Sugar Intake Research Articles

Starch intake and changes in dental caries among adults: A longitudinal study in Finland.

To evaluate the association between starch intake (amount and type) and changes in dental caries among adults over 11 years. Data from 1679 adults, aged 30 years and over, who participated in three consecutive surveys in Finland were pooled for analysis. Participants completed a validated semi-structured 128-item food frequency questionnaire at baseline, from which total starch intake (g/day and % energy intake) and the intake (g/day) of seven food groups high in starch (potatoes, potato products, roots and tubers, refined grains, pasta, wholegrains, and legumes) were estimated. Dental caries was determined during clinical examinations and summarized using the DMFT score, which was treated as a repeated outcome. The association between baseline starch intake and 11-year-change in DMFT score was tested in linear mixed-effects models adjusted for sociodemographic factors, behaviors, sugar intake, and health status. The mean DMFT score was 21.9 (95%CI: 21.6, 22.2) in 2000 (baseline), increasing by 0.47 (95% CI: 0.38, 0.56) in 2004/05, and additionally by 0.33 (95%CI: 0.20, 0.45) in 2011. Total starch intake was not associated with change in DMFT. This finding was similar irrespective of how starch intake was expressed (g/day or %EI). Of the seven food groups evaluated, only the intake of pasta was inversely associated with the DMFT score at baseline, but not with the change in DMFT over time. Neither the amount nor the type of starch intake was associated with changes in dental caries over 11 years among Finnish adults.

The environmental and social opportunities of reducing sugar intake

Sugar is the largest agricultural crop by mass and has seen a rapid increase in consumption around the world. There are widespread public health efforts to curb sugar intake through targeted policies given its association with noncommunicable diseases. Although curbing sugar intake aligns with sustainable diets that meet essential environmental and health targets, such a shift may be challenging from a political economy perspective. Utilizing sugar for other purposes such as the production of microbial protein, biofuels, and bioplastics, or using sugar lands to grow other food items, or rewilding could provide health and environmental win–wins that could be more politically palatable. Here, we explore several potential scenarios to illustrate the option space from which national and international stakeholders could choose locally appropriate pathways for alternative utilization of sugar or its lands. While beneficial, such alternative pathways would require the integration of environmental, economic, and health policies to provide a smoother diet transition that reduces stakeholder tensions. Given the trade in sugar as a commodity crop, international approaches that compensate sugar producers for avoided production or incentivize them for redirecting sugars to other uses will be needed. Such approaches could borrow concepts from Just Transition Partnerships that have been applied to energy system transitions in ensuring a transition for major exporters of sugar cash crops across low- and middle-income nations.

Abstract 4136294: Carbohydrate intakes and cardiovascular disease risk factors in South Asians: Results from 56,024 participants in Bangladesh, India, Pakistan, and Sri Lanka

Background: Evidence on effects of carbohydrate intake with cardiovascular disease risk factors is inconsistent and has limited generalizability to diverse populations such as South Asians, whose carbohydrate intakes are typically high. Aims: We examined the association of the quantity and types of carbohydrate intake with two risk factors for major cardiovascular events– hypertension (HT) and hypercholesterolemia (HC). Methods: We analyzed cross-sectional data from participants aged ≥18 years in the South Asia Biobank in Bangladesh, India, Pakistan, and Sri Lanka. Using dietary data assessed with interviewer-led 24h diet recalls, we calculated intakes of total and subtypes of carbohydrates and several indices of carbohydrate quality. Primary outcomes were HT and HC, defined by medication use, doctor diagnosis, blood pressure and blood lipid levels. With mixed effects Poisson regression, HT and HC was regressed on quantiles of carbohydrate intakes by country to estimate prevalence ratios (PR) and 95% confidence intervals (CI), followed by meta-analysis pooling country-specific estimates. We examined interactions by diabetes status and adiposity. Results: Of 56,024 adults, 36.6% had HT, 16.1% had HC. In pooled multivariable analyses comparing extreme quantiles, total carbohydrate intake was not associated with HT or HC prevalence. Fructose, free sugar and free sugar-to-fiber ratio were associated with higher prevalence of HT (PRs Q5vsQ1 : 1.03-1.15). Higher intakes of cereal fiber (PR Q4vsQ1 : 0.96, 95% CI: 0.95-0.98) and legume fiber (PR Q4vsQ1 : 0.98, 95% CI: 0.97-0.98) were associated with lower prevalence of HT and higher cereal fiber intake with lower HC prevalence (PR Q5vsQ1 : 0.80, 95% CI: 0.75-0.85). Diabetes and adiposity were observed as effect-modifiers (p<0.001). There were null associations in adults with diabetes but in non-diabetic adults, free sugar intake was related positively with HT (PR Q5vsQ1 : 1.07, 95% CI: 1.05-1.09) while fiber intake was inversely related (PR Q5vsQ1 : 0.98, 0.95-0.97). Starch, sugar and free sugar intake were associated positively with HT prevalence in adults with high body fat (≥20% for men; ≥30% for women) and visceral fat (≥10%) levels (PRs Q5vsQ1 : 1.03-1.20); associations were null for low body and visceral fat levels. Associations varied by country (between-country heterogeneity I 2 >60%). Conclusion: Associations of dietary carbohydrates with HT and HC depended on the quality and type of intake in South Asians.

