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

Abstract

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...

Added and Free Sugars Intake and Metabolic Biomarkers in Japanese Adolescents

“…Children and adolescents in Portugal [54], Spain [55], Slovenia [56], Colombia, and Ecuador [43] had a mean intake of 9.5-11.6%E and 9.8-10.1%E, respectively. The intake in this study was lower than that in previous studies; in particular in the Netherlands [57], the UK [58], the US [42], Argentina, Brazil, Chile, Costa Rica, Peru, and Venezuela [43] (12.9-18.4%E and 17.6-20.7%E, respectively). Most literatures that reported significant associations of cardiometabolic risks came from the US [45,46,49], where the prevalence of metabolic syndrome based on the IDF definition, i.e., 5.2-9.5% at age 14 years [59,60] was higher than that in the current study.…”

Total and Free Sugars Consumption in a Slovenian Population Representative Sample

“…Adherence of the Slovenian population to the WHO guidelines to consume less than 10% TEI in free sugars was higher compared to that in other countries; more than half of the Slovenian adolescents and as many as 84% of adults and 81% of the elderly met the recommendation. In a similar study conducted in Switzerland, 36% of adolescents, 45% of adults, and 53% of the elderly reported free sugars consumption below 10% TEI [42], whereas in the U.K., the same criteria were met by 27% of adolescents and 54% of the adult participants [34]. Only Portugal has reported comparably high or even higher percentages of adherence to the guidelines than reported in the present study (51.3% among adolescents, 68.9-85.1% among adults, and 92.1% among the elderly) [45].…”

“…The results indicated that habitual consumption of total and free sugars is the highest among 10-17-year-olds, which is in line with other studies, although the reported intakes are somewhat lower compared to the other European countries. In the U.K. National Nutrition Survey (2014-2016), teenagers were reported to consume on average 13% TEI from free sugars [34]. The results from the Dutch National Food Consumption Survey occurring 2007-2010 were even more alarming, with the reported median daily intake of free sugars in adolescents being as high as 17.6-19.8% TEI [35].…”

“…However, the main sources of free sugars across different countries showed a certain degree of regional variability. In Slovenia, non-alcoholic beverages are by far the most important source of free sugars; the main sources in other European countries range from sweets and candy in The Netherlands [35], to cereals and cereal products in the U.K. [34]. However, direct comparisons of free sugars sources between different studies are difficult due to the different categorizations of food items.…”

Neuroendocrine and Metabolic Effects of Low-Calorie and Non-Calorie Sweeteners

“…With regard to children and adolescents, a scientific statement published by the American Heart Association (AHA) in 2017 recommends <25 g of added sugars per day, although added sugar should not be included in the diet for children <2 years of age (16). According to a recent study, in UK added or free sugar intake has been estimated between 7% and 13% of total energy intake, respectively, and it is higher in children than in adults (17). The prevalence of obesity and its comorbidities (such as type 2 diabetes, cardiovascular diseases and cancer) has dramatically increased (18) and several governments started to promote policies aimed to encourage a healthy diet and lifestyle (19).…”