Total Sugar Intake 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.

Total sugar intake significantly associated with systolic blood pressure in small sample population

Abstract Background Hypertension contributes to 45% of all deaths from heart disease and up to 51% of deaths from strokes. Dietary factors, such as sodium (Na+) and potassium (K+) can play a role, but recent studies have also highlighted the importance of sugar intake on blood pressure. Very few studies have evaluated the impact of these factors and their ratio on cardiometabolic biomarkers. This study aims to assess the impact of dietary sugar intake, Na+, K+ and NA+/K+ ratio on hypertension and cardiometabolic biomarkers. Methods Fasting venous blood was collected to measure glucose, triacylglycerols (TAG), total cholesterol, HDL-c, ApoA1, ApoB, or hs-CRP, with enzymatic and turbidimetric techniques, and oxidized LDL by ELISA, and IL-6 and TNFa by Luminex system, the latter’s in a subset sample. Blood pressure (SBP, DBP, and HR) was measured at least twice with an automatic recorder. Dietary intake was obtained using semi-quantitative FFQ, comprising 82 items, and reported to the previous year. Data was analysed using R software through descriptive analysis and partial correlations adjusted to the participant’s BMI. A significant level of 0.05 was used. Results 78 participants, aged from 19 to 80 years old (M = 48,5±13,5) were evaluated, with 47% taking hypertensive medication. BMI ranged from 19,7 to 41,1 Kg/m2 (M = 29,2±5,4). The average intake of Na+, K+ and NA+/K+ ratio were 3805±1397 mg, 3980±1300 mg and 1.65±0,38, respectively. Total mean sugar intake (% energy) represents 21,4%. No significant correlation was found between Na+ or K+ with SBP, HR, and the cardiometabolic biomarkers (p > 0.05). A positive correlation was found between % sugar intake and SBP (rs = 0,29, p < 0,05), which remains significant after adjusting for BMI, and a positive correlation, in the borderline of significance, with TAG (rs = 0,23, p = 0,0561). Conclusions N+, K+, and their ratio do not associate with SBP, HR and cardiometabolic biomarkers. However, % of sugar intake is positively associated with SBP. Key messages • Sodium and potassium may not always be associated with changes in blood pressure. • Sugar intake might have an important role in the etiopathology of hypertension.

Carbohydrate intakes, food sources and tracking in Australian young children.

Carbohydrate intake and key food sources of carbohydrates in early childhood are poorly understood. The present study described total carbohydrate intake and subtypes (i.e. starch, sugar), their primary food sources and their tracking among young Australian children. Data from children at ages 9 months (n 393), 18 months (n 284), 3·5 years (n 244) and 5 years (n 240) from the Melbourne InFANT Program were used. Three 24-hour recalls assessed dietary intakes. The 2007 AUSNUT Food Composition Database was used to calculate carbohydrates intake and food groups. Descriptive statistics summarised total carbohydrate and subtype intake and their main food sources. Tracking was examined using Pearson correlations of residualised scores between time points. Total carbohydrate, starch and sugar intakes (g/d) increased across early childhood. The percentage of energy from total carbohydrates (% E) remained stable overtime (48·4-50·5 %). From ages 9 months to 5 years, the %E from total sugar decreased from 29·4 % to 22·6 %, while the %E from starch increased from 16·7 % to 26·0 %. Sources of total carbohydrate intake changed from infant formula at 9 months to bread/cereals, fruits and milk/milk products at 18 months, 3·5 and 5 years. Across all time points, the primary sources of total sugar intake were fruit, milk/milk products and cakes/cookies, whereas main food groups for starch intake included bread/cereals, cakes/cookies and pasta. Weak to moderate tracking of total carbohydrates, total sugar and starch (g/d) was observed. These findings may have the potential to inform the refinement of carbohydrate intake recommendations and design of interventions to improve children's carbohydrate intake.

Association of sugar consumption with risk of depression and anxiety: a systematic review and meta-analysis.

Sugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis. Forty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I 2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case-control studies) and different sample sizes (<5,000, 5,000-10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I 2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I 2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89). Total dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety. CRD42024540548.

