scholarly journals Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 20 ◽  
Author(s):  
Ines Perrar ◽  
Alena M. Schadow ◽  
Sarah Schmitting ◽  
Anette E. Buyken ◽  
Ute Alexy
Keyword(s):  
Children And Adolescents ◽  
Linear Trend ◽  
Total Sample ◽  
Free Sugar ◽  
Food Groups ◽  
Linear Quadratic ◽  
Added Sugars ◽  
Dietary Records ◽  
Age Trends ◽  
German Children

Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.

scholarly journals Time and age trends in morning and evening protein intakes of German children and adolescents

2018 ◽  
Vol 7 ◽  
Author(s):  
Sarah Roßbach ◽  
Tanja Diederichs ◽  
Christian Herder ◽  
Anette E. Buyken ◽  
Ute Alexy
Keyword(s):  
Children And Adolescents ◽  
Energy Intake ◽  
Protein Intake ◽  
Linear Trend ◽  
Quadratic Trend ◽  
Linear Quadratic ◽  
Dietary Records ◽  
Age Trends ◽  
German Children ◽  
Starchy Foods

AbstractThe present study describes time and age trends in morning and evening protein intakes and sources among German children and adolescents from 1985 to 2014. A total of 9757 three-day weighed dietary records of 1246 3- to 18-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed using polynomial mixed-effects regression models. Morning protein intake increased over the study period by approximately 1 % of morning energy intake (linear trend P < 0·0001), with the youngest and the oldest children having the highest protein intake (linear, quadratic trend P < 0·0001). Evening protein intake increased over time by approximately 2 % of evening energy intake in girls (linear trend P < 0·0001) and 1 % of evening energy intake in boys (quadratic trend P = 0·0313), with decreasing intake with age (girls: linear trend P < 0·0001; boys: linear trend P = 0·0963). Time trends were largely due to increases in protein from ‘starchy foods’. In conclusion, morning and evening protein intakes increased modestly between 1985 and 2014; these increases were, however, not accompanied by increases in traditional protein sources (i.e. meat or dairy products).

scholarly journals Associations between intake of added sugars and intakes of nutrients and food groups in the diets of German children and adolescents

2003 ◽  
Vol 90 (2) ◽  
pp. 441-447 ◽  
Author(s):  
Ute Alexy ◽  
Wolfgang Sichert-Hellert ◽  
Mathilde Kersting
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Dilution Effect ◽  
Mixed Linear Model ◽  
Fat Intake ◽  
Food Groups ◽  
Added Sugars ◽  
Dietary Records ◽  
Analyse Data ◽  
German Children

The aim of the present analysis was to evaluate the effect of intake of added sugars on intakes of nutrients and food groups. We used a mixed linear model (PROC MIXED) to analyse data from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study (an ongoing longitudinal cohort study between infancy and adulthood). Between July 1985 and August 2001, 3 d weighed dietary records (n 4993) from 849 children and adolescents (416 male, 433 female) aged 2–18 years were collected and evaluated. Overall mean intake of added sugars was 12·4 (SD 5·3) (median 12·0) % energy. Fat intake (% energy) and intake of all analysed nutrients (as % reference values for nutrient intakes) fell across quintiles 1–5 of energy intake from added sugars (P<0·001). With the exception of ‘Sugary foods’ and ‘Beverages’ (significant increase, P<0·0001) and ‘Dairy’ (NS), intake of all other food groups decreased with increasing intake of added sugars (P<0·0001). In conclusion, we found a slight, but statistically significant, nutrient-dilution effect of added sugars and a significant reduction in intake of important nutrient-bearing food groups. However, the DONALD study gives no clear indicator on grounds of micronutrient dilution for a quantitative limit on intake of added sugars.

scholarly journals Time and age trends in urinary sugar excretion among German children and adolescents

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ines Perrar ◽  
Gunter K. Kuhnle ◽  
Thomas Remer ◽  
Anette E. Buyken ◽  
Ute Alexy
Keyword(s):  
Children And Adolescents ◽  
Energy Intake ◽  
Time Trend ◽  
Linear Trend ◽  
Predictive Biomarkers ◽  
Sugar Intake ◽  
Dietary Records ◽  
Age Trends ◽  
Dietary Sugar ◽  
Maternal Overweight

