It has been postulated that dietary sugar consumption contributes to increased inflammatory processes in humans, and that this may be specific to fructose (alone, in sucrose or in high-fructose corn syrup (HFCS)). Therefore, we conducted a meta-analysis and systematic literature review to evaluate the relevance of fructose, sucrose, HFCS, and glucose consumption for systemic levels of biomarkers of subclinical inflammation. MEDLINE, EMBASE, and Cochrane libraries were searched for controlled intervention studies that report the effects of dietary sugar intake on (hs)CRP, IL-6, IL-18, IL-1RA, TNF-α, MCP-1, sICAM-1, sE-selectin, or adiponectin. Included studies were conducted on adults or adolescents with ≥20 participants and ≥2 weeks duration. Thirteen studies investigating 1141 participants were included in the meta-analysis. Sufficient studies (≥3) to pool were only available for (hs)CRP. Using a random effects model, pooled effects of the interventions (investigated as mean difference (MD)) revealed no differences in (hs)CRP between fructose intervention and glucose control groups (MD: −0.03 mg/L (95% CI: −0.52, 0.46), I2 = 44%). Similarly, no differences were observed between HFCS and sucrose interventions (MD: 0.21 mg/L (−0.11, 0.53), I2 = 0%). The quality of evidence was evaluated using Nutrigrade, and was rated low for these two comparisons. The limited evidence available to date does not support the hypothesis that dietary fructose, as found alone or in HFCS, contributes more to subclinical inflammation than other dietary sugars.
Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.
Purpose To describe age and time trends in dietary intake of Total Dairy (TD) (g/1000 kcal Total Energy Intake) and types of dairy (weight percent of total dairy intake, w%TD) represented as Low Fat Dairy (LFD), High Sugar Dairy (HSD), Fermented Dairy (FD) and Liquid Dairy (LD) among children and adolescents in Germany. Methods Overall, 10,333 3-day dietary records kept between 1985 and 2019 by 1275 DONALD participants (3.5–18.5 years; boys: 50.8%) were analyzed using polynomial mixed-effects regression models. Results TD intake decreased with age (♂: linear trend p < 0.0001; ♀: linear and quadratic trend p < 0.0001), whereas FD (♀: linear, quadratic, cubic trend p ≤ 0.02) increased slightly in girls. HSD (♂: linear, quadratic, cubic trend p ≤ 0.004; ♀: linear, quadratic, cubic trend p ≤ 0.005) and LD (linear, quadratic trend p ≤ 0.0002) decreased with age. In terms of time trends, TD intake decreased in the last three decades, especially since 1995 (quadratic trend for ♂ 0.0007 and ♀ p = 0.004). LFD intake increased until 2010 and decreased thereafter (linear, quadratic, cubic trend p < 0.0001). HSD decreased until 1995, then increased until 2010 and decreased again afterwards (♂: linear, quadratic, cubic trend p ≤ 0.001; ♀: linear, quadratic, cubic trend p ≤ 0.003). While FD intake increased linear (in both ♂ and ♀: p < 0.0001), LD intake decreased (linear, quadratic trend p ≤ 0.03). Conclusion Our results showed changes in dairy consumption patterns among children and adolescents over the past three decades, demonstrating a decrease in TD intake with age and time, and a shift from liquid to solid dairy products with a simultaneous increase in fermented dairy products, while LFD and HSD fluctuated over time. Further evaluations will examine the health significance of these consumption patterns.
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