Adherence to the nutritional recommendations according to diabetes status in Korean adults: a cross-sectional study

BackgroundNutritional therapy plays a crucial role in diabetes management. Assessing adherence to nutritional recommendations is critical for evaluating whether the current status of nutrition education is appropriate. This study aimed to evaluate adherence to nutritional recommendations according to diabetes status using data from the Korean National Health and Nutrition Examination Survey from 2016 to 2019.MethodsA total of 2,793 participants (55.4% male) were evaluated regarding their adherence to nutritional recommendations. The “aware” group comprised people who had been clinically diagnosed by a physician. The “treated” group comprised people receiving anti-diabetic medications. The “control” group comprised people who achieved an HbA1c level < 6.5%. The “educated” group comprised people who had received nutrition education or counseling at various locations.ResultsAmong the 1,918 individuals in the “aware” group, only 243 (8.7%) had received nutrition education. Adherence to nutritional recommendations was generally low, with people with diabetes showing slightly higher adherence to total energy intake (59.6% vs. 55.3%) and total sugar intake (88.0% vs. 84.5%) than people without diabetes. However, adherence to total carbohydrate intake was poor in both the treated and educated groups (34.3% and 26.0%, respectively) compared to the untreated and non-educated groups (44.4% and 36.0%, respectively).ConclusionsThese findings indicate inadequate nutritional management for people with diabetes in Korea. Nutrition education should be effectively strengthened to achieve nutritional goals.

Evolution of critical nutrients (salt, sugars and saturated fats) in Spanish foods and beverages in the last 25 years

Non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, etc.) are the leading cause of death worldwide, accounting for 71 % of global deaths. The risk factors for all of them are closely linked to lifestyle and in particular to diet. For this reason, public health policies in European Union countries, in line with World Health Organization (WHO) recommendations, include in their priority measures actions aimed at promoting healthier food environments. One of these measures are policies for the reformulation of processed foods to reduce critical nutrients: salt, saturated fats, trans fats and added sugars. In Spain, as part of the NAOS Strategy, food reformulation measures have been implemented since 2008. Of all of them, the Plan de Colaboración para la Mejora de la Composición de Alimentos y Bebidas y otras Medidas 2020 stands out, which has led to a reduction in the content of salt, sugar, saturated and total fat in foods belonging to 57 subcategories marketed by the main food manufacturing and marketing companies from 2016 to 2021. Despite this, to date no population-based study has been conducted to test the impact of the measure on the diet of the Spanish population. The present article, by way of example, shows results of the theoretical estimation of total sugar intake in the pre-reformulation period (2016) and post-reformulation period (2024) based on the consumption of beverages in Spain. Data highlight that reformulation policies could have positive effects that need to be evaluated in representative studies of the Spanish population assessing the overall diet, in order to solidly confirm their positive effects on the population's diet.

Consumption of Low-Calorie Sweeteners among Children Aged 6 Months to 5 Years in the United States, NHANES 2017–2020

BackgroundAlthough the American Academy of Pediatrics advises against low-calorie sweeteners (LCS) consumption by children <5 y due to potential health and development concerns, the extent of this consumption among these children is unknown. ObjectivesThe objective of this study was to describe the intake, sources, and dietary patterns associated with LCS consumption among United States infants and preschoolers. MethodsWe used cross-sectional 24-h dietary recall data (day 1) among 1497 children aged 6 mo to 5 y from the National Health and Nutrition Examination Survey 2017–2020 prepandemic. Complex survey procedures and sampling weights were applied to compare LCS consumption patterns (prevalence and frequency [times/day] of any LCS, any LCS-containing beverages [LCSBs], and any LCS-containing foods [LCSFs], with each occurrence of consumption = 1 “serving”) across demographic subgroups and to assess the associated nutrients and % of total energy intake (TEI). ResultsThirty-one percent of children aged 6 mo to 5 y consumed ≥1 LCSB and/or LCSF on a given day. The prevalence of LCS consumption increased with age, 10.5% (6 to <12 mo) to 34.3% (2–5 y). Among LCS consumers, mean serving frequency was 1.4 times/d, with no differences by age or sex. Of all LCSBs servings consumed, 64.0% were fruit drinks; 57.8% of all LCSFs servings were non-Greek yogurt. As consumption levels increased from no LCS to >1 serving/d, intake of the following also increased: total sugar (+1.8% TEI, P-trend = 0.04), added sugar (+1.1%, P-trend = 0.048), sodium (+304 mg, P-trend = 0.04), and fiber (+0.8 g, P-trend = 0.01). In contrast, protein intake was lower (−0.7% TEI, P-trend = 0.02). Those consuming 1 LCS serving/d consumed more total energy than LCS nonconsumers (1606 compared with 1401 kcal), but TEI did not increase further with >1 LCS serving/d (1607 kcal). LCS consumption was not associated with carbohydrate or fat intake. ConclusionsLCS consumption, primarily from fruit drinks and non-Greek yogurt, is prevalent among United States preschoolers, and this consumption is associated with greater intake of total sugar, added sugar, and sodium.

