A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology

Abstract

Previous systematic reviews, which focused on sugars intake and its relationship with health issues were mainly conducted in Western countries, not Asian countries characterised by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugars intake. To provide an overview of the epidemiological studies on sugars intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugars intake, we conducted a scoping review of the epidemiological studies estimating sugars intake in Asian countries (the United Nations’ definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugars intake in the whole diet, dietary assessment methods, and data sources used for estimating sugars content. We identified 143 studies from 136 publications from Eastern (n=63), Southern (n=30), South-eastern (n=26), and Western (n=24) Asia. Total sugars were investigated in 95 studies, while 23–30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relationships (n=85) and estimation of dietary intake (n=40), and 62 studies assessed sugars as the primary exposure/outcome. One hundred twenty studies assessed sugars intake in the whole diet, and 62 studies used validated FFQ or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food composition databases or directly measured the sugars content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugars intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugars composition databases, are essential for producing high quality studies with accurate sugars intake to examine their association with health outcomes.

Preventive epidemiology as a branch of epidemiology

“…Prevention studies in epidemiology can help pinpoint potential disease risks and guide strategies to prevent them (3). For instance, evaluating diet is a critical aspect of preventive epidemiology, so that various techniques, such as food frequency questionnaires and food composition databases, can be utilized to assess dietary intake for preventing diseases (4).…”