Association between iron and vitamin intake and cardiorespiratory fitness in adolescents of both sexes

Abstract Cardiovascular parameters and cardiorespiratory fitness in adolescents may be influenced by eating habits. The aim was to evaluate the association between the levels of some nutrients and micronutrients with blood pressure and VO2max in adolescents. A total of 60 adolescents (15.77 ± 0.96 years old) participated in the study, of whom 35 were girls and 25 were boys. Eating habits were assessed frequency questionnaire (FFQ). Before and after a cardiorespiratory fitness test (YOYO TEST), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were collected. A backward elimination method of multiple regression was performed to analyse the data. A positive association was found between VO2max and the intake of iron (), vitamin D (), vitamin B6 () and vitamin B12 () for girls. Additionally, no significant associations were found between sugar, fibre and fat intake and VO2max. There was a positive association between SBP and sugar intake () for girls and negative association between DBP after exertion and fibre intake () and body mass index () for boys. There is a positive association between the intake of iron, vitamins and VO2max in girls and intake of sugar with SBP for girls and negative association between fibres and DBP after exertion for boys.

Linking Big Five personality traits to components of diet: A meta-analytic review.

This research synthesis sought to determine the magnitude of associations between major personality dimensions and components of diet. A comprehensive literature search identified 49 articles (584 effect sizes; 151,750 participants) that met the inclusion criteria. Pooled mean effects were computed using inverse-variance weighted random effects meta-analysis. Mean effect sizes from 98 separate meta-analyses provided evidence that lower levels of neuroticism, r = -.05 (95% confidence interval, CI [-.09, -.01]), and higher levels of extraversion, r = .07 (95% CI [.03, .11]); openness, r = .13 (95% CI [.07, .18]); agreeableness, r = .07 (95% CI [.04, .11]); and conscientiousness, r = .12 (95% CI [.08, .16]), are associated with a healthier diet. Personality traits related to fruit and vegetable consumption; sugar intake (e.g., candy, sugary drinks); salt intake; consumption of meat, dairy, and fiber; low-fat foods; fast food and snacks; convenience foods; breakfast frequency; meal irregularity; and emotional and restrained eating. There was evidence of publication bias complicating conclusions for conscientiousness and meat eating. Random effects metaregression showed that agreeableness had a stronger positive association with healthy eating among older adults. These findings should be of interest to health care professionals developing health care services that aim to promote healthy eating. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Immigrant Parents' Knowledge and Attitudes: Sociodemographic Variation Related to Restriction of Children's Sugar Intake.

Focusing on immigrant parents with children aged 0-6 months, this study assessed whether awareness of and attitudes towards restricting children's sugar consumption vary according to family sociodemographic background and parents' oral-health-related behaviours. A cross-sectional study was conducted including immigrant parents attending child public health centers for vaccination of their children. The study included parents born in Asia, Africa, South America, Central America and Eastern Europe. Parents from Western Europe and North America were included if they were partners of the above-mentioned participants. Cross-tabulation and multiple variable logistic regression were used to assess associations of parental knowledge and attitudes with their child's sugar intake and sociodemographic characteristics. Overall, response rate was 72.6%. A total of 345 parents completed personal, structured interviews during their visit to the health centers. Attitudes and knowledge, but not indulgence, related to children's sugar restriction were sociodemographically unequally distributed among immigrant parents. Employed mothers, mothers with immigrant background from North America or Western Europe as well as parents with less frequent own sugar intake were more likely to confirm positive attitudes towards restricting children's sugar snacking. The corresponding odds ratios were OR=1.8 (95% CI 1.1-3.1) and OR=6.6 (95% CI 2.3-18.9). Employed mothers and parents having received dental care information were more likely than their counterparts to possess good oral-health-related knowledge. Parents from sociodemographically disadvantaged backgrounds were less inclined to express positive attitudes and demonstrate sufficient knowledge regarding the limitation of their children's sugar snacking. Culturally adapted oral health intervention programs should be implemented for immigrants, with special reference to children's dietary habits.

