Americans on diet: results from the 1994-1996 Continuing Survey of Food Intakes by Individuals

OBJECTIVE: To examine the prevalence of dieting to lose weight or for a health reason in a representative sample of US adults. DESIGN: Cross-sectional study design. SUBJECTS/SETTING: Data from 10,144 participants of the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996) were used in the analysis. All data were self-reported. STATISTICAL ANALYSIS: Analysis included: cross-tabulation of dieting status by sociodemographic characteristics; comparison of the type of diet, the reason for dieting, and the source of diet used by men and women; comparison of the nutrient intake and health status of dieters and nondieters. RESULTS: Prevalence of dieting varied by gender and race, being highest in white women (21%) and lowest in Hispanic men (8%). About 71% of all dieters reported that they were dieting to improve health, and 50% reported that they were dieting to lose weight. Dieters reported lower intakes of total fat, saturated fat, cholesterol, sodium, monounsaturated fat, polyunsaturated fat, calcium, and selenium compared with nondieters. The rate of chronic health conditions was higher among dieters than nondieters. Self-reported physical activity was similar in both groups. CONCLUSIONS: The prevalence of dieting varies according to sociodemographic characteristics. The reason for dieting and the type of diet used by dieters also vary and need to be studied further. Our results suggest that the dieters generally consumed a more nutrient-dense diet than the nondieters but still low in certain nutrients.     

Food label use by older Americans: data from the Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey 1994-96

This study examined older Americans' use of food labels as a tool to moderate dietary risk factors for heart disease. Data from the USDA's Continuing Survey of Food Intakes by Individual (CSFII) 1994- 96 and the Diet and Health Knowledge Survey (DHKS) from 2,846 respondents aged 51 years and older was used. Indices were constructed to measure and correlate dietary intake, label use and understanding, and health status data. Understanding and use of food labels was lower among older age groups, while heart-related health problems increased. Use of food labels and percent energy intake from fat were inversely related (P < 0.01). Older Americans would benefit from education on food label use and interpretation to decrease their dietary risk factors for heart disease.     

Nutrient contributions of dairy foods in the United States, Continuing Survey of Food Intakes by Individuals, 1994-1996, 1998

OBJECTIVE: This study was designed to quantify the impact of dairy foods on nutrient intakes in the United States. SUBJECTS: Data were from 17959 respondents to the 1994-1996, 1998 Continuing Survey of Food Intakes by Individuals (CSFII).Statistical analyses Nutrient intakes were quantified by quartile of dairy food intake. Also, dairy intakes were compared in people who met vs did not meet intake recommendations for select nutrients. Finally, the direct contribution of dairy foods/ingredients to calcium and lipid intakes was determined. SAS and SUDAAN software were used. Data were weighted. Energy intake was a covariable in regression models. RESULTS: Intake of all micronutrients examined, except vitamin C, was higher with increasing quartile of total dairy and milk intake, controlling for energy intake. Calcium was the only micronutrient positively associated with cheese intake. Fat intake either did not differ or was lower among people in quartile 2, 3, or 4 vs quartile 1 of total dairy and milk intake, whereas fat was higher as quartile of cheese intake increased. Dietary cholesterol was lower as intakes of any of the dairy categories increased; the opposite was true for saturated fat. Dairy foods/ingredients directly contributed an average of 51% of dietary calcium, 19% of total fat, 32% of saturated fat, and 22% of cholesterol. CONCLUSIONS: Total dairy and milk intakes were associated with higher micronutrient intakes without adverse impact on fat or dietary cholesterol. Results reinforce the strong nutritional profile of dairy-rich diets, although results with saturated fat and with cheese suggest that it would be useful to modify product composition and/or eating patterns to optimize nutritional contributions of dairy products.     