Association between different dietary carbohydrates and risk of gallstone: a case-control study in Iranian adults

PurposeDietary components have been mentioned as modifiable risk factors in the development of gallstone disease (GSD), but it has been less addressed. The present study aimed to investigate the potential association between different types of dietary carbohydrate and the risk of gallstone.Design/methodology/approachIn this case-control study 189 patients diagnosed with GSD as a case group and 342 people as a control group were enrolled. Dietary intake of the participants was collected through a 168-item semi-quantitative food frequency questionnaire. Total intakes of calories, macronutrients and different types of carbohydrate were estimated. Crude and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between carbohydrate intake and GSD.FindingsPatients with gallstone consumed significantly more fructose and sucrose and less fiber. After fully adjustment, the logistic regression indicated significant association between GSD with dietary intake of total carbohydrate (OR = 1.65, 95% CI: 1.1–2.4, p = 0.009), sugar (OR = 1.23, 95% CI: 0.8–1.7, p = 0.014), fructose (OR = 2.5, 95% CI: 1.7–3.9, p < 0.001), glucose (OR = 1.9, 95% CI: 1.3–2.9, p = 0.002) and sucrose (OR = 1.37, 95% CI: 0.9–1.6, p = 0.042). Also, increasing intakes of lactose, galactose and maltose were associated with a decrease in the risk of GSD, but not statistically significant, although lactose was close to significance (OR = 0.71, 95% CI: 0.48–1, p = 0.051).Originality/valueThere is a positive and significant relationship between total carbohydrate, sugar, fructose, glucose and sucrose intake and the occurrence of gallstone.

A Diet Containing Animal Source Protein as Fresh, Lean Beef Is More Well Liked and Promotes Healthier Eating Behavior Compared with Plant-Based Alternatives in Women with Overweight

BackgroundDespite limited evidence from intervention trials, replacing animal-source protein-rich foods with plant alternatives continues to be recommended as part of a healthy dietary pattern. ObjectivesThe objective of this study was to examine whether a diet containing fresh, lean beef elicits greater satiety, reduces ad libitum food intake, and is more acceptable compared with a diet containing plant alternatives in women with overweight. MethodsSeventeen women with overweight (mean ± SEM, age: 33 ± 1 y; BMI: 27.8 ± 0.1 kg/m2) completed an acute, tightly controlled, crossover design study. Participants were provided with eucaloric, isonitrogenous diets (15% of daily intake as protein) containing either 2 servings/d of fresh lean beef (BEEF) or plant equivalents (PLANT) for 7 d/pattern. During day 6 of each pattern, the participants completed a 10-h controlled-feeding, clinical testing day, which included repeated appetite and satiety questionnaires and blood sampling to assess pre- and postprandial plasma peptide YY (PYY) and GLP-1 across the day. On day 7, the participants completed a free-living testing day in which they consumed their respective protein foods and were provided with additional carbohydrate- and fat-rich foods to consume, ad libitum, during each eating occasion. Energy and macronutrient composition were assessed. A 2- to 3-wk washout period occurred between patterns. ResultsNo differences in daily satiety were detected between patterns. During the ad libitum testing day, 24-h food intake was not different between patterns (BEEF: 2714 ± 219 compared with PLANT: 2859 ± 147 kcals/d), BEEF led to fewer carbohydrates consumed compared with PLANT (338 ± 34 compared with 370 ± 22 g/d, P < 0.05), especially as sugar (169 ± 73 g compared with 186 ± 57 g, P = 0.05). Furthermore, BEEF was more well liked (i.e., higher flavor, texture, and acceptability) compared with PLANT (all, P < 0.05). ConclusionsAlthough satiety was similar between patterns, the consumption of animal-source protein-rich foods, such as fresh and lean beef, was more well liked and resulted in voluntary reductions in total carbohydrate and sugar intake in middle-aged women with overweight during a single ad libitum testing day.This study was registered at clinicaltrials.gov as NCT02614729.