Children’s Diets and Planetary Health: A Study in Wroclaw, Poland, and Sydney, Australia

Meals served to children should not only satisfy hunger and taste preferences but also be nutritionally adequate. Nutrition in early childhood is critical, as children spend a significant portion of their day in kindergarten or preschool, making these settings key contributors to their overall dietary intake. With the rising prevalence of nutrition-related health conditions among children, early interventions are essential for developing and establishing lifelong healthy eating habits. This study assessed the nutritional value and quality of children’s diets in two distinct settings: kindergartens in Wroclaw, Poland, and preschools in Sydney, Australia, evaluating their alignment with the planetary health diet. The research analysed 10-day menu cycles from five kindergartens in Wroclaw and the contents of lunchboxes from five preschools in Sydney’s Upper North Shore area. A total of 100 menus were reviewed in Poland, while 100 children’s lunchboxes were assessed in Australia. Different analytical methods were employed: the Diet 6D software program for the Polish menus and the Food Consumption Score for the Australian lunchboxes. Both methods revealed dietary imbalances, such as excessive intake of protein, vitamin A, salt, and sugar, alongside deficiencies in calcium, vitamin C, and vitamin D. The study concluded that children’s diets should adhere to nutritional guidelines, meeting both Polish and Australian standards, and align with the principles of the planetary health diet. To achieve this, nutritional education is essential for kindergarten staff in Poland, while targeted educational interventions are needed for parents and children in both Poland and Australia, promoting health and environmental sustainability through better nutrition.

Exploring and enhancing the accessibility of children's oral health resources (called HABIT) for high risk communities

BackgroundWithin the city of Bradford in West Yorkshire, South Asian and Eastern European communities have an increased risk of childhood tooth decay, especially among families with Limited English Proficiency. Tooth decay is preventable, with national guidelines advocating home-based behaviours (toothbrushing with fluoride toothpaste and reducing sugar intake). In England, Health Visitors have opportunities to undertake oral health conversations during universal visits for children aged 0–24 months. The HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) intervention provides structured oral health conversations, underpinned by complex intervention methodology. A feasibility study found HABIT acceptable to parents, feasible to deliver and led to improvements in home-based behaviours. However, the reach of this original study was limited to those proficient in English. This new study focused on exploring and enhancing the accessibility of the HABIT intervention to parents with Limited English Proficiency.MethodTwenty-four parents participated in interviews and focus groups, with 21 requesting support from interpreters. Community centres and WhatsApp were used to maximise inclusivity. Interviews and focus groups, followed a topic guide and the “Think Aloud” technique, were professionally transcribed, managed in NVivo, and thematically analysed. Team discussions facilitated analytical rigour. Recruitment continued until data saturation.ResultsThree themes were developed: (1) Navigating linguistic barriers; (2) Engagement through visuals; and (3) Addressing oral health challenges. Parents employed diverse strategies to interpret resources, including Google Translate, as well as family and wider community members. Consequently, the HABIT resources were modified to include simple text, subtitles, and translation tools. Parents highlighted the benefits of shorter oral health messages with clear visuals to help understanding, and this strategy was applied across all resources. Challenges surrounding children's resistance to toothbrushing, high sugar intake within their wider families and communities, and limited dental access were all raised. The HABIT resources were updated to address these challenges.ConclusionCollaborative community engagement has enhanced the HABIT resources, enabling access for high-risk communities to preventive oral-health programmes thereby promoting health equity.

