Estimating Free and Added Sugar Intakes in New Zealand

Kibblewhite, Rachael; Nettleton, Alice; McLean, Rachael; Haszard, Jillian J.; Fleming, Elizabeth; Kruimer, Devonia; Morenga, Lisa Te

doi:10.3390/nu9121292

Cited by 35 publications

(40 citation statements)

References 14 publications

(17 reference statements)

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“…These results are similar to the figures presented in a review [26] of added sugar consumption reported in nine nutrition surveys across the world (6% TE to 19% TE in people over 4 years old). In the present study, the intake of free sugars as defined by the WHO and the SACN ranged from 9% TE to 13% TE, similar to the free sugar intake reported in the Dutch National Food Consumption Survey 2007-2010 [16], in the New Zealand Adult Nutrition Survey 2008/09 [17] and in Swiss National Nutrition Survey (2014-2015) [27] which were, on average, 14% TE in 7-69 years old, 11% TE in 15-71 years old and 11% TE in 18-75 years old, retrospectively.…”

Section: Discussionsupporting

confidence: 83%

“…The measurement of added and free sugar content of foods and drinks is a challenge as there is no laboratory based analytical method or biomarker [14] that can objectively measure these sugars due to the difficulty in distinguishing intrinsic sugars from extrinsic sugars [15,16]. There are some methods [15,17] which estimate the added and free sugars content of foods in a systematic way from intake data. However, these are mostly specific to a single definition such as added sugar or free sugar only and are difficult to use more flexibly.…”

mentioning

confidence: 99%

“…Contribution (%) of NDNS RP food group sources to intake of sugars by age(11)(12)(13)(14)(15)(16)(17)(18) Years) (NDNS 2014-2016)*.…”

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confidence: 99%

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Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16)

et al. 2020

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Monitoring dietary intake of sugars in the population's diet has great importance in evaluating the efficiency of national sugar reduction programmes. The study objective was to provide a comprehensive assessment of dietary sources of added and free sugars to assess adherence to public health recommendations in the UK population and to consider the impact of different sugar definitions on monitoring. The terms "added sugar" and "free sugar" are different sugar definitions which include different sugar components and may result in different sugar intakes depending on the definition. Dietary intake of added sugars, free sugars and seven individual sugar components (sugar from table sugar; other sugars; honey; fruit juice; fruit puree; dried fruit; and stewed fruit) of 2138 males and females (1.5-64 years) from the National Diet and Nutrition Survey (NDNS) 2014-2016, collected using a 4 day estimated food diary, were studied. Added and free sugar intake accounted for 7% to 13% of total energy intake respectively. Major sources of free sugar intake were "cereals and cereal products", "non-alcoholic beverages", and "sugars, preserves, confectionery". Differences between added and free sugar intake were significantly large, and thus use of free sugar versus added sugar definitions need careful consideration for standardised monitoring of sugar intake in relation to public health.Nutrients 2020, 12, 393 2 of 18 this includes a sugar reduction and wider reformulation programme introduced by Public Health England [9] and a "sugar tax" on sweetened drinks, officially called the Soft Drinks Industry Levy which took effect in April 2018 [10]. Efficient quantification of the dietary sources of added and free sugar in the population's diet has prominent importance in evaluating sugar reduction programmes. The World Health Organization (WHO) issued dietary guidelines which recommend limiting free sugar intake to less than 10% of daily energy intake [1]. In the UK, the recommendation by the Scientific Advisory Committee on Nutrition (SACN) is for no more than 5% of total energy intake to come from free sugars [7]. However, there are different and inconsistent definitions of what constitutes added and free sugars that are used by international and national organisations [11] which present important considerations for public health monitoring and surveillance programmes and for comparison across countries and over time. For example, the free sugar definition used by the SACN in the UK [7] includes sugars within pureed fruits, whereas this distinction is not made by the WHO [1].The term "sugars," as applied to human diets, is a collective term for several different chemical species. Thus, "table sugar" is essentially pure sucrose, whereas fruit juice, honey and syrups contain mixtures of sucrose, glucose and fructose, and often oligosaccharides of different size. These compounds are invariably combined as "sugars". In this paper, added sugars are defined according to the European Food Safety Authority (EFSA) definition [12] which i...

