Skip to main content Accessibility help
×
Home

Total, added and free sugar intakes, dietary sources and determinants of consumption in Portugal: the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016)

  • Ana Rita Marinho (a1) (a2), Milton Severo (a1) (a2), Daniela Correia (a2), Liliane Lobato (a2), Sofia Vilela (a1) (a2), Andreia Oliveira (a1) (a2), Elisabete Ramos (a1) (a2), Duarte Torres (a2) (a3), Carla Lopes (a1) (a2) and on behalf of the IAN-AF Consortium (a1) (a2) (a3)...

Abstract

Objective:

To assess total sugar (TS), added sugar (AS) and free sugar (FS) intakes, dietary sources, adherence to recommendations and determinants of consumption, in a Portuguese national sample.

Design:

Cross-sectional study. Dietary assessment was obtained by two food diaries in children aged <10 years and two non-consecutive 24 h recalls for other age groups. TS, AS and FS intakes were estimated by using SPADE software. TS content in food was estimated at the ingredient level. AS content in food was assessed through a systematic methodology and FS was based on the WHO definition.

Setting:

National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016), Portugal.

Participants:

Representative sample from the Portuguese population, aged from 3 months to 84 years (n 5811).

Results:

Mean daily intake and contribution to total energy intake (E%) were 84·3 g/d (18·5 E%) for TS, 32·1 g/d (6·8 E%) for AS and 35·3 g/d (7·5 E%) for FS. Of the population, 76 % adhered to the FS recommendation (FS < 10 E%). The lowest adherence was in children (51·6 %) and adolescents (51·3 %). The main dietary source of TS was fruit across all ages, except in adolescents which was soft drinks. In children, the main dietary sources of FS were yoghurts and sweets, soft drinks in adolescents and table sugar in adults/elderly. FS intake was lower in children with more educated parents and in adults who practised physical activity regularly, and higher among smokers.

Conclusions:

Interventions ought to be planned towards decreasing intakes of added and free sugars considering population-specific characteristics.

Copyright

Corresponding author

*Corresponding author: Email carlal@med.up.pt

Footnotes

Hide All

Members of the IAN-AF Consortium are listed in the Appendix.