AbstractA high sugar intake is increasingly discussed to affect health. Preceding analyses based on dietary records, collected between 1985–2016, suggest a decreasing time trend in total [TS], added [AS] and free [FS] sugar intake (calculated as % of energy intake [%E]) since 2005 - most notably from 2010 onwards - among children and adolescents in Germany. While TS [%E] intake decreased with age, the youngest children had the lowest AS [%E] intake and the oldest children had the lowest FS [%E] intake, with minor differences in the other age groups. However, self-reported data is likely introducing bias due to selective underreporting, especially of sugar-rich foods, which can distort results. Therefore, we analysed time and age trends in dietary sugar intake using urinary biomarkers.Urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE + SE) as predictive biomarkers for sugar intake was measured by UPLC-MS/MS in 997 24-h urine samples from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study cohort collected from 8.5–16.5-year-olds (239 boys, 253 girls) between 1990–2016. Time and age trends of log-transformed FE, SE and FE + SE were analyzed using polynomial mixed-effects regression models. Sex, creatinine and urea excretion, urine volume, total daily energy intake, overweight status, type of weekday, maternal overweight and educational status as well as maternal employment were considered as potentially confounding factors.The mean (± SD) FE was 26.1 ± 20.9 mg/d, SE 33.4 ± 38.3 mg/d, and FE + SE 59.6 ± 49.1 mg/d. While FE increased significantly with age (linear trend: p = 0.0147), there were no significant age trends for SE and FE + SE in adjusted models. Between 1990–2016 FE as well as FE + SE decreased significantly (linear trend: p = 0.0280 and p < 0.0001, respectively). SE showed a tendency towards a negative quadratic time trend (p = 0.0574).The decreasing time trend of urinary sugar excretion supports our previous observed time trends in dietary sugar intake based on dietary records among children and adolescents. In contrast, the observed age trend in dietary sugar was not confirmed by the biomarker trend analysis, suggesting increasing underreporting with age during adolescence. Although predictive biomarkers do not allow conclusions on the amount of the respective dietary intake, the combination of biomarker and dietary record data points towards the need of further public health measures to support the observed decline in sugar intake among children and adolescents in Germany.The project is funded by the German Federal Ministry of Food and Agriculture.

scholarly journals Two approaches to derive a proposal for added sugars intake for German children and adolescents

2003 ◽  
Vol 6 (7) ◽  
pp. 697-702 ◽  
Author(s):  
Ute Alexy ◽  
Mathilde Kersting ◽  
Verena Schultze-Pawlitschko
Keyword(s):  
Children And Adolescents ◽  
Nutrient Intake ◽  
Child Nutrition ◽  
Dietary Quality ◽  
Mixed Diet ◽  
Dietary Survey ◽  
Added Sugars ◽  
Dietary Records ◽  
German Children ◽  
Survey Approach

AbstractObjective:Intake of sugars is restricted in most international food guides. However, in recent recommendations quantified limits of added sugars intake have not been given, although deemed necessary by those who criticised the recommendations.Design:Two approaches to derive a scientifically based quantified limit of added sugars intake for German children and adolescents are suggested. For the first dietary survey approach, 5120 three-day weighed dietary records from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study were used. Added sugars intakes in records of high vs. low dietary quality, measured by a nutrient intake score, were compared. For the second approach, a total dietary concept for German children and adolescents developed and evaluated by the Research Institute of Child Nutrition – the Optimised Mixed Diet – was used.Results:Whereas in the latter dietary concept an added sugars intake of about 6% of energy intake is tolerated, the dietary survey approach resulted in only small differences between high and low dietary quality, with a median added sugars intake of 12% of energy in records with high dietary quality.Conclusions:A reasonable dietary quality is possible within higher ranges of added sugars intake than derived from the dietary concept approach. Therefore we suggest a range of intake of added sugars for German children and adolescents, from 6% to 12% of energy.

