by the AMSTAR tool. Of the 3637 articles identified, 29 articles met eligibility criteria. High-quality systematic reviews were identified for questions relating to diet, infant feeding, dental check-ups and oral hygiene. Free sugars consumption above 5% of energy intake, infrequent toothbrushing, smoking/vaping and alcohol intake were consistently associated with poorer oral health outcomes. Breastfeeding up to the age of 24 months was not associated with an increased risk of early childhood caries. The use of interdental cleaning devices and mouthguards during contact sports are likely to be effective in preventing dental disease.

Free sugars and gingival inflammation: A systematic review and meta-analysis.

Consumption of free sugars has been associated with chronic non-communicable diseases. The aim of the study was to investigate the effect of free-sugar consumption on gingival inflammation using a systematic review and meta-analysis based on the PICO question 'What impact does the restriction of free sugars have on the inflammation of gingival tissue?' Literature review and analyses were based on the Cochrane Handbook for Systematic Reviews of Interventions. Controlled clinical studies reporting on free-sugar interventions and gingival inflammation were included. Risk of bias was performed with ROBINS-I and ROB-2, and effect sizes were estimated with robust variance meta-regressions. Of the 1777 primarily identified studies, 1768 were excluded, and 9 studies with 209 participants with gingival inflammation measures were included. Six of these studies reported on the dental plaque scores of 113 participants. Restriction of free sugars, when compared with no such restriction, was associated with statistically significantly improved gingival health scores (standard mean difference [SMD] = -0.92; 95% confidence interval [CI]: -1.43 to -0.42, p < .004; I2 [heterogeneity] = 46.8) and a trend towards lower dental plaque scores (SMD = -0.61; 95% CI: -1.28 to 0.05, p < .07; I2 = 41.3). The observed improvement of gingival inflammation scores with restricted consumption of free sugar was robust against various statistical imputations. No meta-regression models were feasible because of the limited number of studies. The median publication year was 1982. Risk-of-bias analysis showed a moderate risk in all studies. Restriction of free sugar was shown to be associated with reduced gingival inflammation. The systematic review was registered at PROSPERO (CRD 42020157914).

Trajectories of child free sugars intake and dental caries - a population-based birth cohort study

To investigate the association between trajectories of free sugars intake during the first five years of life and dental caries experience at five years. Data from the SMILE population-based prospective birth cohort study, collected at one, two and five years old, were used. A 3-days dietary diary and food frequency questionnaire were used to estimate free sugars intake (FSI) in grams. The primary outcomes were dental caries prevalence and experience (dmfs). The Group-Based Trajectory Modelling method was used to characterize three FSI trajectories ('Low and increasing'; 'Moderate and increasing'; and 'High and increasing'), which were the main exposures. Multivariable regression models were generated to compute adjusted prevalence ratios (APR) and rate ratios (ARR) for the exposure, controlling for socioeconomic factors. The prevalence of caries was 23.3%, with a mean dmfs of 1.4, and a median of 3.0 among those who had caries. There were clear gradients of caries prevalence and experience by the FSI trajectories. The 'High and increasing' had an APR of 2.13 (95%CI 1.23-3.70) and ARR of 2.77 (95%CI 1.45-5.32) against the 'Low and increasing'. The 'Moderate and increasing' group had intermediate estimates. A quarter of the caries cases could have been prevented if the whole study sample had been in the 'Low and increasing' FSI trajectory. A sustained, high trajectory of FSI from a young age was positively associated with child dental caries. Measures to minimise consumption of free sugars must commence early in life. The study has provided high level evidence to inform clinicians' decisions in promoting a healthy dietary pattern for young children.

Dietary sugar consumption and health: umbrella review

ObjectiveTo evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes.DesignUmbrella review of existing meta-analyses.Data sourcesPubMed, Embase, Web of Science,...