Impact of Dietary Patterns and Serum Amino Acid Profile on Metabolic Syndrome Development in Mexican Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is the main endocrine disorder in women of reproductive age worldwide. This condition is often associated with various metabolic alterations that contribute to the development of metabolic syndrome (MetS). Recent research suggests that branched-chain amino acid (BCAA) dysregulation is observed in PCOS. This study aims to investigate the relationship between dietary patterns, body composition, metabolic analytes, and serum amino acid levels in Mexican women with PCOS. Utilizing a cross-sectional design, we found that both study groups, PCOS (n = 24) and PCOS + MetS (n = 21), exhibited increased relative fat mass and dietary habits characterized by high simple sugar intake and low protein consumption, correlating with levels of relative fat mass and leptin. Notably, serum concentrations of BCAAs and glutamic acid were significantly elevated in the PCOS + MetS group. Our findings suggest that a metabolic approach may enhance the prediction and management of MetS in women with PCOS, highlighting the importance of dietary interventions in this population.

Empirically Derived Dietary Patterns in Association with Asthma Symptoms in Children and Adolescents: A Cross-Sectional Study

Background: Limited data exists regarding the association between dietary patterns and asthma. This study aims to determine the relationship between empirically derived dietary patterns and the likelihood of asthma among a large population of children and adolescents living in central Iran. Methods: A total of 7667 of male and female students aged 6-14 from 48 public and private schools in YAZD urban areas entered the current cross-sectional study. Data on dietary intakes, as well as asthma symptoms and other possible confounders, were collected using a self-administered questionnaire filled by parents. Factor analysis was applied to find major dietary patterns. Multivariate logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for asthma development across quintiles of dietary patterns. Results: Two main dietary patterns were established. A “traditional diet” was determined by meat, fish, fruits, cooked vegetable, raw vegetable, legumes, cereals, bread, macaroni, rice, margarine, butter, olive oil, milk, yogurt, egg, nuts, potato, and a “western-like diet” was characterized by high intakes of simple sugars, fast food(hamburger), fast food (pizza), soft drinks, jelly, chocolate and biscuits of cocoa, ice cream, and sauce. After adjusting for potential confounders, individuals in the top quintile of traditional diet were 0.31 times less likely to have asthma than those in the lowest quintile (OR=0.69; 95% CI: 0.47-1.00). Moreover, individuals in the top quintile of traditional diet were 0.43 times less likely to have wheezing compared with those in the lowest quintile (OR=0.57, 95% CI: 0.46-0.70). However, individuals in the top quintile of the western diet were 0.35 times more likely to have wheezing than those in the lowest quintile (OR=1.35, 95% CI: 1.10-1.66). Conclusions: According to the results, a traditional diet might be associated with lower odds of asthma; however, a western-like diet might be adversely associated with asthma symptoms.

Quantitative relationship between free sugars intake and early childhood caries among preschoolers in Sri Lanka

IntroductionBefore implementing the WHO sugar recommendations, more studies are needed concerning its application to given contexts. ObjectiveTo identify free sugars intake levels associated with a minimum caries risk in primary dentition MethodsUsing probability proportionate to size technique and cluster sampling, 813 children aged 4-5-years were selected from preschools in the Colombo district, Sri Lanka. A 67-item quantitative food frequency questionnaire was developed and validated to evaluate free sugars intake. Dental caries was assessed clinically using dmft index. For the selection of cut-off values for free sugars intake levels, ROC curves were used. ResultsThe median (IQR) amount of free sugars intake was 57.9 (33.2 -95.8) g/day or 21.1% (12.5%-35.9%) of total energy requirement, with a frequency of 4.0 (2.7-6.1) times/day. Dental caries prevalence was 42.9% (n=349). Among all possible risk factors, free sugars intake as a percentage of total energy requirement (p<0.001) and frequency of free sugars intake (p<0.001) were significantly associated with the presence of dental caries. The percentage of free sugars that discriminates against a possible highest number of children with dental caries (99%) was determined as 4%, of the total energy requirement of a child, which is approximately 12g/day (3 level teaspoons/day). Sugar intake once a day has a 97% sensitivity in identifying children with dental caries. These cut-off values do not differ among the group who brush twice a day with fluoridated toothpaste. ConclusionFor optimal caries prevention, children's free sugar intake to less than 5% of their total energy intake or consume less frequently than once daily.

School food policy in secondary schools in England and its impact on adolescents' diets and dental health: the FUEL multiple-methods study.