scholarly journals Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 676
Author(s):  
Emmanuella Magriplis ◽  
George Michas ◽  
Evgenia Petridi ◽  
George P. Chrousos ◽  
Eleftheria Roma ◽  
...  
Keyword(s):  
Total Energy ◽  
Children And Adolescents ◽  
Age Groups ◽  
Significant Proportion ◽  
Dietary Intakes ◽  
Food Groups ◽  
Added Sugar ◽  
Added Sugars ◽  
Sugar Intake ◽  
Sweetened Beverages

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor was sugar-sweetened beverages (20.6%). Being overweight or obese was 2.57 (p = 0.002) and 1.77 (p = 0.047) times more likely for intakes ≥10% of total energy from added sugars compared to less <10%, when accounting for food groups and macronutrient intakes, respectively. The predicted probability of becoming obese was also significant with higher total and added-sugar consumption. We conclude that high consumption of added sugars increased the probability for overweight/obesity among youth, irrespectively of other dietary or macronutrient intakes.

Significance of Fortified Beverages in the Long-term Diet of German Children and Adolescents: 15-Year Results of the DONALD Study

2001 ◽  
Vol 71 (6) ◽  
pp. 356-363 ◽  
Author(s):  
Wolfgang Sichert-Hellert ◽  
Mathilde Kersting
Keyword(s):  
Vitamin A ◽  
Children And Adolescents ◽  
Time Trends ◽  
Vitamin B1 ◽  
Fortified Food ◽  
Micronutrient Intake ◽  
Dietary Records ◽  
Males And Females ◽  
German Children

Fortified beverages and instant drinks are the most frequently consumed fortified products in children and adolescents in Germany. However, little is known about the contribution of these products to micronutrient intake. Between 1986 and 2000, consumption of fortified food (total and the subgroup of fortified beverages) and time trends in energy and micronutrient intake were assessed on the basis of 3 day-weighed dietary records (n = 4358) of males and females between the ages of 2 and 14 years (n = 398/408) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). As percentage of recent references for micronutrient intake, a significant increase in intake from fortified beverages was observed for calcium (from 1 to 3%), iron (3 to 4%), vitamin A (5 to 15%), and vitamin C (5 to 60%). Significant increases in intakes were only observed from 1995–1997 for vitamin E, folate, and niacin (all 5 to 15–25%), vitamin B1 and B2 (both 10–15 to 25–30%) and vitamin B6 (20 to 55%). Thereafter significant decreases were found. Among the fortified beverages, juice was the most important for micronutrient intake, followed by soft drinks (calcium, vitamin A, E, C, folate, niacin) or by instant beverages (energy, iron, vitamin B1, B2, B6). Significant linear and nonlinear time trends in micronutrient intakes from fortified food and fortified beverages were observed in German children and adolescents.

Association between free sugar intake and nutrient dilution among Japanese children and adolescents: the 2016 National Health and Nutrition Survey, Japan

2020 ◽  
pp. 1-11
Author(s):  
Aya Fujiwara ◽  
Emiko Okada ◽  
Chika Okada ◽  
Mai Matsumoto ◽  
Hidemi Takimoto
Keyword(s):  
Children And Adolescents ◽  
National Health ◽  
Weight Status ◽  
Free Sugar ◽  
Food Groups ◽  
Japanese Children ◽  
Nutrition Survey ◽  
Sugar Intake ◽  
Health And Nutrition ◽  
Dietary Record

