Non-milk Extrinsic Sugars Intake Research Articles

Short sleep and social jetlag are associated with higher intakes of non-milk extrinsic sugars, and social jetlag is associated with lower fibre intakes in those with adequate sleep duration: a cross-sectional analysis from the National Diet and Nutrition Survey Rolling Programme (Years 1-9).

To investigate associations and interactions between sleep duration and social jetlag status with nutrient intake, nutrient status, body composition and cardio-metabolic risk factors in a nationally representative UK adult population. A cross-sectional study using 4-d food diary and self-reported sleep data from the UK National Diet and Nutrition Survey Rolling Programme 2008-2017. UK free-living population. Totally, 5015 adults aged 19-64 years. Thirty-four per cent were short sleepers (< 7 h); 7 % slept ≥ 9 h; 14 % had > 2 h difference in average sleep duration between weeknights and weekend nights (social jetlag). Compared to those reporting optimal sleep duration (≥ 7-< 9 h), short sleep was associated with higher intakes of non-milk extrinsic sugars (NMES) (0·9 % energy, 95 % CI: 0·4, 1·4), total carbohydrate (0·8 % energy, 95 % CI: 0·2, 1·4) and a lower non-starch polysaccharides fibre intake (-0·5 g/d, 95 % CI -0·8, -0·2). There was a significant interaction between short sleep and social jetlag for fibre intakes, where adequate sleepers with social jetlag as well as all short sleepers (regardless of social jetlag) had lower fibre intakes than adequate sleepers with no social jetlag. Short sleep, but not social jetlag, was associated with greater adiposity, but there were no differences in other markers of cardiometabolic disease risk. The present study reports that both short sleep and social jetlag are associated with higher intakes of NMES, but only sleep duration is associated with markers of adiposity. Social jetlag was associated with lower fibre intakes even in individuals with adequate weekly sleep duration, suggesting catch-up sleep does not prevent the adverse impact of irregular sleep habits on food choices.

Implementation of Universal Infant Free School Meals: a pilot study in NE England exploring the impact on Key Stage 1 pupil's dietary intake.

To consider the principal effect of an interaction between year (pre- and post-Universal Infant Free School Meals (UIFSM)) and school on pupil's dietary intakes. A repeated cross-sectional survey using dietary data from 2008 to 2009 (pre-) and 2017 to 2018 (post-UIFSM). Two primary schools, NE England. Pupils aged 4-7 years (2008-2009 n 121; 2017-2018 n 87). At lunchtime, there was a statistically significant decrease in pupils non-milk extrinsic sugars intake (%E NMEs) pre- to post-UIFSM (mean change -4·6 %; 95 % CI -6·3, -2·9); this was reflected in total diet (-3·8 %; -5·2, -2·7 %). A year and school interaction was found for mean Ca intakes: post-UIFSM pupils in School 2 had a similar mean intake as pre; in School 1 intakes had increased (difference of difference: -120 mg; 95 % CI -179, -62); no reflection in total diet. Post-UIFSM mean portions of yogurt decreased in School 2 and remained similar in School 1 (-0·25; -0·46, -0·04); this was similar for 'cake/pudding' and fruit. Within the limitations, these findings highlight positives and limitations following UIFSM implementation and demonstrate the role of school-level food practices on pupil's choices. To facilitate maximum potential of UIFSM, national levers, such as discussions on updating school food standards, including sugars, could consider removing the daily 'pudding' option and advocate 'fruit only' options 1 d/week, as some schools do currently. Small school-level changes could maximise positive health impacts by decreasing NMEs intake. A more robust evaluation is imperative to consider dietary impacts, equitability and wider effects on schools and families.

Associations between yogurt consumption and nutrient intake in the United Kingdom