Dietary Sugar and Anthropometrics among Young Children in the Guelph Family Health Study: Longitudinal Associations.

Purpose: Our understanding of the influence of sugar intake on anthropometrics among young children is limited. Most existing research is cross-sectional and has focused on sugar-sweetened beverages. The study objective was to investigate longitudinal associations between young children's total, free, and added sugar intake from all food sources at baseline with anthropometric measures at baseline and 18 months.Methods: The Guelph Family Health Study (GFHS) is an ongoing randomized controlled trial and a family-based health promotion study. Food records and anthropometric data were collected at baseline (n = 109, 55 males; 3.7 ± 1.1 y, mean ± SD) and 18 months (n = 109, 55 males; 5.1 ± 1.1 y) of the GFHS pilots. Associations between sugar intakes and anthropometrics were estimated using linear regression models with generalized estimating equations adjusted for age, sex, household income, and intervention status.Results: Total sugar intake was inversely associated with body weight at 18 months (P = 0.01). There was no effect of time on any other associations between total, free, and added sugar intakes and anthropometrics.Conclusions: Early life dietary sugar intakes may not relate to anthropometric measures in the short term. Further investigation into potential associations between dietary sugar intakes and anthropometric variables over longer time periods is warranted.

Adaptation and validation of the EPIC-Norfolk food frequency questionnaire for assessing dietary intake in Ukrainian adults

IntroductionCurrently, there are no validated food frequency questionnaires (FFQs) for evaluating nutrient intake in Ukrainian adults. This study aimed to adapt and validate the European Prospective Investigation into Cancer Food...

The Association between Dietary Nutrient Intake and Acceleration of Aging: Evidence from NHANES.

The acceleration of aging is a risk factor for numerous diseases, and diet has been identified as an especially effective anti-aging method. Currently, research on the relationship between dietary nutrient intake and accelerated aging remains limited, with existing studies focusing on the intake of a small number of individual dietary nutrients. Comprehensive research on the single and mixed anti-aging effects of dietary nutrients has not been conducted. This study aimed to comprehensively explore the effects of numerous dietary nutrient intakes, both singly and in combination, on the acceleration of aging. Data for this study were extracted from the 2015-2018 National Health and Nutrition Examination Surveys (NHANES). The acceleration of aging was measured by phenotypic age acceleration. Linear regression (linear), restricted cubic spline (RCS) (nonlinear), and weighted quantile sum (WQS) (mixed effect) models were used to explore the association between dietary nutrient intake and accelerated aging. A total of 4692 participants aged ≥ 20 were included in this study. In fully adjusted models, intakes of 16 nutrients were negatively associated with accelerated aging (protein, vitamin E, vitamin A, beta-carotene, vitamin B1, vitamin B2, vitamin B6, vitamin K, phosphorus, magnesium, iron, zinc, copper, potassium, dietary fiber, and alcohol). Intakes of total sugars, vitamin C, vitamin K, caffeine, and alcohol showed significant nonlinear associations with accelerated aging. Additionally, mixed dietary nutrient intakes were negatively associated with accelerated aging. Single dietary nutrients as well as mixed nutrient intake may mitigate accelerated aging. Moderately increasing the intake of specific dietary nutrients and maintaining dietary balance may be key strategies to prevent accelerated aging.

Intake of Sugar and Food Sources of Sugar and Colorectal Cancer Risk in the Multiethnic Cohort Study