Abstract The influence of free sugar intake on nutrient intake remains unclear in Japanese children and adolescents with relatively low free sugar intake. This cross-sectional study aimed to investigate the relationship between free sugar and selected nutrient intakes using data from the 2016 National Health and Nutrition Survey, Japan, based on the WHO recommendations (<5 % or <10 % of energy (%E)) for free sugar intake. A 1-d weighed dietary record was assessed in Japanese children and adolescents (aged 1–19 years; n 2919). Mean intakes for selected nutrients and food groups were compared according to free sugar intake categories (<2·5 %E, 2·5 to <5 %E, 5 to <10 %E and ≥10 %E) with adjustment for sex, age and weight status. Inverse associations were observed between intakes of free sugars and twenty-one of twenty-four micronutrients assessed, except for vitamins A and C and Ca. Significantly reduced intakes were identified for twenty-two and fourteen micronutrients in the ≥10 %E and 5 to <0 %E categories, respectively, compared with the lower categories. Mean micronutrient intakes at the <2·5 %E category did not differ from those at the 2·5 to <5 %E category. Free sugar intake had positive associations with intakes of sugars and jams, confectioneries, fruit and vegetable juices, and soft drinks and negative associations with intakes of pulses and nuts and vegetables. This study showed that nutrient dilution was associated with higher free sugar intake among Japanese children and adolescents. The findings suggest that the WHO recommendations might help prevent nutrient dilution in Japanese children and adolescents.

scholarly journals Dietary Intakes, Sources, and Determinants of Total and Free Sugar Consumption Among Lebanese Children and Adolescents: Findings from a National Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1421-1421
Author(s):  
Lamis Jomaa ◽  
Samer Hamamji ◽  
Samer Kharroubi ◽  
Marwa Diab El Harake ◽  
Lara Nasreddine
Keyword(s):  
Children And Adolescents ◽  
Energy Intake ◽  
Low Income ◽  
Fruit Juice ◽  
World Health ◽  
National Study ◽  
Free Sugar ◽  
National Council ◽  
Dietary Intakes ◽  
Food Groups

Abstract Objectives To determine the intake levels and main sources of total sugars (TS) and free sugars (FS) among Lebanese children and adolescents and to investigate the determinants of high FS consumption. Methods In a national cross-sectional survey, data on socio-demographic, anthropometric, and lifestyle characteristics of Lebanese children and adolescents (5–18 years-old) were collected (n = 1133). Dietary intake (24-hr recall) was analyzed using Nutri Pro software to determine average daily energy intake in kilocalories (kcal/d), TS and FS in grams (g/d) and as % of total energy intake (% kcal/d). FS content of foods was defined as 100% of added sugars for non-fruit juice sources and 100% of TS for fruit juice and drinks. Independent t -tests were used to compare mean daily intakes of TS and FS by sex and age groups. Logistic regressions were conducted to explore determinants of high FS intake (&gt;10% kcal/d), as per the World Health Organization recommendations. Results Children and adolescents consumed, on average, 1899.9 ± 25.2 kcal/d of which 17 ± 0.2% kcal/d from TS and 16 ± 0.2% kcal/d from FS. Percentage of children and adolescents having high FS consumption was 62%. Main contributors to TS and FS were sweetened beverages, biscuits/chocolates, and syrups, jams and honey. Per consumer basis, intakes of FS from all food groups were significantly higher in older boys and girls than younger ones, except for candies, ice cream and fresh fruit juices. Multiple logistic regression showed children with higher paternal educational level and highest household monthly income had significantly lower odds of high FS intake (OR = 0.79, 95% CI: 0.64, 0.96 and OR = 0.70, 95% CI: 0.58, 0.83, respectively). Children meeting physical activity recommendations had higher odds of high FS compared to their counterparts (OR = 1.12, 95% CI: 1.003, 1.23). Conclusions High proportion of Lebanese children and adolescents exceeded upper limits for FS intake. Findings highlight the need for developing culture-specific interventions aimed at reducing the intake of TS and FS among adolescents, particularly those from low-income families, to curb rising obesity rates. Funding Sources This project was funded by the Lebanese National Council for Scientific Research and the University Research Board at the American University of Beirut.

scholarly journals Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic—Results of the DONALD Study

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 297
Author(s):  
Ines Perrar ◽  
Ute Alexy ◽  
Nicole Jankovic
Keyword(s):  
Total Energy ◽  
Children And Adolescents ◽  
Fruits And Vegetables ◽  
Lifestyle Changes ◽  
Free Sugar ◽  
Processed Foods ◽  
Food Groups ◽  
Sugar Sweetened Beverages ◽  
Sweetened Beverages ◽  
The Impact

The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.

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