AbstractIntroduction: The present study was conducted to examine yogurt consumption patterns and investigate associations between yogurt consumption and nutrient intake using data from the National Diet and Nutrition Survey (NDNS) rolling programme in the United Kingdom.Materials and Methods: Children aged 1.5–18 years old (N = 2564) and adults aged 19 years or older (N = 2705) from the NDNS 2012/13–2015/16 were included in the study. The average of four-day food diary data was used for analysis. Yogurt included all food items from the yogurt, fromage frais and dairy dessert food group, excluding dairy dessert products. Participants were classified as yogurt eaters if they reported consumption of yogurt at least once during the four days. Percentage contribution of yogurt to daily intake of nutrients in yogurt eaters was calculated. Multiple linear regression analyses for surveys were used to compare differences in energy and nutrient intake between yogurt eaters and non-eaters, adjusting for sociodemographic characteristics. Energy intake was also adjusted for in nutrient data analysis.Results: The prevalence of yogurt consumption was 53% in children and 39% in adults. The daily intake of yogurt was 105 g and 132 g, respectively. Yogurt is an important source of calcium and riboflavin in children and adults, as well as vitamin D in children, accounting for over 15% of daily intake of these nutrients. Compared to non-eaters, yogurt eaters had significantly higher energy intake in both children and adults; they also had significantly higher intake of protein, fiber, calcium, magnesium, phosphorus, potassium, folate, riboflavin, thiamin, and vitamin C, as well as significantly lower intake of sodium. Child yogurt eaters also had significantly higher intake of vitamin A and vitamin B12, and lower intake of total fat, whereas adult yogurt eaters had significantly higher intake of carbohydrate, iron, zinc, vitamin D and vitamin E, compared to non-eaters. Both yogurt eaters in children and adults had higher intake of total sugar; nonetheless, non-milk extrinsic sugar intake did not differ by yogurt consumption status in children, and it was significantly lower in adult yogurt eaters. Saturated fat intake did not differ by yogurt consumption status in children and adults.Discussion: Yogurt is an important dietary source of several nutrients in the United Kingdom. Its consumption was positively associated with intake of total energy and many nutrients to encourage, but not positively associated with intake of sodium, total fat, saturated fat, and non-milk extrinsic sugar in both children and adults.

Non-Milk Extrinsic Sugars Intake and Food and Nutrient Consumption Patterns among Adolescents in the UK National Diet and Nutrition Survey, Years 2008-16.

The revised guidelines from the Department of Health (DoH) in the UK state that mean population intakes of free sugars should be below 5% of the total energy (TE) consumption of the British population. However, very few studies have assessed the impact of this recommendation on diet quality in the UK. We explored the dietary patterns and intakes of micronutrients of British adolescents with low intakes of non-milk extrinsic sugars (NMES) (similar to free sugars but not equal, with slight differences in the categorisation of fruit sugars from dried, stewed or canned fruit and smoothies), using the National Diet and Nutrition Survey Rolling Programme, years 1–8 (NDNS RP). The sample included 2587 adolescents aged 11–18 years. Four percent (112) of adolescents reported consuming 5% or lower NMES as a proportion of TE. The odds of being categorised as a low-sugar consumer in adolescents (≤5% TE from NMES) were significantly lower with higher intakes of sweetened drinks, fruit juice, cakes, biscuits, sugar and sweet spreads, chocolate confectionery and sugar confectionery, and significantly higher with higher intakes of pasta and rice, wholemeal and brown bread, and fish. Across the five categories of NMES intakes, micronutrient intakes were lowest for those consuming either ≤5% TE or more than 20% TE from NMES, and optimal for those consuming between 10–15% of energy from NMES. These findings confirm the difficulties of meeting the free sugars recommended intake for adolescents. Care needs to be taken to ensure that an adequate consumption of micronutrients is achieved in those adhering to the revised guidelines on free sugars.

A pilot study to improve sugar and water consumption in Maltese school children.

Excessive sugar consumption remains implicated as one of the key dietary factors that has been linked to overweight and obesity in children. Schools have been identified as an important setting for health promotion interventions in children and can be successful in bringing about dietary behavioral change when well designed. The main aim of the study was to conduct a pilot intervention study and assess the possible effects of educational and environmental methodological components on sugar intake and water consumption in Maltese school children. Face-to-face educational sessions for children and parents were supported by written materials and provision of free drinking water for children for a 12 week period in the school setting. Two main dietary outcomes were measured: non-milk extrinsic sugars(NMES) intake (measured as g/day) and water consumption (measured as servings/day), measured in the pre- and post-intervention periods. The dietary outcomes were measured at school using the novel online dietary assessment tool, REALITYMALTA™. 55 children, aged 10-11 years, were recruited, and 48 provided diet data at baseline and end. A reduction in mean energy intakes was noted from 7733 kJ/day (SD 2046) to 6809 (SD 2224) kJ/day (p = 0.03), with water servings intake increased and NMES intake decreased but results not statistically significant. Parent attendance at the educational sessions was low. A larger scale study, including multi-level analysis is recommended. Modifying the content of the intervention and finding ways to increase parent engagement should be considered in future.

Breakfast Consumption in the UK: Patterns, Nutrient Intake and Diet Quality. A Study from the International Breakfast Research Initiative Group.

