The 2015 to 2020 Dietary Guidelines for Americans recommend that added sugar (AS) consumption be limited to less than 10% of the total energy intake to reduce the risk of obesity and chronic disease. Currently, individuals 2 years or older in the United States consume nearly 15% of their daily total energy as ASs. Little is known about the sugar consumption patterns of younger children. This study used dietary data from the 2009 to 2010 and 2011 to 2012 cycles of the National Health and Nutrition Examination Survey and AS content information from the 2009 to 2010 and 2011 to 2012 Food Patterns Equivalents Database to estimate AS intake consumed by US toddlers aged 12 up to 24 months). Food codes and descriptions were used to categorize all sugars as either dairy or nondairy and as ASs or naturally occurring sugars (NOSs). Sugars were also categorized by the forms in which they were consumed—liquids (beverages) versus solids (foods). Intake was assessed for all children by demographic subgroups and by occasion and location of consumption. Statistical analyses were conducted using SAS 9.4 software (Cary, North Carolina). Sample weights were applied to obtain nationally representative estimates of intake, and SAS survey procedures were used to account for the complex sampling methods used in the National Health and Nutrition Examination Survey. United States toddlers consumed an average of 90.5 g/d of total sugars, which provided 30.1% of their total energy intake. Most of the sugars consumed (64.4 ± 2.5 g) were NOSs. Mean daily intake of AS among toddlers was 26.2 ± 1.3 g, which was 8.4% of their total energy intake. The leading sources of AS for toddlers were sweetened fruit juices/fruit flavored drinks (23.3%), cakes/cookies/pastries/pies (15.3%), sugars/sweets (10.3%), cereals/rice/pasta (8.4%), and yogurt (7.3%). The consumption of AS among US toddlers approaches the limit recommended by the 2015 to 2020 Dietary Guidelines for Americans for the prevention of obesity and chronic disease. The leading sources of AS are those that tend to lack nutrients important in the diets of young children.
Jean A. Welsh, PhD, MPH, is an assistant professor in the Department of Pediatrics at Emory University, Atlanta, and the research director for the Strong4Life (Child Obesity Prevention) Initiative at Children’s Healthcare of Atlanta, Georgia.
Janet Figueroa, MPH, is a biostatistician with the Pediatric Biostatistics Core at Emory University School of Medicine, Atlanta, and a member of the research and evaluation team at the Strong4Life (Child Obesity Prevention) Initiative at Children’s Healthcare of Atlanta, Georgia.
This article is based on a presentation by Dr Jean Welsh during a conference held in Washington, DC, on October 29–30, 2015. This conference was funded by the Sugar Association and planned in part by the Department of Pediatrics Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus.
Dr. Welsh received travel expenses and an honorarium from The Sugar Association for her participation in the conference. Ms Figueroa received an honorarium from Lippincott Williams and Wilkins for her assistance with the data analysis and the preparation of this article. This article appears in the Nutrition Today supplement, Sweet Taste Perception and Feeding Toddlers, funded by The Sugar Association.
The authors have no conflicts of interest to disclose.
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Correspondence: Jean A. Welsh, PhD, MPH, Department of Pediatrics, Emory University, 1760 Haygood Dr, Atlanta, GA 30322 (firstname.lastname@example.org).