BackgroundThe influence of sugar intake on the risk of colorectal cancer (CRC) remains controversial, and there is a need to investigate the heterogeneity of effects among racial and ethnic groups. ObjectivesTo examine the association of intake of simple sugars and their food sources with CRC risk according to race/ethnicity in a multiethnic cohort study. MethodsWe analyzed data from 192,651 participants who participated in the Multiethnic Cohort Study comprising African American, Japanese American, Latino, Native Hawaiian, and White older adults living in Hawaii and California with an average follow-up of 19 y. Intakes of total and specific types of sugars and sugary foods were estimated from a quantitative food frequency questionnaire completed by the participants in 1993–1996. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC risk according to quintiles (Q) of sugar and food intakes using Cox models adjusted for potential confounders. ResultsAs of December 2017, 4403 incident CRC cases were identified. Among all participants, multivariable-adjusted CRC HRs for Q2, Q3, Q4, and Q5 compared with Q1 for total sugars were 1.03 (95% CI: 0.94, 1.13), 1.05 (95% CI: 0.96, 1.16), 1.12 (95% CI: 1.01, 1.24), and 1.13 (95% CI: 1.01, 1.27), respectively. A similar positive association was observed for total fructose, glucose, fructose, and maltose but not for added sugars and sugary foods. The increased risk appeared to be limited to colon cancer and to be strongest among younger participants (i.e., 45–54 y at baseline); an association with CRC was observed for sugar-sweetened beverages in the latter group. Among racial and ethnic groups, increased risk of CRC was most apparent in Latinos. ConclusionsIn this diverse cohort, intakes of total sugar, total fructose, glucose, fructose, and maltose were associated with an increased risk of CRC, and the association was strongest for colon cancer, younger participants, and Latinos.

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.

Evolution of household availability of added sugars and their sources in Brazil: analysis of Household Budget Surveys from 2002 to 2017.

The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002-2003, 2008-2009 and 2017-2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians' total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.

Intake of free sugars by 11–13-year-old schoolchildren living in Delhi, India

Intake of free sugars is associated with a risk of non-communicable diseases including dental caries, and authoritative organisations recommend limiting intake to &lt;5% energy intake (E) or lower (1, 2). National surveys of schoolchildren in India indicate the prevalence of obesity is rising &gt;10%/year(3) and that 52.5% of young adolescents are affected with dental caries(4), yet, there is a dearth of data on dietary intake of sugars by this population. The objective of this research was to assess the intake of total and free sugars, and the contribution of food sources to free sugars intake, in a random sample of 11–13-year-old schoolchildren in Delhi, India. The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intake. A statistician external to the research team generated a random sample of 150 schools stratified by district (n = 11). Schools were recruited in turn from the list until 10 schools had consented. Teachers shared study information with parents who were invited to complete an online consent form. Child assent was obtained before data collection. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. The information recorded was entered into an online dietary assessment tool, Intake24 (Southeast Asia version), during an interview with each participant during which portion size was ascertained with reference to the database of over 2400 food photographs of more than 100 foods. The Intake24 database converted food and drink reported into the intake of total and free sugars through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.5%) (169 girls, 224 boys) completed the study. In girls, the median (IQR) daily intakes of total and free sugars were 95.0 (70.1-120.2) g/day and 43.0 (28.1-68.5) g/day respectively. The corresponding values in boys were significantly higher at 104.0 (80.2-138.7) g/day and 53.1 (34.1-76.5) g/day (p = 0.004). No between-gender difference was observed in the median percent contribution of sugars to E: total and free sugars contributed 14.9% (IQR 11.4-18.1%) and 7.1% (IQR 4.8-10.1%) respectively. The percent contribution of the main sources of sugars to free sugars intake were: (i) Sugars Preserves and Syrups (31.2% (IQR. 9.6-51.7%)); (ii) Cakes and Biscuits (13.7% (IQR 0-26.4%)); (iii) Desserts (5.4% (0-17.5%)) and (iv) Sugar-Sweetened Beverages and Juices (2.1% (IQR 0-15.7%)). In conclusion, in this sample of 11-13-year-old schoolchildren from Delhi, free sugars intake was above the WHO &lt;5% E threshold. Forms of sugars that are added to foods by the consumer made the largest contribution to intake.

Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker

ABSTRACT Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0–10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup’ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.

Ultra-Processed Food Consumption in the Central Division of Fiji

Availability of ultra-processed foods is likely to be high in the Pacific(1) however, information on consumption is limited. This study aimed to assess consumption levels and dietary sources of ultra-processed foods (UPFs) in a population of adults in the Central Division of Fiji. A random sample of 700 adults was selected from two statistical enumeration areas (one semi-urban, one rural) in Fiji. Participant characteristics were collected, along with a three-pass 24-hour diet recall. Foods consumed were coded based on level of processing, in alignment with the NOVA categorisation system (1 = unprocessed, 2 = minimally processed,3 = processed and 4 = ultra-processed). UPF contribution to total energy, salt, fat, and sugar intake were estimated. Main sources of UPFs were then estimated by food group. 534 adults participated (76% response rate, 50% female). Preliminary results suggest that UPFs contributed 21.5% (%95 CI, 19.5% to 23.4%) of total energy intake. Further, UPFs contributed to 22.8% (%95CI 20.5% to 25.1%) of total salt intake, 24.0% (%95 CI, 21.4% to 26.6%) of fat intake and 18.6% (%95 CI, 16.5% to 20.7%) of sugar intake. UPFs contributed over 20% of total energy intake in this sample of Fijian adults and over 20% of salt, fat, and sugar. Messages and interventions that encourage consumption of minimally processed foods while reducing consumption of UPFs are likely needed to improve the healthiness of diets.