Breakfast consumption is associated with higher overall dietary adequacy; however, there is a lack of quantitative guidelines for optimal nutrient intakes at breakfast in the UK. This study aimed to investigate nutrient and food group intakes at breakfast and examine their relationship to overall Diet Quality (DQ). Data from the most recent National Diet and Nutrition Survey (NDNS, 2008–2014) were accessed to provide a representative sample (n = 8174) of the UK population, aged 5–96 years, mean age of 33 years. Food intake was measured by a 4-day estimated food diary and DQ was assessed by the Nutrient Rich Food Index 9.3 method. Energy- and socio-economic-adjusted nutrient and food group intakes were compared across age groups and DQ tertiles by ANCOVA. Breakfast contributed 20–22% to total energy intake. Breakfast intakes of carbohydrate and non-milk extrinsic sugars (NMES) were higher, and intakes of protein, total fat and saturated fatty acid (SFA) were lower, than relative daily intakes. Breakfast was particularly rich in B vitamins, vitamin D, calcium, iron, iodine and magnesium. From the lowest to the highest DQ tertile decreasing intakes of NMES, SFA and total fat and increasing intakes of carbohydrate, protein, fibre and most micronutrients were found. These findings could help to inform the development of nutrient-based recommendations for a balanced breakfast for the first time in the UK.

Empirically Derived Dietary Patterns in UK Adults Are Associated with Sociodemographic Characteristics, Lifestyle, and Diet Quality.

The aim of this study was to examine empirical dietary patterns in UK adults and their association with sociodemographic characteristics, lifestyle factors, self-reported nutrient intake, nutrient biomarkers, and the Nutrient-based Diet Quality Score (NDQS) using National Diet and Nutrition Survey data 2008–2012 (n = 2083; mean age 49 years; 43.3% male). Four patterns explained 13.6% of the total variance: ‘Snacks, fast food, fizzy drinks’ (SFFFD), ‘Fruit, vegetables, oily fish’ (FVOF), ‘Meat, potatoes, beer’ (MPB), and ‘Sugary foods, dairy’ (SFD). ‘SFFFD’ was associated positively with: being male; smoking; body mass index (BMI); urinary sodium; intake of non-milk extrinsic sugars (NMES), fat and starch; and negatively with: age; plasma carotenoids; and NDQS. ‘FVOF’ was associated positively with: being non-white; age; income; socioeconomic classification (National Statistics Socio-economic Classifications; NSSEC); plasma carotenoids; intake of non-starch polysaccharides and polyunsaturated fatty acids. It was negatively associated with: being male, smoking, BMI, urinary sodium, intake of saturated fat; and NMES and NDQS. Whilst the patterns explained only 13.6% of the total variance, they were associated with self-reported nutrient intake, biomarkers of nutrient intake, sociodemographic and lifestyle variables, and the NDQS. These findings provide support for dietary patterns analyses as a means of exploring dietary intake in the UK population to inform public health nutrition policy and guidance.

Challenges and opportunities in the use of low‐energy sugar replacers

Challenges and opportunities in the use of low‐energy sugar replacers

High Intake of Nonmilk Extrinsic Sugars Is Associated With Protein and Micronutrient Dilution in Home-Dwelling and Institutionalized Older People

BackgroundHigh dietary sugar intake may compromise protein and micronutrient intakes in people with low energy intakes. The results of micronutrient dilution studies in older people have been few and conflicting. We examined the nutritional status and nutrient intakes associated with nonmilk extrinsic sugars (NMES) intakes in older people representing a broad spectrum of both healthy and vulnerable older populations. Design and participantsThis cross-sectional study combined five Finnish data sets covering home-dwelling (n = 526) and institutionalized (n = 374) older people. Their nutritional status was assessed using Mini Nutritional Assessment (MNA) and nutrient intakes retrieved from 1- to 3-day food records. The participants were divided into quartiles corresponding to the proportions of energy received from NMES. Energy, nutrient, and fiber intakes were classified according to the NMES quartiles, and the participants were divided according to their places of residence (home, institution). ResultsHigh NMES intakes were associated with older age, female sex, poor cognition, low MNA scores, immobility, and institutionalization. In all, 90% of the participants in the highest NMES quartile (Q4) were institutionalized. In the institutionalized individuals, low protein and micronutrient intakes were observed in both those with low energy intake (Q1) and in those with very high NMES intakes (Q4). In home-dwelling individuals, the nutrient intakes tended to decline linearly with increasing NMES intakes in protein and most micronutrients. ConclusionsInstitutionalized older people consumed diets high in NMES, compared with those living at home, and their low energy and high NMES intakes were associated with low protein and micronutrient intakes.