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Section: Discussionsupporting

confidence: 83%

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confidence: 99%

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Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16)

et al. 2020

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“…"Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates [36]." Since free sugars are not found in the South African Food Composition Tables, we used the method used to calculate free sugars in New Zealand [40].…”

Section: Data Analysesmentioning

confidence: 99%

Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

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Nel

Malczyk

et al. 2020

IJERPH

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The double burden of malnutrition is still prevalent in South Africa, hence the importance of a dietary survey to identify risks of under-and over-nutrition. A multistage stratified cluster random sampling design was applied in two economically active provinces, Gauteng (GTG) (N = 733) and Western Cape (WC) (N = 593). Field workers completed questionnaires, and a 24 h recall with children taking part aged 1-<10-years (N = 1326). Important findings were that 71% and 74%, respectively, of 3-<6-year-olds and 6-<10-year-olds had an energy intake below the estimated energy requirement (EER), while 66% 1-<3-year-olds had intakes above the EER. The percentage of children with a total fat intake below recommended levels decreased as age increased ((51%, 40% and 5%) respectively, for the three age groups). Similarly, the percentage of those who had a total fat intake above the recommendation increased with increasing age (4%, 11% and 26%, respectively, for the three age groups). Saturated fat intake above 10%E was highest in the youngest and oldest children (33% and 32%, respectively). The percentage of children with a free sugars intake above 10%E was 47%, 48% and 52% respectively, and 98-99% had a fibre intake that was less than recommended. Overall, the diet was not healthy, with the main food items being very refined, and the diet being high in salty snacks and sugary items, and low in fruit, vegetables and legumes. non-communicable diseases (NCDs) [6,7]. Rapid weight gain in infancy is also associated with long-term risk of adult weight gain and development of NCDs [8].In a recent publication of the same children whose dietary results are studied here, nutritional status by means of anthropometry was determined [9]. Stunting was found to be 39% and 23% in 1and 2-year-olds, respectively. Overweight and obesity were found to be 23% and 14% in 1-year-olds, and 11% and 9% in 2-year-olds, and those who were both stunted and overweight were 19% and 6%, respectively, in 1-and 2-year-old children. The double burden of malnutrition is clearly illustrated.The double burden of malnutrition is commonly found in many low-and middle-income countries [10] and much of this can be largely attributed to the nutrition transition taking place, in conjunction with decreased levels of physical activity [10]. The nutrition transition implies moving from a traditional diet which is high in carbohydrate and fibre and low in sugar and fat to a more contemporary Western diet which is high in fats, saturated fats, sodium and sugar [11]. One of the main drivers of this transition is urbanization [10,12].A recent review of dietary studies in developing countries by Ochola and Masibo showed what the typical dietary scenario in developing countries is [13]. This review included 50 studies from 42 countries in children and adolescents. The findings were an overall low energy intake, lack of dietary diversity, low intake of fruit and vegetables and micronutrient deficiencies. At the same time the emerging nutrition transition is stressed. This includ...

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“…An added complexity is that it is not possible to distinguish naturally occurring sugars from added sugars from an analytical standpoint [ 19 , 20 ]. There are various indirect methods for estimating the added sugar and free sugar content of food and drinks [ 19 , 20 , 21 , 22 , 23 , 24 ], however, all these methods have limitations, mainly due to the level of subjectivity and general assumptions involved in decision making (for example all savory breads are sugar-free). In addition, these methods are mostly specific to a single definition of sugars, and thus may not be able to adapt readily to accommodate any changes in the definition.…”

Section: Introductionmentioning

confidence: 99%

A Disaggregation Methodology to Estimate Intake of Added Sugars and Free Sugars: An Illustration from the UK National Diet and Nutrition Survey

et al. 2018

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Various and inconsistent definitions for free and added sugars are used in the consideration and assessment of dietary intakes across public health, presenting challenges for nutritional surveillance, research, and policy. Furthermore, analytical methods to identify those sugars which are not naturally incorporated into the cellular structure of foods are lacking, thus free and added sugars are difficult to estimate in an efficient and accurate way. We aimed to establish a feasible and accurate method that can be applied flexibly to different definitions. Based on recipe disaggregation, our method involved five steps and showed good repeatability and validity. The resulting Free Sugars Database provided data for seven components of sugars; (1) table sugar; (2) other sugars; (3) honey; (4) fruit juice; (5) fruit puree; (6) dried fruit; and (7) stewed fruit, for ~9000 foods. Our approach facilitates a standardized and efficient assessment of added and free sugars, offering benefit and potential for nutrition research and surveillance, and for the food industry, for example to support sugar reduction and reformulation agendas.

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Estimating Free and Added Sugar Intakes in New Zealand

Cited by 35 publications

References 14 publications

Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16)

Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16)

Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

A Disaggregation Methodology to Estimate Intake of Added Sugars and Free Sugars: An Illustration from the UK National Diet and Nutrition Survey

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