Total, Free, and Added Sugar Consumption and Adherence to Guidelines

An article published in Nutrients sought to estimate intakes of total sugars, added sugars, and free sugars and their main food sources in Dutch children and adults using data from The Dutch National Food Consumption Survey (DNFCS). The DNFCS is “representative for the Dutch population with regard to age and sex within each age group, region, degree of urbanization and education level” and included those aged 7-69 years. The present study had a sample of 3,817 participants. Dietary intake was measured by two non-consecutive 24-h recalls. Dietary quality was assessed using the Dutch Healthy Diet index and food composition was determined using the 2011 Dutch food composition table.

For this study “Added sugars were defined as all sugars that are added during food manufacturing and preparation…Added sugars did not include naturally occurring sugars found in unprocessed products (fruit, vegetables, legumes, potatoes, fish, meat, poultry, and eggs), juices, fruit concentrates, bread and lactose in dairy. Free sugars were defined according to the definition of the WHO as ‘all sugars that are added during food manufacturing and preparation as well as sugars that are naturally present in honey, syrups, fruit juices, and fruit concentrates.’”

Researchers report that the median total sugar intake was 115g/day which contributed 21.5% of the total caloric intake. The median added sugar intake was 64g/day which contributed 12% of the total caloric intake and the median free sugar intake was 74g/day which contributed 14% of the total caloric intake. Researchers note that children (7-18 years old) had a higher overall sugar intake than adults (19-69 years old).

The food groups which contributed the most to intake of total, free, and added sugars across both age groups were “non-alcoholic beverages”, “sweets and candy”, “dairy”, and “cake and cookies.” “Non-alcoholic beverages” contributed most to total and free sugars whereas “sweets and candy” contributed most to added sugars. Of the “non-alcoholic beverages”, “soft drinks” made the largest contribution to sugar intake.

Of the 3,817 participants, one boy, one girl, and 4% of adults were in alignment with the British Scientific Advisory Committee on Nutrition (SACN) and the conditional World Health Organization (WHO) guidelines to not exceed 5% of daily total calories from sugar. When the guideline was relaxed to not exceed 10% of daily total calories from sugar, 5% of boys and girls, 33% of men, and 29% of women were in adherence. Interestingly, the overall diet quality was comparable between adherent and non-adherent men and women; however, the adherent participants were more likely to have higher fiber and vegetable intake and less saturated fat and alcohol consumption.

Researchers conclude that “within the Netherlands, fruit juices and sugar sweetened beverages, including soft drinks, lemonades, and energy-drinks, contributed most to the intake of free sugar, especially in children.”


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