Intakes of Total, Free, and Naturally Occurring Sugars in the French-Speaking Adult Population of the Province of Québec, Canada: The PREDISE Study

Abstract

The objective of this study was to characterize the intakes of different types of sugars in an age- and sex-representative sample of French-speaking adults from five regions of the Province of Québec, Canada, enrolled in the cross-sectional PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) study (n = 1147, 18–65 years old; 50.2% women). Because only total sugar content of foods and beverages is available in the Canadian Nutrient File (CNF) 2015, the initial step of this study was thus to build a database of free and naturally occurring sugars content of each food item and recipe included in the R24W, which is an automated, self-administered, web-based, 24-h dietary recall validated to estimate nutrient intakes in French-speaking adults of the Province of Québec. Total sugars were manually differentiated into free and naturally occurring sugars using a systematic algorithm based on previously published systematic algorithms. The World Health Organization (WHO)’s free sugar definition was used to differentiate total sugars into free and naturally occurring sugars. Dietary intake estimates were assessed using three 24-h dietary recalls completed with the R24W. Mean total, free, and naturally occurring sugar intakes were 116.4 g (19.3% of daily energy intake (%E)), 72.5 g (11.7%E), and 44.0 g (7.5%E), respectively. Over half (57.3%) of the overall sample did not meet the WHO’s recommendation to consume less than 10%E from free sugars. Women had a higher %E from naturally occurring sugars than men and being younger was associated with a greater %E from free sugars. Sugar intakes among French-speaking adults from the Province of Québec were mainly in the form of free sugars, with the majority of the population exceeding the WHO recommendation regarding free sugar intake. This suggests that public health efforts towards reducing free sugar intake in this population are relevant and necessary, considering that overconsumption of free sugars negatively influences health outcomes.

Free Sugars Consumption in Canada

“…Other Canadian-based studies showed similar results [ 14 , 15 , 22 , 23 ] A study by Bergeron et al 2019 in French-speaking adults ≥18 years in the province of Québec reported an average of 12%E consumption from FS, which is close to our results (11%E in adults) [ 14 ] Additionally, a study by Wang et al published in 2020, using 2015 CCHS-Nutrition data as well, estimated an average consumption of 9.9%E from FS, for Canadian adults >19 years [ 23 ]. Veugelers et al, 2020 also found similar estimates (13.3%E) of FS for Canadians using 2015 CCHS Nutrition data [ 22 ].…”

“…In general, the approaches used to estimate FS intake in all these studies are similar but appear to have a few differences [ 14 , 15 , 22 , 23 ]. One of the factors influencing the estimates is what researchers included in their definition of FS.…”

“…As well, since an ingredient list is not available in the CNF, professional judgement was required when going through the different steps to estimate FS. We also used the University of Toronto’s FLIP database that has nutritional information of food and drink products in the Canadian food supply, rather than databases from other countries which other Canadian studies have used [ 9 , 14 , 22 , 23 ]. These methodological nuances could lead to different decisions when it comes to identifying food sources of FS and, thus, the impact population-level estimates.…”

“…We reviewed the existing methodologies and explored options to assess the FS in foods [ 13 , 14 , 15 , 16 , 17 ]. Most of these methods require ingredient lists of foods to estimate the FS.…”

Canadian Adults with Moderate Intakes of Total Sugars have Greater Intakes of Fibre and Key Micronutrients: Results from the Canadian Community Health Survey 2015 Public Use Microdata File

“…Compared to a contribution of 11.7 %E from free sugars in a cohort of French-speaking adults living in Quebec Canada (the PREDISE Study) [54], this analysis of 2015 CCHS-Nutrition showed a lower national average for free sugars (9.9%E), which may in part be related to a slightly different age range (19 years and older in 2015 CCHS-Nutrition as compared to 18 to 65 years old in the PREDISE Study), as well as some unique cultural traditions, lifestyle and dietary habits and food choices among Quebec residents [55,56]. Compared to sugars intake in other developed countries, added sugars intake in Canadian adults (8.6%E, 42 g/day) was about 30% lower than recent reports for American adults (13.1%E for added sugars, NHANES 2009-2012) and Australian adults (60.3 g/day for added sugars, Australian Health Survey 2011-2012) [36,57].…”