School food standards are a legal requirement for state-funded schools in England and are designed to promote healthy eating in pupils. However, state-funded academies/free schools established between 2010 and 2014 are exempt from this legislation. To complement the school food standards, the government launched the School Food Plan in 2013, which outlines voluntary actions that schools can take to support healthy eating and increase school meal uptake. There has been little evaluation of the school food standards and School Food Plan in secondary schools. To compare implementation and costs of the school food standards and School Food Plan, and pupil dietary and dental outcomes in two groups of secondary schools: those mandated and those not mandated to comply with the school food standards legislation. An observational, multiple-methods study. We sampled state-funded secondary school academies/free schools, pupils aged 11-15 years, and school staff/governors with a role in food provision/education from the Midlands. We collected qualitative data in four schools. The primary outcome was pupil free sugar intake at lunch; across the school day; and during 24-hours. Secondary outcomes were additional nutritional outcomes and dental caries measures. We assessed school food standards/School Food Plan implementation and costs using researcher observation, document analysis, and surveys with staff/governors, schools and pupils. Dietary intake and dental outcomes were measured online using 24-hour dietary recall and surveys, respectively. In the qualitative study we conducted staff/governor interviews and pupil focus groups in a subsample of schools. We used multilevel analyses to explore variation in pupil outcomes across the school food standards-mandated and school food standards-non-mandated school groups. Data were analysed using the Framework approach. Thirty-six schools (13 school food standards-mandated, 23 school food standards-non-mandated), 2453 pupils and 151 staff/governors participated. On average, schools were compliant with 64% of school food standards and implemented 41% of School Food Plan actions, with no differences across school food standards-mandated/non-mandated schools. There was a wide variation in annual costs of the school food standards and School Food Plan reported by schools (mean of £195 per pupil). Pupils in school food standards-mandated schools had lower lunch intakes of free sugar than those in school food standards-non-mandated schools (adjusted mean difference = -2.78 g, 95% confidence interval -4.66 to -0.90 g). After further adjustment for total energy intake, there was no significant difference in free sugar intake, but the school food standards-mandated group had lower fruit and vegetable intake at all time points, and higher consumption of confectionery during the school day and sugar-sweetened beverages over 24 hours. There were no differences in dental outcomes between the two groups. Twenty-one staff/governors and 137 pupils participated in the qualitative study. Staff described balancing school food standards compliance with conflicting priorities related to financial viability. Some pupils felt that school food did not meet their needs for convenience, speed, value for money and taste, and disliked the lunchtime experience. Little time was afforded to healthy-eating education within the curriculum. There were large numbers of missing data for some study elements, including assessment of some School Food Plan actions and cost data. In the secondary school context, the current school food standards are difficult to comply with and the School Food Plan has not achieved the desired outcomes. We found no evidence to show that school food standards legislation has positively influenced nutritional intake. We need to develop healthy secondary-school food provision models that meet pupils' preferences, and better understand how to situate the food and healthy-eating agenda in secondary schools. This trial is registered as ISRCTN68757496. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/92/39) and is published in full in Public Health Research; Vol. 12, No. 12. See the NIHR Funding and Awards website for further award information.

Planetary Health Diet in Malaysia: recommendations for healthier people and planet

Food systems both influence and are influenced by environmental changes. Adopting a Planetary Health Diet (PHD) approach could alleviate the burden of food systems on the environment whilst increasing food security for the population. Here, we assess how the current Malaysian dietary guidelines and dietary intake compares to the PHD and investigate the relationship between the PHD, calorie intake, and food insecurity in Malaysia. We compared the percent of daily calorie intake by food group between the PHD, the Malaysian Dietary Guidelines 2020, and estimated dietary intake from publicly available data. Additionally, the Planetary Health Diet Index (PHDI) was used to compare alignment to the PHD across ethnicity, gender, and area of residence. Spearman's correlation tests assessed aggregated correlations between the PHD, daily calorie intake, and food insecurity. Compared to the PHD, the Malaysian diet lacked in legumes (3.6% vs 23.0% of daily calorie intake). There was an overconsumption of grains & tubers (53.1% vs 34.0%), added sugars (12.4% vs 4.8%), and meat (11.7% vs 4.5%). The ethnic Indian diet was most closely aligned to the PHD, with a PHDI score of 69.1 compared to the overall score of 46.2. The national dietary guidelines were well aligned to the PHD, however, a large proportion of recommended daily calorie intake was unaccounted for in the guidelines (43.4%). Encouraging more whole grain and legumes and reducing meat and added sugar intake could help align Malaysian diets with the PHD, benefiting the health and wellbeing of people and their environment.

