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Influence of higher sugar intake on nutrient consumption, stunting and overweight in children

Posted:  Monday, August 08, 2016

Effect of higher sugar intake on nutrient consumption, stunting, and overweight

High sugar intake may increase the risk of obesity, non-communicable diseases, and dental caries. A study published in the journal PloS One investigated the association between added sugar and dietary diversity, micronutrient intake, weight, and length in a nationally representative study of children in South Africa.

The study was a retrospective analysis of the database of the National Food Consumption Survey (NFCS), which was conducted in 1999. Information on the dietary intake of children aged 1–8.9 years was collected by administering the 24-hour recall and food frequency questionnaires to the caregivers. The quartiles of added sugar intake as a percentage of energy (% EAS) were calculated.

The dietary diversity score (DDS) was calculated to determine the variation in dietary food groups. Data on the total number of different food items consumed in 24 hours were used to estimate the food variety score (FVS). Micronutrient intake was measured using the nutrient adequacy ratio, which was used to determine the mean adequacy ratio (MAR). The weight and length of the children were measured to determine the incidence of stunting and overweight/obesity.

In urban areas, a significantly higher added sugar intake of 32.4 g and % EAS of 10.3% was recorded compared to the rural areas. The major sources of sugar intake in children were white sugar, cool drinks, and carbonated beverages. About 77% of the children consumed white or brown sugar at the breakfast table. Older and urban children had a higher consumption of cool drinks, which contributed to higher intake of added sugar.

As the weekly household food expenditure increased, added sugar consumption and % EAS also increased along with the consumption of energy, protein, and fat. The intake of vegetables, fruits, fats and oils, meat, poultry products, fish, dairy products, and eggs increased in the higher quartiles of % EAS intake. The consumption of cereals, roots, tubers, vitamin A-rich fruits and vegetables, legumes, nuts, and dairy foods decreased with increased % EAS intake.

The % EAS increased with DDS and FVS, but not with MAR. Added sugar intake increased with an increase in intake of all micronutrients, except vitamin B12 and magnesium. However, the added sugar intake increased as protein, fibre, thiamine, pantothenic acid, biotin, vitamin E, calcium, phosphorus, magnesium, and zinc decreased. Overweight and obesity were more common in older children, aged 4–8 years, compared to children aged 1–3 years. Stunting and underweight were less common inchildren from in urban areas compared to children from rural areas.

This study has some limitations. While collecting information on the child’s dietary intake, caregivers may have under-reported the amount of snacks and sugar-sweetened beverages consumed outside the house. The study indicated that when the child’s sugar intake increased, dietary diversity and food variety also increased, while, at the same time, the consumption of proteins, fibre, and micronutrients decreased. Higher added sugar intake, overweight, and obesity were more common in the older children, aged 4–8 years, compared to younger ones, aged 1–3 years.

News source – Maunder EM, Nel JH, Steyn NP, Kruger HS, Labadarios D. Added sugar, macro–and micronutrient intakes and anthropometry of children in a developing world context. PloS one. 2015 Nov 11; 10 (11):e0142059.