Associations between meal and snack frequency and diet quality and adiposity measures in British adults: findings from the National Diet and Nutrition Survey.

To examine how different definitions of meals and snacks can affect the associations of meal frequency (MF) and snack frequency (SF) with dietary intake and adiposity measures. Based on 7 d weighed dietary record data, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 % or <15 %) or time (06.00-10.00, 12.00-15.00 and 18.00-21.00 hours; other). Diet quality was assessed using the Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS). Great Britain. British adults aged 19-64 years (n 1487). MF based on energy contribution was associated with higher intake of dietary fibre, lower intakes of non-milk extrinsic sugars and alcohol, and higher HDI (only men) and MDS. MF based on time was associated with higher HDI and MDS in women only. Conversely, irrespective of the definition of snacks, SF was associated with higher intakes of confectionery and alcohol, lower intakes of cereals, protein, fat and dietary fibre, and lower HDI (except for SF based on energy contribution in women) and MDS. After adjustment for potential confounders, MF based on time, but not MF based on energy contribution, was positively associated with BMI and waist circumference in men only. SF was positively associated with BMI and waist circumference, irrespective of the definition of snacks. Higher SF was consistently associated with lower diet quality and higher adiposity measures, while associations with MF varied depending on the definition of meals and sex.

Adolescents' beverage choice at school and the impact on sugar intake.

To examine students' beverage choice in school, with reference to its contribution to students' intake of non-milk extrinsic (NME) sugars. Beverage and food selection data for students aged 11-18 years (n=2461) were collected from two large secondary schools in England, for a continuous period of 145 (school A) and 125 (school B) school days. Descriptive analysis followed by cluster analysis of the beverage data were performed separately for each school. More than a third of all items selected by students were beverages, and juice-based beverages were students' most popular choice (school A, 38.6%; school B, 35.2%). Mean NME sugars derived from beverages alone was high (school A, 16.7 g/student-day; school B, 12.9 g/student-day). Based on beverage purchases, six clusters of students were identified at each school (school A: 'juice-based', 'assorted', 'water', 'cartoned flavoured milk', 'bottled flavoured milk', 'high volume juice-based'; school B: 'assorted', 'water with juice-based', 'sparkling juice/juice-based', 'water', 'high volume water', 'high volume juice-based'). Both schools included 'high volume juice-based' clusters with the highest NME sugar means from beverages (school A, 28.6 g/student-day; school B, 24.4 g/student-day), and 'water' clusters with the lowest. A hierarchy in NME sugars was found according to cluster; students in the 'high volume juice-based' cluster returned significantly higher levels of NME sugars than students in other clusters. This study reveals the contribution that school beverages combined with students' beverage choice behaviour is making to students' NME sugar intake. These findings inform school food initiatives, and more generally public health policy around adolescents' dietary intake.

Sensory profiles and consumer acceptability of a range of sugar-reduced products on the UK market

Current UK intake of non-milk extrinsic sugars (NMES) is above recommendations. Reducing the sugar content of processed high sugar foods through reformulation is one option for reducing consumption of NMES at a population level. However, reformulation can alter the sensory attributes of food products and influence consumer liking. This study evaluated consumer acceptance of a selection of products that are commercially-available in the UK; these included regular and sugar-reduced baked beans, strawberry jam, milk chocolate, cola and cranberry & raspberry juice. Sweeteners were present in the reformulated chocolate (maltitol), cola (aspartame and acesulfame-K) and juice (sucralose) samples. Healthy, non-smoking consumers (n=116; 55 men, 61 women, age: 33±9years; BMI: 25.7±4.6kg/m2) rated the products for overall liking and on liking of appearance, flavor and texture using a nine-point hedonic scale. There were significant differences between standard and reduced sugar products in consumers' overall liking and on liking of each modality (appearance, flavor and texture; all P<0.0001). For overall liking, only the regular beans and cola were significantly more liked than their reformulated counterparts (P<0.0001). Cluster analysis identified three consumer clusters that were representative of different patterns of consumer liking. For the largest cluster (cluster 3: 45%), there was a significant difference in mean liking scores across all products, except jam. Differences in liking were predominantly driven by sweet taste in 2 out of 3 clusters. The current research has demonstrated that a high proportion of consumers prefer conventional products over sugar-reduced products across a wide range of product types (45%) or across selected products (27%), when tasted unbranded, and so there is room for further optimization of commercial reduced sugar products that were evaluated in the current study. Future work should evaluate strategies to facilitate compliance to dietary recommendations on NMES and free sugars, such as the impact of sugar-reduced food exposure on their acceptance.