Assessment of the intake and sources of total sugar among Filipino children and adolescents based on national consumption data

Diabetes is a public health issue in the Philippines, commonly resulting from high sugar intake. This study examined the consumption and sources of total sugar among Filipinos aged 7 months to 18 years old using nationally representative data. Total sugar consumption was estimated using two non-consecutive 24-h recalls and food composition tables. Mean intakes were converted into usual intakes to reduce measurement errors using the Software for intake distribution estimation software. The percentile of usual intakes, energy from sugar consumption, and the amount of sugar in minimally processed and processed foods for different age groups were calculated using STATA. Changes in consumption between 2008 and 2013 were also examined. Children aged 7 &amp;ndash; 11 months old consumed 26% of energy from total sugar, higher than that of older age groups. Those in the richest income quintile and living in urban areas had the highest percentage intakes. The median intake of total sugar exceeded 25 g/day, with children aged 1 &amp;ndash; 2 years old in the highest income quintile consuming the greatest amount (54.7 g/day). Total sugar comprised 5.3 &amp;ndash; 30.9% of energy intake. Processed foods contributed 64 &amp;ndash; 75% of total sugar. Food categories that contributed the highest amounts (&amp;ge;10%) of total sugar to different age groups were as follows: (i) 7 &amp;ndash; 11 months old: milk formula, milk products, baked products, sugar, and sweets; (ii) 1 &amp;ndash; 2 years old: Sugar, sweets, milk formula, milk products, baked products, and non-alcoholic beverages; and (iii) 3 &amp;ndash; 18 years old: Sugar, sweets, baked products, and non-alcoholic beverages. From 2008 to 2013, the consumption of sweetened beverages and baked products increased significantly, while the consumption of fresh and minimally processed fruits and vegetables decreased significantly. Therefore, it is suggested to reduce added sugar in processed foods, provide unsweetened alternatives, reduce the intake of table sugar, baked goods, and confections, and increase the intake of fresh fruits and vegetables.

Combined effect of dietary calcium consumption and physical activity on dental caries in children and adolescents: a study of the NHANES database

BackgroundCalcium (Ca) is a nutritional factor that associated with dental caries. A recent study showed that in the case of adequate Ca intake, a higher level of physical activity may contribute to bone mass accumulation. However, the combined effect between Ca intake and physical activity on caries experience is unclear. Herein, we aimed to explore the above combined effect on dental caries in children and adolescents.MethodsData of 5,917 children and adolescents were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2015–2020 in this cross-sectional study. The NHANES assessed the dietary Ca intake through the 24-hour dietary recalls, and the physical activity level was self-reported using the questionnaires. Also, the dental caries was diagnosed according to the Decayed, Missing and Filled Teeth/Surfaces (DMFT/S) index. Weighted univariate and multivariate logistic regression analyses were utilized to screen the covariates and to investigate the associations of dietary Ca intake and physical activity with dental caries, respectively, and assess the combined effect between dietary Ca intake and physical activity on dental caries. The evaluation indexes were odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age, obesity, and total sugar intake were also performed.ResultsAmong the eligible participants, 2,687 had caries experience. After adjusting for the covariates, we found that children and adolescents who not reach the recommendation level of Ca intake combined with physical activity less than 7 time in 1 week seemed to have higher odds of dental caries [OR = 1.77, 95%CI: (1.38–2.27)], compared with those who reached the standards. In addition, this potential combined effect was also found in age < 12 years old [OR = 1.62, 95%CI: (1.23–2.14)], non-obesity [OR = 1.88, 95%CI: (1.49–2.35)], and total sugar intake (all P < 0.05) subgroups.ConclusionsCa intake and physical activity had a potential combined effect on dental caries in children and adolescents, but the causal relationships between them needed further clarification.