The recommended level of five fruits and vegetables per day is reached by a minority of French children. No-added sugars fruit puree (NASFP) can be consumed as a complement of fresh fruit to meet the recommendation for fruits and vegetables. The objective was to simulate the nutritional impact of an increase in consumption of NASFP among French children, together with a reduction in sweetened foods.

The study was conducted on French children aged 1–17 years. The simulation consisted in introducing NASFP on four different eating occasions (breakfast, lunch, snack and dinner) to reach one serving and removing the same serving of sweetened foods. Intakes in nutrients to favour, nutrients to limit and prevalence of adequacy to nutritional requirements were compared between observed and simulated diets in the whole sample and in five different age groups.

France.

Children from 1 to 17 years of age in the last available French representative dietary survey (INCA3).

Simulated diets were more nutrient-dense thanks to increases in nutrients to favour from NASFP (especially fibres, iodine, Se, and vitamin A and C) associated with reductions in energy and nutrients to limit (especially free sugars) coming from sweetened foods. Prevalence of adequacy increased from 2 to 14·5 points for fibres and from 4·5 to 12 points for free sugars according to age group and eating occasion.

Promoting NASFP in replacement of sweetened products is a promising strategy to improve the nutritional quality of French children’s diet through a better adherence to national guidelines.

To develop and internally validate a Free Sugars Screener (FSS) for Australian children aged 2 and 5 years.

Using data collected from a ninety-nine-item (2-year-olds) and ninety-eight-item (5-year-olds) FFQ in the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE-FFQ), a regression-based prediction modelling approach was employed to identify a subset of items that accurately estimate total free sugars intake (FSI). The predictors were grams of free sugars (FSg) for individual items in the SMILE-FFQ and child’s age and sex. The outcome variable was total FSI per person. To internally validate the SMILE-FSS items, the estimated FSg was converted to percent energy from free sugars (%EFS) for comparison to the WHO free sugars guideline categories (< 5 %, 5–< 10 % and ≥ 10 %EFS) using cross-classification analysis.

Australia.

858 and 652 2- and 5-year-old children, respectively, with complete dietary (< 5 % missing) and sociodemographic data.

Twenty-two and twenty-six items were important in predicting FSI at 2 and 5 years, respectively. Items were similar between ages with more discretionary beverage items (e.g. sugar-sweetened beverages) at 5 years. %EFS was overestimated by 4·4 % and 2·6 %. Most children (75 % and 82 %) were categorised into the same WHO free sugars category with most (87 % and 95 %) correctly identified as having < 10 %EFS in line with the WHO recommendation.

The SMILE-FSS has good internal validity and can be used in research and practice to estimate young Australian children’s FSI and compare to the WHO free sugars guidelines to identify those ‘at risk’.

Governments worldwide have been implementing interventions aimed at improving citizens’ dietary habits. Examining how individuals perceive these interventions is relevant for promoting future policies in this area, as well as informing the way they are designed and implemented. In the current study, we focused on interventions aimed at reducing sugar intake in Portugal, given the current high sugar consumption patterns in the population.

Online survey to assess which interventions are the most salient and receive greater public support.

Portugal.

1010 (76·7 % female, MAge 36·33, sd 13·22).

Data from a free-recall task showed that only about one-third of participants reported knowing about these interventions, namely those related to taxation, weight restrictions in individual sugar packets and limited availability of products with high sugar content. We also found evidence of high support for the eight interventions presented (except for replacing sugar by artificial sweeteners), positive attitudes towards the need of reducing sugar intake in the Portuguese population and high agreement with the importance of reducing sugar intake across all age groups, particularly among children. Participants also indicated paying attention to the amount of sugar in their diets and a low self-reported frequency of consumption of high sugary foods and beverages. A hierarchical regression analysis suggested that these variables were significantly associated with the overall acceptance of interventions, independently of social-demographic variables (i.e., age, education and sex).

By examining how people perceive and accept different interventions targeting the reduction of sugar intake, the current work aims to support policymaking in this domain.

Emerging evidence suggests that free sugars intake in many countries exceeds that recommended by the WHO. However, information regarding real-world dietary patterns associated with meeting the WHO free sugars guidelines is lacking. The current study aimed to determine dietary patterns associated with meeting the guidelines to inform effective free sugars reduction interventions in New Zealand (NZ) and similar high-income countries.

Dietary patterns were derived using principal component analysis on repeat 24-h NZ Adult Nutrition Survey dietary recall data. Associations between dietary patterns and the WHO guidelines (<5 and <10 % total energy intake) were determined using logistic regression analyses.