Footnotes

References

Hide All
1. Te Morenga, L, Mallard, S & Mann, J (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 346, e7492.
2. Moynihan, P (2016) Sugars and dental caries: evidence for setting a recommended threshold for intake. Adv Nutr 7, 149156.
3. Yang, Q, Zhang, Z, Gregg, EW et al. (2014) Added sugar intake and cardiovascular diseases mortality among us adults. JAMA Intern Med 174, 516524.
4. Greenwood, DC, Threapleton, DE, Evans, CEL et al. (2014) Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose–response meta-analysis of prospective studies. Br J Nutr 112, 725734.
5. Louie, JC & Tapsell, LC (2015) Association between intake of total vs added sugar on diet quality: a systematic review. Nutr Rev 73, 837857.
6. Ruiz, E, Rodriguez, P, Valero, T et al. (2017) Dietary Intake of individual (free and intrinsic) sugars and food sources in the Spanish population: findings from the ANIBES study. Nutrients 9, 275.
7. Azaïs-Braesco, V, Sluik, D, Maillot, M et al. (2017) A review of total & added sugar intakes and dietary sources in Europe. Nutr J 16, 6.
8. Bray, GA & Popkin, BM (2014) Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes? Health be damned! pour on the sugar. Diabetes Care 37, 950956.
9. Kahn, R & Sievenpiper, JL (2014) Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes? We have, but the pox on sugar is overwrought and overworked. Diabetes Care 37, 957962.
10. Zheng, M, Rangan, A, Olsen, NJ et al. (2014) Sugar-sweetened beverages consumption in relation to changes in body fatness over 6 and 12 years among 9-year-old children: the European Youth Heart Study. Eur J Clin Nutr 68, 7783.
11. Malik, VS, Pan, A, Willett, WC et al. (2013) Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 98, 10841102.
12. European Food Safety Authority (2010) Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFSA J 8, 14621539.
13. Gibson, S (2008) Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions. Nutr Res Rev 21, 134147.
14. European Food Safety Authority (2009) Review of labelling reference intake values – Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to the review of labelling reference intake values for selected nutritional elements. EFSA J 7, 10011014.
15. World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. 916. Geneva: WHO.
16. World Health Organization (2015) Guideline: Sugars Intake for Adults and Children. Geneva: WHO.
17. Scientific Advisory Committee on Nutrition (2015) SACN Carbohydrates and Health report. https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report (accessed May 2016).
18. Nordic Council of Ministers (2014) Nordic Nutrition Recommendations 2012: Integrating Nutrition and Physical Activity, 5th ed. Copenhagen: Nordisk Ministerråd.
19. US Department of Health and Human Services & US Department of Agriculture (2015) Dietary Guidelines for Americans 2015–2020, 8th ed. http://health.gov/dietaryguidelines/2015/guidelines/ (accessed July 2016).
20. Newens, KJ & Walton, J (2016) A review of sugar consumption from nationally representative dietary surveys across the world. J Hum Nutr Diet 29, 225240.
21. Mis, NF, Braegger, C, Bronsky, J et al. (2017) Sugar in infants, children and adolescents: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 65, 681696.
22. European Food Safety Authority (2014) Guidance on the EU Menu methodology. EFSA J 12, 3944.
23. Lopes, C, Torres, D, Oliveira, A et al. (2018) National food, nutrition, and physical activity survey of the Portuguese general population (2015–2016): protocol for design and development. JMIR Res Protoc 7, e42.
24. Carla, L, Duarte, T, Andreia, O et al. (2017) National food, nutrition and physical activity survey of the Portuguese general population. EFSA Supporting Publications 14, 1341E.
25. Vilela, S, Lopes, C, Guiomar, S et al. (2018) Validation of a picture book to be used in a pan-European dietary survey. Public Health Nutr 21, 16541663.
26. National Institute of Health Doutor Ricardo Jorge (2006) Food Composition Table. Lisbon: National Institute of Health Dr Ricardo Jorge.
27. Roe, MA, Bell, S, Oseredczuk, M et al. (2013) Updated food composition database for nutrient intake. EFSA Supporting Publications 10, 355E.
28. Reinivuo, H, Bell, S & Ovaskainen, M-L (2009) Harmonisation of recipe calculation procedures in European food composition databases. J Food Compost Anal 22, 410413.
29. Louie, JCY, Moshtaghian, H, Boylan, S et al. (2015) A systematic methodology to estimate added sugar content of foods. Eur J Clin Nutr 69, 154161.
30. Dekkers, ALM, Verkaik-Kloosterman, J, van Rossum, CTM et al. (2014) SPADE, a new statistical program to estimate habitual dietary intake from multiple food sources and dietary supplements. J Nutr 144, 20832091.
31. R Core Team (2017) R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing.
32. Sluik, D (2016) Total, free, and added sugar consumption and adherence to guidelines: the Dutch National Food Consumption Survey 2007–2010. Nutrients 8, 70.
33. Louie, JC, Moshtaghian, H, Rangan, AM et al. (2016) Intake and sources of added sugars among Australian children and adolescents. Eur J Nutr 55, 23472355.
34. Lluch, A, Maillot, M, Gazan, R et al. (2017) Individual diet modeling shows how to balance the diet of French adults with or without excessive free sugar intakes. Nutrients 9, 162.
35. Lei, L, Rangan, A, Flood, VM et al. (2016) Dietary intake and food sources of added sugar in the Australian population. Br J Nutr 115, 868877.
36. Pawellek, I, Grote, V, Theurich, M et al. (2016) Factors associated with sugar intake and sugar sources in European children from 1 to 8 years of age. Eur J Clin Nutr 71, 2532.
37. Kranz, S & Siega-Riz, AM (2002) Sociodemographic determinants of added sugar intake in preschoolers 2 to 5 years old. J Pediatr 140, 667672.
38. Oliveira, A, Maia, B & Lopes, C (2014) Determinants of inadequate fruit and vegetable consumption amongst Portuguese adults. J Hum Nutr Diet 27, 194203.
39. Moreira, PA & Padrão, PD (2004) Educational and economic determinants of food intake in Portuguese adults: a cross-sectional survey. BMC Public Health 4, 58.
40. Kaartinen, NE, Similä, ME, Kanerva, N et al. (2017) Naturally occurring and added sugar in relation to macronutrient intake and food consumption: results from a population-based study in adults. J Nutr Sci 6, e7.
41. Khan, TA & Sievenpiper, JL (2016) Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes. Eur J Nutr 55, 2543.
42. Carlson, JA, Crespo, NC, Sallis, JF et al. (2012) Dietary-related and physical activity-related predictors of obesity in children: a 2-year prospective study. Child Obes 8, 110115.
43. Gibson, S & Neate, D (2007) Sugar intake, soft drink consumption and body weight among British children: further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity. Int J Food Sci Nutr 58, 445460.
44. Moshtaghian, H, Louie, JCY, Charlton, KE et al. (2016) Added sugar intake that exceeds current recommendations is associated with nutrient dilution in older Australians. Nutrition 32, 937942.
45. Sieri, S, Krogh, V, Saieva, C et al. (2009) Alcohol consumption patterns, diet and body weight in 10 European countries. Eur J Clin Nutr 63, Suppl. 4, S81S100.
46. Portuguese Legislation (2017) Integrated Strategy for the Promotion of Healthy Eating. Order nº. 11418/2017 of the 29th of December 2017. Portuguese Official State Gazette nº. 249.

Keywords

Type Description Title
WORD
Supplementary materials

Marinho et al. supplementary material
Table S1

 Word (19 KB)
19 KB

Total, added and free sugar intakes, dietary sources and determinants of consumption in Portugal: the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016)

  • Ana Rita Marinho (a1) (a2), Milton Severo (a1) (a2), Daniela Correia (a2), Liliane Lobato (a2), Sofia Vilela (a1) (a2), Andreia Oliveira (a1) (a2), Elisabete Ramos (a1) (a2), Duarte Torres (a2) (a3), Carla Lopes (a1) (a2) and on behalf of the IAN-AF Consortium (a1) (a2) (a3)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed