Consumption of added sugars among US children and adults by food purchase location and food source

Abstract

Background: The proposed changes to the Nutrition Facts Label by the US Food and Drug Administration will include information on added sugars for the first time.

Objective: The objective was to evaluate the sources of added sugars in the diets of a representative sample of US children and adults by food purchase location and food source (eg, food group).

Design: This cross-sectional study among 31,035 children, adolescents, and adults aged ≥6 y from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 NHANES used data from a 24-h dietary recall to evaluate consumption of added sugars. Food locations of origin were identified as stores (supermarket or grocery store), quick-service restaurants/pizza (QSRs), full-service restaurants (FSRs), schools, and others (eg, vending machines or gifts). Added sugars consumption by food purchase location was evaluated by age, family income-to-poverty ratio, and race-ethnicity. Food group sources of added sugars were identified by using the National Cancer Institute food categories.

Results: Added sugars accounted for ∼14.1% of total dietary energy. Between 65% and 76% of added sugars came from stores, 6% and 12% from QSRs, and 4% and 6% from FSRs, depending on age. Older adults (aged ≥51 y) obtained a significantly greater proportion of added sugars from stores than did younger adults. Lower-income adults obtained a significantly greater proportion of added sugars from stores than did higher-income adults. Intake of added sugars did not vary by family income among children/adolescents. Soda and energy and sports drinks were the largest food group sources of added sugars (34.4%), followed by grain desserts (12.7%), fruit drinks (8.0%), candy (6.7%), and dairy desserts (5.6%).

Conclusions: Most added sugars came from foods obtained from stores. The proposed changes to the Nutrition Facts Label should capture the bulk of added sugars in the US food supply, which suggests that the recommended changes have the potential to reduce added sugars consumption.

FIGURE 1.

Mean added sugars (tsp equivalent) consumption by food purchase location and age group, NHANES 2003–2010. 1 tsp equivalent = ∼4.2 g table sugar (23). Values in parentheses are SEs. Asterisks indicate a statistically significant difference from the 20–50 y age group (reference group; age 12–19 y is the reference group for school data) based on a survey-weighted Wald test: ***P < 0.001, **0.001 < P < 0.01, *0.01 < P < 0.05. FSR, full-service restaurant; QSR, quick-service restaurant; ref, reference; tsp, teaspoon.

FIGURE 2.

Age-adjusted mean added sugars (tsp equivalent) intake by food purchase location and family income-to-poverty ratio among US children/adolescents (age 6–19 y) and adults (age ≥ 20 y), NHANES 2003–2010. 1 tsp equivalent = ∼4.2 g table sugar (23). Values in parentheses are SEs. Asterisks indicate a statistically significant difference from the family income-to-poverty ratio < 1 (reference group) based on a survey-weighted Wald test: ***P < 0.001, **0.001 < P < 0.01, *0.01 < P < 0.05. FSR, full-service restaurant; QSR, quick-service restaurant; ref, reference; tsp, teaspoon.

FIGURE 3.

Age-adjusted mean added sugars (tsp equivalent) intake by food purchase location and race-ethnicity among US children/adolescents (age 6–19 y) and adults (age ≥ 20 y), 2003–2010. 1 tsp equivalent = ∼4.2 g table sugar (23). Values in parentheses are SEs. Asterisks indicate a statistically significant difference from non-Hispanic whites (reference group) based on a survey-weighted Wald test: ***P < 0.001, **0.001 < P < 0.01, *0.01 < P < 0.05. FSR, full-service restaurant; QSR, quick-service restaurant; ref, reference; tsp, teaspoon.