Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001–2018

Abstract

Background Over the past 2 decades there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intakes, particularly among children, adolescents and teens. Objective The present study provides a comprehensive time trends analysis of added sugars intake and contributing sources in the diets of U.S. children, adolescents and teens (2–18 y) from 2001–2018, focusing on variations according to sociodemographic factors (age, sex, race and ethnicity, income), food assistance and health-related factors (physical activity, body weight status). Methods Data from 9 consecutive 2-y cycles of the National Health and Nutrition Examination Survey (NHANES) were combined and regression analyses were conducted to test for trends in added sugars intake and sources from 2001–2018 for the overall age group (2–18 y) and for 2 age subgroups (2–8 and 9–18 y). Trends were also examined on subsamples stratified by sex, race and ethnicity (Hispanic, non-Hispanic Asian, non-Hispanic Black, non-Hispanic White), income (household poverty income ratio), food assistance, physical activity and body weight status. Results From 2001–2018, added sugars intake decreased significantly (P < 0.01) from 15.6 to 12.6% kcal among children (2–8 y) and from 18.4 to 14.3% kcal among adolescents and teens (9–18 y), mainly due to significant declines in added sugars from sweetened beverages, which remained the top source. Declines in added sugars intake were observed for all strata, albeit to varying degrees. Conclusions Declines in added sugars intake were observed among children, adolescents and teens from 2001–2018, regardless of sociodemographic factors, food assistance, physical activity or body weight status, but variations in the magnitude of decline suggest persistent disparities related to race and ethnicity and income. Despite these declines, intakes remain above the DGA recommendation, and thus continued monitoring is warranted.

Trends in Diet Quality by Race/Ethnicity among Adults in the United States for 2011–2018

“…Sweetened beverages, mainly soft drinks, are the number one source of added sugars among US adults; fruit drinks rank as the second largest source of added sugars among NH blacks and Hispanics [ 30 ]. Consistent with results among US youth [ 31 ], our results showed decreases in 100% fruit juice intake for most racial/ethnic groups, which may be one contributor to the observed declines in intakes of added sugars among US adults, particularly those in the Hispanic and NH black groups. Consistent with previous reports among US adults [ 32 ], we observed significant increases in egg consumption in most racial/ethnic groups, except among NH blacks, which may be owed to the removal of dietary egg restrictions from the Dietary Guidelines for Americans [ 33 ].…”

Trends in Sugar From Packaged Foods and Beverages Purchased by US Households Between 2002 and 2020

“…In terms of calories purchased from sugar, the biggest decrease occurred for households with children younger than 18 years. These results are consistent with recent studies finding decreases in sugar intake among children, 59 at least partially because of the efforts of scientists and professional societies to increase awareness about the risks of high sugar intake among children. 60 , 61 Percentage of purchases from sugar also decreased for households that identified as non-Hispanic other race/ethnicity, whereas households that identify as non-Hispanic Black had a smaller decrease and continued to be the racial or ethnic group with the highest sugar purchases.…”

Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence

“…Another strength of the ECHO Program is that cohort study sites span decades of data collection, with some beginning collection in the 1980s, allowing for examination of secular trends in diet over time. For example, decreases in sugar-sweetened beverage consumption among US children from 2001–2018 were identified using NHANES data [ 65 ]. Using ECHO data, similar analyses could be achieved, potentially with an expanded time interval and the inclusion of the same group of children over time.…”