A review of total & added sugar intakes and dietary sources in Europe

Abstract

Public health policies, including in Europe, are considering measures and recommendations to limit the intake of added or free sugars. For such policies to be efficient and monitored, a precise knowledge of the current situation regarding sugar intake in Europe is needed. This review summarizes published or re-analyzed data from 11 representative surveys in Belgium, France, Denmark, Hungary, Ireland, Italy, Norway, The Netherlands, Spain and the UK. Relative intakes were higher in children than in adults: total sugars ranged between 15 and 21% of energy intake in adults and between 16 and 26% in children. Added sugars (or non-milk extrinsic sugars (NMES), in the UK) contributed 7 to 11% of total energy intake in adults and represented a higher proportion of children’s energy intake (11 to 17%). Educational level did not significantly affect intakes of total or added sugars in France and the Netherlands. Sweet products (e.g. confectionery, chocolates, cakes and biscuits, sugar, and jam) were major contributors to total sugars intake in all countries, genders and age groups, followed by fruits, beverages and dairy products. Fruits contributed more and beverages contributed less to adults’ total sugars intakes than to children’s. Added sugars were provided mostly by sweet products (36 to 61% in adults and 40 to 50% in children), followed by beverages (12 to 31% in adults and 20 to 34% in children, fruit juices excluded), then by dairy products (4 to 15% in adults and 6 to 18% in children). Caution is needed, however, as survey methodologies differ on important items such as dietary data collection, food composition tables or estimation of added sugars. Cross-country comparisons are thus not meaningful and overall information might thus not be robust enough to provide a solid basis for implementation of policy measures. Data nevertheless confirm that intakes of total and added sugars are high in the European countries considered, especially in children, and point to sweet products and beverages as the major contributors to added sugar intakes.

The Importance of the World Health Organization Sugar Guidelines for Dental Health and Obesity Prevention

“…In addition, emerging research suggest that diet high in sugars may increase the risk of developing dementia such as Alzheimer disease Pase et al, 2017]. Although, trends between added sugar intake and socioeconomic status (SES) in Europe are not as clear as in the US [Azaïs-Braesco et al, 2017], data from the UK show that low SES is associated with higher added sugar intake. Individuals from lower SES also experience a higher prevalence of tooth decay and obesity and its health consequences (Sugar Reduction, The Evidence for Action, 2015).…”

“…In Europe, the consumption of added sugars 4 currently contributes between 7-11 and 11-17% of the total energy intake in adults and children, respectively [Azaïs-Braesco et al, 2017]. Worldwide, data suggest that added sugar intake begins to rise from the age of 1 year, and is highest among school-age children and adolescents compared to younger children or adults [Newens and Walton, 2016].…”

“…Worldwide, data suggest that added sugar intake begins to rise from the age of 1 year, and is highest among school-age children and adolescents compared to younger children or adults [Newens and Walton, 2016]. Sweet products (i.e., cakes, biscuits, pastries, confectionary, jam/honey, ice cream, table sugar), beverages (i.e., sugar-sweetened beverages and fruit nectars excluding fruit juice) and dairy products (i.e., yoghurts, milk-based desserts) contribute most to added sugar intake in both adults and children [Azaïs-Braesco et al, 2017;Bailey et al, 2018]. In addition to the definitional differences between added sugars and free sugars, added sugars (and foods rich in added sugars) are also the items that are most underreported by both adults and children in dietary surveys [Newens and Walton, 2016].…”

Estimation of total, added and free sugar intakes in Japanese adults using a newly developed food composition database

“…For free sugar intake (Fig. 3), 8·2 % for men and 13·3 % for women exceeded the recommendation by WHO (10 %E), while the percentage of participants consuming <5 %E (the WHO conditional recommendation and the UK recommendation) was 44·9 % for men and 12·2 % for women, respectively.In conclusion, mean sugar intakes in this Japanese population were lower than those in Western countries (14·5-20·2 %E for total sugar and 7·3-13·2 %E for added sugar (4,5) ). Nevertheless, while the prevalence of excessive intake (≥10 %E of free sugar) was low, there were only a few participants whose intake was within the recommended limit (<5 %E of free sugar), particularly in women.…”

“…In conclusion, mean sugar intakes in this Japanese population were lower than those in Western countries (14·5-20·2 %E for total sugar and 7·3-13·2 %E for added sugar (4,5) ). Nevertheless, while the prevalence of excessive intake (≥10 %E of free sugar) was low, there were only a few participants whose intake was within the recommended limit (<5 %E of free sugar), particularly in women.…”