Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

Abstract

A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.

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

“…The difference between NMES and free sugars is that non-milk extrinsic sugars include 50% of the fruit sugars from stewed, dried or canned fruit (assuming that processing changes intrinsic sugars into extrinsic ones) but free sugars does not take processing effects into account [20]. In this review, data have been gathered on total sugars, added sugars and NMES; only one survey reported intakes on “free sugars” [21]. In some studies analyzed in this review, the wording “soluble carbohydrates” can be found, and this term was assumed to correspond to “sugars” [22].…”

“…When several surveys were identified in the same country, only the most recent was analyzed and no survey older than 20 years was retained since the aim was to present the most current intakes. Eleven nation-wide surveys, providing reliable data on total and/or added sugars or NMES have been identified in 10 countries: Belgium [23], Denmark [24], France [25], Hungary [26], Ireland [27, 28], Italy [22, 29], the Netherlands [21, 30], Norway [31], Spain [32, 33], and the UK [34] (Table 1). Information has been also identified from representative surveys carried out in Austria [35], Finland [36] and Germany [37, 38].…”

Sugar Restriction for Caries Prevention: Amount and Frequency. Which Is More Important?

“…Also the type of products, sugar sweetened beverages and fruit drinks, sweets and candy, and sweetened diary products (milk excepted) contributing to the intake of sugar [Sluik et al, 2016] lend themselves to skip, to combine or to reduce the moments of intake.…”

“…Assuming a daily energy intake of 2,000 kcal, 10 E% equals 50 g of sugar a day and 5 E% equals 25 g a day. At the moment, for instance in the Netherlands, the average daily energy intake from free sugars is 14% for the whole population but varies from 20% for children and adolescents to 11% for those over the age of 50 [Sluik et al, 2016]. Added sugars constitute approximately 80-90% of this energy intake from free sugars.…”

“…Added sugars constitute approximately 80-90% of this energy intake from free sugars. Significant contributors, for approximately 80%, are non-alcoholic beverages (sugar sweetened beverages and fruit drinks), sweets and candy and dairy products (with the exception of milk) [Sluik et al, 2016].…”