The contribution of yogurt to nutrient intakes across the life course

The contribution of yogurt to nutrient intakes across the life course

Summary of: Sugars consumption in a low-income sample of British young people and adults

Objective To report the consumption of non-milk extrinsic sugars (NMES) among a low-income UK sample, compare it with nationally representative estimates and examine the association between socioeconomic position and NMES consumption among low income adults. Design Secondary analysis of the Low Income Diet and Nutrition Survey (LIDNS) data. Setting and subjects Two thousand, seven hundred and ninety-six adults and 415 young people from 2,477 households. Main outcome measures Mean NMES intakes (grams) and their percentage contribution to food energy, from dietary data collected via a 24-hour recall 'multiple pass' method. Results The low income sample consumed more NMES than the general population sample. The percentage of food energy from NMES exceeded the 11% target, especially among adolescents (17.2% in males, 16.3% in females). After adjusting for age, men who finished full-time education aged 16 years consumed significantly more sugar (p = 0.028), whereas those who finished aged 18 consumed significantly less sugar (p = 0.023) than the reference group (finished aged 15). No significant associations were found between NMES and socioeconomic variables in women. Conclusion Compared to the general population, the nutritional disadvantage of the most deprived segments of society relates primarily to excessive NMES consumption. In men, higher educational level appears to play a protective role against high sugar intakes.

Sugars consumption in a low-income sample of British young people and adults

To report the consumption of non-milk extrinsic sugars (NMES) among a low-income UK sample, compare it with nationally representative estimates and examine the association between socioeconomic position and NMES consumption among low income adults.Design Secondary analysis of the Low Income Diet and Nutrition Survey (LIDNS) data. Two thousand, seven hundred and ninety-six adults and 415 young people from 2,477 households.Main outcome measures Mean NMES intakes (grams) and their percentage contribution to food energy, from dietary data collected via a 24-hour recall 'multiple pass' method. The low income sample consumed more NMES than the general population sample. The percentage of food energy from NMES exceeded the 11% target, especially among adolescents (17.2% in males, 16.3% in females). After adjusting for age, men who finished full-time education aged 16 years consumed significantly more sugar (p = 0.028), whereas those who finished aged 18 consumed significantly less sugar (p = 0.023) than the reference group (finished aged 15). No significant associations were found between NMES and socioeconomic variables in women. Compared to the general population, the nutritional disadvantage of the most deprived segments of society relates primarily to excessive NMES consumption. In men, higher educational level appears to play a protective role against high sugar intakes.

Initial findings of the impact of an 8-week intervention of sugar reformulated product exchange on cardiovascular risk factors

It has been reported from supply data that at a population level, every 628kJ/d (150kcal/d) increase in sugar availability, (equivalent to approximately one can of sugar-sweetened beverage daily), is independently associated with a 1.1% increase in diabetes mellitus prevalence (1) . The WHO has recommended restricting non-milk extrinsic sugars (NMES) to £ 10% of E (2) . Reformulation of sugarcontaining processed foods is considered by some as a key option for achieving this target and for improving population health (3) . The impact of a sugar reformulated product exchange on cardiovascular risk factors was assessed using a randomised controlled, double-blind, crossover dietary intervention study. Fifty healthy volunteers (16 male, 34 female; age 31.3 (SD 9.6) years; BMI 24.0 (SD 3.3) kg/m 2 ) were randomly assigned to consume either unmodified or sugar reformulated foods and drinks, including juice, soft drinks, pasta sauces, baked beans, muesli, chocolate, ketchup and jam, for an 8-week period. This was followed by a 4-week washout period before volunteers crossed to the alternate intervention. The minimum target difference in dietary NMES intake between the unmodified and reformulated product exchange was 38g/d. Fasting serum was collected pre-and post-intervention and used to determine glucose, lipid and inflammatory markers. Logarithmically transformed data were statistically analysed using ANCOVA. There was no significant effect of the intervention on BMI. When adjusted for BMI, dietary restraint, age and gender there were no differences in fasting serum glucose, total cholesterol, TAG, NEFA or C-reactive protein (CRP) concentrations between interventions.

