Commercial complementary food consumption is prospectively associated with added sugar intake in childhood

Abstract

Given that commercial complementary food (CF) can contain high levels of added sugar, a high consumption may predispose to a preference for sweet taste later in life. This study examined cross-sectional associations between commercial CF consumption and added sugar intake in infancy as well as its prospective relation to added sugar intake in pre-school and primary-school age children. In all, 288 children of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study with 3-d weighed dietary records at 0·5 and 0·75 (infancy), 3 and 4 (pre-school age) and 6 and 7 years of age (primary-school age) were included in this analysis. Individual commercial CF consumption as percentage of total commercial CF (%cCF) was averaged at 0·5 and 0·75 years. Individual total added sugar intake (g/d, energy percentage/d) was averaged for all three age groups. Multivariable logistic and linear regression models were used to analyse associations between %cCF and added sugar intake. In infancy, a higher %cCF was associated with odds for high added sugar intake from CF and for high total added sugar intake (>75th percentile, P < 0·033). Prospectively, a higher %cCF was related to higher added sugar intake in both pre-school (P < 0·041) and primary-school age children (P < 0·039), although these associations were attenuated in models adjusting for added sugar intake in infancy. A higher %cCF in infancy may predispose to higher added sugar intake in later childhood by virtue of its added sugar content. Therefore, offering home-made CF or carefully chosen commercial CF without added sugar might be one strategy to reduce sugar intake in infancy and later on.

Sweet taste exposure and the subsequent acceptance and preference for sweet taste in the diet: systematic review of the published literature

“…Findings from these 7 cohort studies are given in groups with a higher exposure to sweet foods reported lower (22) and higher (23) preferences for sweet foods (other than those involved in exposure), and higher (25)(26)(27), lower (24,26) and no differences (21,24,26) in intakes of other sweet foods.…”

“…Of the cohort studies, 3 studies involved retrospective measures of exposure (21)(22)(23), and 4 studies used prospective methods (24)(25)(26)(27). Methodological details of these studies are given in Table 1.…”

“…In the 4 prospective studies, children were followed for 2-10 y. Assessments of exposure to sweetened weaning foods (25), fruit juice (27), sugar-sweetened beverages (26), and artificially and naturally sweetened beverages (24) were made at 6-9 mo, 12 mo, 16-25 mo, and 5 y, respectively, and exposure groups were subsequently compared to groups who received no exposure (24,27) or lower exposure (25,26) to the target foods, although other sources of sweet-tasting stimuli in the diet were again permitted in all studies. All 4 studies measured dietary intake of sweetened foods or beverages at later timepoints using validated self-report measures.…”

“…Few studies were explicitly designed to test our research question, but instead addressed our question only indirectly (19,22,23,25). Only 1 short-term study (28) directly compares exposure to sweetness with no exposure, whereas all other studies investigated the exposure or manipulation of ≥1 sweet foods or beverages within a background of additional sweet items.…”

“…Consideration of only the studies of lower risk of bias reduces the evidence available, but again provides equivocal results. Dietary intakes were rarely comprehensive, and often only "added sugars" or a few specific sweet foods or beverages were considered (22,25). The studies identified were also notably all undertaken in children, in whom effects of sweet taste exposure may be difficult to see against a background of strong innate liking (15), and in whom differences in dietary intakes may reflect parenting practices and household food offerings, rather than preferences for specific sensory attributes.…”