New Zealand.

NZ adults (n 4721) over 15 years old.

Eight dietary patterns were identified: ‘takeaway foods and alcohol’ was associated with meeting both WHO guidelines; ‘contemporary’ was associated with meeting the <10 % guideline (males only); ‘fast foods, sugar-sweetened beverages and dessert’, ‘traditional’ and ‘breakfast foods’ were negatively associated with meeting both guidelines; ‘sandwich’ and ‘snack foods’ were negatively associated with the <5 % guideline; and ‘saturated fats and sugar’ was negatively associated with the <10 % guideline.

The majority of NZ dietary patterns were not consistent with WHO free sugars guidelines. It is possible to meet the WHO guidelines while consuming a healthier (‘contemporary’) or energy-dense, nutrient-poor (‘takeaway foods and alcohol’) diet. However, the majority of energy-dense patterns were not associated with meeting the guidelines. Future nutrition interventions would benefit from focusing on establishing healthier overall diets and reducing consumption and free sugars content of key foods.

To establish high intake of free sugars and its related disease burden as a significant public health challenge in Australia.

We discuss five key actions to reduce intake of free sugars tailored to the Australian context. These strategies are informed by reviewing the global scientific evidence on the effectiveness of a range of policy responses to reduce intake of free sugars at the population level.

Australia.

Australian population.

The five key actions to reduce population levels for intake of free sugars tailored to the Australian context include prioritising health in trade agreements and policy; introducing a fiscal policy supporting health and promoting food reformulation; regulating advertising and improving labelling; strengthening the current dietary guidelines; and encouraging healthy choices.

The adoption and implementation of the strategies discussed in the current commentary would aid in tackling the rising health burden from the intake of free sugars in Australia.

Studies have shown that the consumption of added sugars may be associated with harmful health effects. The present study investigated the presence and types of added sugars in packaged foods.

Cross-sectional analysis of the presence and types of added sugars in the ingredients lists of packaged foods sold in a major Brazilian supermarket. The nomenclature of ingredients classified as added sugars and their frequency were identified. Data were organised and analysed through descriptive statistics: absolute and relative frequencies of the presence of added sugars categorised by food groups were calculated, and ingredients were analysed by text mining using R statistical environment.

A supermarket in Florianópolis, a metropolis in southern Brazil.

Packaged food products (n 4539) classified into eight groups.

Of the 4539 products, 71 % had some type of added sugar. The group with the highest frequency of added sugars was ‘products in which carbohydrates and fats are the main energy source’ (93 %). Food groups containing predominantly salty foods had a high frequency of added sugars, such as ‘meats and eggs’ (61 %). In total, 179 different terms for added sugars were identified, of which sugar, maltodextrin and glucose syrup were the most frequent.

Most of the packaged foods sold in Brazil contain added sugars, which may hamper adherence to the recommendation of limiting added sugars intake. The data may be useful for monitoring tendencies in the use of added sugars in packaged foods and as supplementary information to support the improvement of food label regulations.

Excessive free sugars consumption has a possible role in health issues, diet quality and obesity development. The present cross-sectional study aimed to identify the major food sources of free sugars in Greek children’s diet and investigate possible associations of dietary patterns with free sugars intake.

Anthropometric measurements and information on dietary and physical activity habits were obtained. Energy and free sugars intake coming from foods were estimated and principal components analysis was applied to identify dietary patterns.

The GRECO (Greek Childhood Obesity) study.

Nationwide sample of 3089 children (aged 10–12 years).

Adopting WHO criteria, 44·2 % of participants were categorized as having free sugars intake above 10 % of total energy intake. Mean contribution of free sugars to energy intake was 11·2 %, and the major food sources of free sugars differed from those of other childhood populations. Free sugars intake was not associated with overweight/obesity. Multiple linear regression analysis revealed that two lifestyle and dietary patterns, characterized by higher consumption of sweets, fast foods, fries, sugared drinks, frequently ordering/eating outside home and having meals in front of a screen (pattern 1) and higher consumption of whole fruits, 100 % fruit juices, vegetables, legumes and honey/jam (pattern 2), were positively associated with free sugars intake.

A large proportion of children exceeded the recommended cut-off and free sugars intake was associated with lifestyle patterns rather than single foods. Public health programmes aiming to reduce free sugars consumption should be tailored on promoting the correct dietary habits of specific childhood populations.