The contribution of breakfast cereals to the nutritional intake of the materially deprived UK population

Breakfast is an important source of micronutrients in the diet and its consumption has been linked to positive health outcomes. The present analysis investigated the contribution that breakfast cereals make to the nutrient intakes of the materially deprived (low income) UK population. Data for 3728 respondents aged 2 years and over from the UK Low Income Diet and Nutrition Survey (2003-2005) were analysed. Nutrient intakes of consumers and non-consumers of breakfast cereal were compared. Breakfast cereals were consumed by 49% of men, 58% of women, 80% of boys and 80% of girls, and median intakes were: 35, 25, 29 and 21 g/d, respectively. Consumers of breakfast cereals had higher intakes of thiamin, riboflavin, niacin, biotin, folate, vitamin B(6), vitamin B(12), iron and zinc than non-consumers. Breakfast cereal consumption was also related to higher intakes of calcium, attributable to higher milk consumption. The intake of wholegrain and high-fibre breakfast cereals was associated with a higher intake of non-starch polysaccharides. Intakes of niacin, biotin, calcium and zinc were higher but that of vitamin B(6) was lower among consumers of exclusively wholegrain and high-fibre breakfast cereals compared with consumers of other breakfast cereals. There were no significant differences observed in intakes of non-milk extrinsic sugars according to type of breakfast cereal consumed. Breakfast cereals make a significant contribution to the micronutrient intake of the low-income UK population.

P1-330 Inequalities in dental caries: the role of NMES intake

IntroductionDental caries is one of the most prevalent diseases of childhood in the UK, with a disproportionate burden experienced by the most disadvantaged groups. Non-milk extrinsic sugar (NMES) intake, poor...

Childhood diet and behavioural problems: results from the ALSPAC cohort.

ObjectiveTo investigate whether a ‘junk food’ diet at 81 months of age is associated with the development of behavioural problems over the following 16 months.Subjects/MethodsThe study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and 12,942 children were included. The main outcome measure was behavioural problems, measured using the Strengths and Difficulties Questionnaire (SDQ). SDQ scores were available at 81 and 97 months of age. Child-based dietary data were collected at 81 months by food frequency questionnaire; from this a ‘junk food’ score was derived, and mean weekly non-milk extrinsic sugar (NMES) intake estimated. Statistical analyses examined the associations between dietary exposures at 81 months and SDQ outcomes at 97 months. Children with SDQ scores suggesting behavioural problems at baseline were excluded in order to identify new cases. Adjustments were made for potential confounders such as socioeconomic status.ResultsUnadjusted analyses suggested associations between the ‘junk food’ score at 81 months and both total difficulties and pro-social behaviour at 97 months. However, adjustment for baseline SDQ scores attenuated these associations, with confidence intervals including the null for both total difficulties [OR(95% CI):1.05(0.92,1.21);P=0.45] and pro-social behaviour [1.13(1.00,1.26);P=0.04]. Adjustment for other potential confounders further attenuated the effects. Adjustment for confounders similarly attenuated modest associations between NMES intake and behavioural problems.ConclusionsThere was no evidence to support an association between a ‘junk food’ diet at 81 months of age and behavioural problems 16 months later.

Sugar intake and dental decay: results from a national survey of children in Scotland

The aim of this analysis was to investigate the strength of the association between sugar intake and treatment for dental decay in children in Scotland, and the impact of tooth brushing frequency on this association. The Survey of Sugar Intake among Children in Scotland was carried out in 2006 in those aged 3-17 years. Diet was assessed using the Scottish Collaborative Group FFQ, and interviews were carried out by trained fieldworkers who asked about dental health. A total of 1700 interviews were carried out, and 1512 FFQ were returned. Of the children, 56% had received treatment for decay (fillings or teeth removed due to decay). Intake of non-milk extrinsic sugars (NMES), but not total sugar, increased the risk of having had treatment for decay: adjusted OR 1.84 (95% CI 1.28, 2.64) for the highest ( ≥ 20.0% food energy) v. lowest ( ≤ 14.8% food energy) tertile of NMES intake. This raised risk remained in children who reported brushing their teeth at least twice a day. Compared with children who reported brushing their teeth at least twice a day and were in the lowest tertile of NMES intake, children who reported brushing their teeth once a day or less and were in the highest tertile of NMES intake were over three times more likely to have received treatment for decay (adjusted OR 3.39, 95% CI 1.97, 5.82). In order to improve dental health in children in Scotland, dental health strategies must continue to stress the importance of both reduced NMES intake and good oral hygiene.