Healthy Drinks, Healthy Teeth – Ciunerkaq Tanqigtuq (The Future is Bright): A study protocol for a community-based, non-randomized sociobehavioral trial to reduce added sugar intake in Alaska Native Yup'ik children in the Yukon-Kuskokwim Delta

BackgroundThis study protocol describes a community-based intervention that will seek to reduce added sugar intake in Yup'ik Alaska Native children by targeting reductions in sugar-sweetened fruit drinks. MethodsA two-group non-randomized design will be used to evaluate the intervention in three Yup'ik communities in Alaska focusing on children age 1 to less than age 12 years with a minimum enrollment target of 192 children. Families in the intervention arm will participate in a program consisting of five sessions plus four brief check-ins, all delivered by a Yup'ik Community Health Worker. Modifications to the local store environment will be made to give families a place to purchase sugar-free water enhancers. Families in the delayed treatment control arm will receive no intervention during the main study period. There will be five data collection visits (baseline, 1-month, 3-months, 6-months, and 12-months) that will include collection of survey and dietary data, and a hair and plaque sample from each participating child. The outcomes will be change, from baseline to 6 months, in added sugar intake based on a validated hair biomarker (grams of added sugar/day). We hypothesize children in the intervention arm will have greater reductions in added sugar intake compared to children in the control arm as measured by the hair biomarker. DiscussionThis is one of the first known community-based sociobehavioral interventions aimed specifically at reducing added sugar intake in Alaska Native communities by targeting sugar-sweetened fruit drinks. Trial registrationClinicalTrials.govNCT05219448 (first posted on February 2, 2022).

Exposure to sugar rationing in the first 1000 days of life protected against chronic disease.

We examined the impact of sugar exposure within 1000 days since conception on diabetes and hypertension, leveraging quasi-experimental variation from the end of the United Kingdom's sugar rationing in September 1953. Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-rationing. Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, we found that early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by 4 and 2 years. Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began. In-utero sugar rationing alone accounted for about one third of the risk reduction.

The Role of Nationality in Childhood Caries in Qatar.

There were two objectives. First, to understand the variation of primary dentition caries among 4- to 8-year-old children in Qatar across nationality classified into four groups, and second, to explore whether the association persisted in the presence of socio-demographic and behavioural indicators. The study used data from the Qatar Child Oral Health Survey 2017 (QCOHS 2017). Detailed information was collected through a parental dual-language questionnaire and an oral epidemiological examination conducted by calibrated dentist examiners. Children in 20 kindergartens and 40 schools across Qatar were recruited. Data were weighted to represent the Qatar child population. Overall, 1154 children aged 4-8 years old (48.9% female, 51.1% male) participated. Qatari children made up 26.3%, Non-Qatari (N-Q) Arabic children 44.2% N-Q Indian sub-continent 16.4% and N-Q Other 13.1%. There were no significant differences by nationality for age or sex, but differences existed for kindergarten/school type and parents' highest level of education. Among behavioural indicators, Qatari and N-Q Arabic children began toothbrushing later, and more N-Q Other children brushed 2+ times a day and had made a check-up visit in the last 12 months. More Qatari children were in the highest tertial for sugar intake and drank bottled water with no fluoride. All N-Q children had a significantly lower prevalence and experience of caries. The means ratio (95% CI) for N-Q Arabic (0.78; 0.65-0.94), Indian (0.58; 0.46-0.72) and other children (0.61; 0.42-0.88) were all significant against Qatari nationality children. Multivariable models showed an attenuation of the association with caries with the means ratio for N-Q Arabic (0.92; 0.73-1.16), Indian (0.79; 0.57-1.11) and other children (0.94; 0.61-1.44) being non-significant compared to Qatari nationality children. The variables which were significantly associated with caries were parental education, toothbrushing frequency, sugar intake and check-up visiting in the last 12 months in the multivariable models. Primary dentition caries in children resident in Qatar differed by nationality. The association of primary dentition caries with nationality was markedly attenuated and non-significant in the presence of socio-demographic and behavioural variables, pointing towards the importance of these variables as the pathways to improving primary dentition caries prevalence and experience of children in Qatar.

Supply- and demand-side drivers of the change in the sugar density of food purchased between 2015 and 2018 in Great Britain.

The UK government launched a two-component sugar-reduction programme in 2016, one component is the taxation of sugar-sweetened beverages, the Soft Drinks Industry Levy, and the second is a voluntary sugar reduction programme for products contributing most to children's sugar intakes. These policies provided incentives both for industry to change the products they sell and for people to change their food and beverage choices through a 'signalling' effect that has raised awareness of excess sugar intakes in the population. In this study, we aimed to identify the relative contributions of the supply- and demand-side drivers of changes in the sugar density of food and beverages purchased in Great Britain. While we found that both supply- and demand-side drivers contributed to decreasing the sugar density of beverage purchases (reformulation led to a 19 % reduction, product renewal 14 %, and consumer switching between products 8 %), for food products it was mostly supply-side drivers (reformulation and product renewal). Reformulation contributed consistently to a decrease in the sugar density of purchases across households, whereas changes in consumer choices were generally in the opposite direction, offsetting benefits of reformulation. We studied the social gradient of sugar density reduction for breakfast cereals, achieved mostly by reformulation, and found increased reductions in sugar purchased by households of lower socio-economic status. Conversely, there was no social gradient for soft drinks. We conclude that taxes and reformulation incentives are complementary and combining them in a programme to improve the nutritional quality of foods increases the probability of improvements in diet quality.

Medicinal Plants Approach for Diabetes Mellitus-A Computational Model

The multidimensional metabolic syndrome that includes diabetes mellitus poses a serious threat to world health. There is an increasing interest in researching herbal remedies for their possible therapeutic advantages, even as traditional allopathic treatments continue to be widely used. This work throws light on the multiple ways of metabolism and biochemical interactions of medicinal plants in the control of glucose level, highlighting their crucial role in the process. The work clarifies several herbal extracts' efficacy and safety profiles, such as Aloe vera, Garlic, Gurmar, Bitter Melon, Neem, Tulsi, and through a thorough literature review and empirical evidence. These plants, which are abundant in bioactive substances like tannins, flavonoids, and alkaloids, show promise in treating insulin resistance, improving pancreatic function, and controlling blood sugar level. A further assessment of the rising risk associated with diabetes mellitus is discussed, and a differential equation model for diabetes mellitus is developed to minimize the complications. When using medicinal plants to treat diabetes, several factors are considered, including blood sugar level, sugar intake activity, and plasma insulin concentrations. The stability criterion for the mathematical model is examined through the system of differential equations. A representation highlighting the medicinal plants that can aid individuals with diabetes mellitus is provided. The blood sugar level, insulin generalization variable and plasma insulin concentration have all been measured at different points in time. Aloe vera, Gurmar, Garlic, Tulsi, Bitter Melon and Neem are among the medicinal plants selected for their demonstrated anti-hyperglycemic properties due to their easy availability in India. Mathematical solutions were calculated for every plant and proved to be steady.

Effectiveness of a Sugar Consumption Prevention Program in the First Year of Life on the Occurrence of Early Childhood Caries: A Multicentric Randomized Trial in Brazil.

This study aims to investigate the effectiveness of a nutritional counseling program for mothers of newborns to prevent sugar consumption in the first year of the child's life on the occurrence of Early Childhood Caries (ECC). A multicentric randomized clinical trial (ClinicalTrials.gov NCT03841123) was conducted in three state capitals of Brazil (n=516). Mothers were randomly assigned to the intervention group (IG) or control group (CG) after delivery. The IG received face-to-face nutritional counseling based on UNICEF dietary guidelines, followed by monthly phone calls. The CG received standard counseling. Dietary intake was measured through structured questionnaires and 24-hour recalls at six and 12 months. Calibrated dentists performed a dental clinical examination for ECC diagnosis after the children completed their first year of life. The prevalence of ECC was 17.4% in the overall sample (49/290). The number of affected teeth ranged from 0 to 6 (mean 0.43). The IG had a 2.4 times probability of not consuming sugar in the first six months of the child's life (RR 2.44; 95% CI 1.18-5.00) and they had Fa significantly lower mean number of sweet items consumed at 12 months (p=0.016). No significant differences between groups were found concerning the occurrence of ECC (RR 1.33; 95% CI 0.79-2.25) or the number of teeth affected by caries (p=0.273). The intervention to prevent and reduce sugar intake in the first year of life was not effective at reducing the occurrence of early childhood caries or the number of teeth with carious lesions.

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

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. 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. 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. 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.