Dietary sources of nutrients among US adults, 1994 to 1996

OBJECTIVE: To identify major food sources of 30 nutrients and dietary constituents among US adults during 1994 to 1996, and to compare them with those identified for 1989 to 1991. DESIGN: A total of 6419 foods were assigned to 112 food groups based on similarities in nutrient content or use. These foods included 3778 food mixtures disaggregated by the US Department of Agriculture's (USDA) FoodLink computerized research tool, so ingredients could be assigned to the appropriate groups and nutrient values ascribed accordingly.Subjects/setting Single 24-hour dietary recalls from a nationally representative sample of 10019 adults aged 19 years or older in USDA's 1994 to 1996 Continuing Survey of Food Intakes by Individuals were used. Statistical analyses performed The population proportion formula was used to determine weighted nutrient intakes by food groups. Results were tabulated in descending rank order for food groups providing at least 1% of total nutrient intake. RESULTS: Dietary food sources found for 1994 to 1996 were fairly consistent with 1989 to 1991 results for the rank order and proportion these sources made to total nutrient intakes. Remarkable changes were seen in the higher proportion of energy from alcoholic beverages, in the shifts in the proportion of total fat and fatty acids from oil (higher ranked) and margarine (lower ranked), and in the lower proportion of vitamins and minerals from ready-to-eat cereals. CONCLUSIONS: Despite changes in survey methodology, the food supply, and eating patterns, food sources of nutrients among US adults in 1994 to 1996 and 1989 to 1991 were similar. The 1994 to 1996 data are the first known national population estimates for dietary sources of vitamin A (retinol equivalents), selenium, caffeine, and theobromine among US adults.     

Dietary intake and food sources of fatty acids in Australian adolescents

Background

Dietary fat consumed during childhood and adolescence may be related to the development of cardiovascular and other chronic diseases in adulthood; however, there is a lack of information on specific fatty acid intakes and food sources in these populations. Our study aimed to assess fatty acid intakes in Australian adolescents, compare intakes with national guidelines, and identify major food sources of fatty acids.

Methods

Dietary intake was assessed using measured 3-d records in 822 adolescents aged 13-15 y participating in The Western Australian Pregnancy Cohort (Raine) Study, Australia.

Results

Mean daily total fat intakes were 90 ± 25 g for boys and 73 ± 20 g for girls, with saturated fat contributing 14% of total energy intake. Mean contribution to daily energy intake for linoleic, alpha-linolenic, eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids were 3.0%, 0.40%, 0.02%, 0.01%, and 0.04%, respectively, for boys, and 3.3%, 0.42%, 0.02%, 0.01%, and 0.05% for girls. To meet guidelines for chronic disease prevention, consumption of long-chain omega-3 fatty acids in this population may need to increase up to three-fold and the proportion of saturated fat decrease by one-third. Girls were more likely to achieve the guidelines. Major food sources were dairy products for total fat, saturated fat and alpha-linolenic acid, margarines for linoleic acid, and fish for long-chain omega-3 fatty acids.

Conclusion

Results suggest that for this population, a higher dietary intake of long-chain omega-3 fatty acids, particularly for boys, and lower proportion of saturated fat is required to meet recommendations for prevention of chronic disease.     

Dietary vitamin B-6 intake and food sources in the US population: NHANES II, 1976-1980

Dietary vitamin B-6 intake and food sources were estimated from the Second National Health and Nutrition Examination Survey (NHANES II) dietary data for 11,658 adults aged 19-74 y. The average daily intake of vitamin B-6 was 1.48 +/- 0.01 mg (mean +/- SEM) for the total population, 1.85 +/- 0.02 for males and 1.14 +/- 0.01 for females. Seventy-one percent of males and 90% of females consumed less than the 1980 recommended dietary allowance (RDA) of vitamin B-6. Sixty-four percent of all survey respondents reported a ratio of vitamin B-6 to dietary protein of less than 0.02 (expressed as mg/g protein). Foods from animal and plant sources provided 48% and 52% of the total vitamin B-6, respectively. Vitamin B-6 intake decreased (P less than 0.0001) with increasing age and decreasing education and income status. Beef steaks and roasts, alcoholic beverages, potatoes, ready-to-eat cereals, and milk were important dietary sources of vitamin B-6.     

Antioxidant intakes and smoking status: data from the continuing survey of food intakes by individuals 1994-1996

BACKGROUND: Cigarette smoking is a major risk factor for several chronic oxidative diseases that can be ameliorated by antioxidants. OBJECTIVES: This study identified the typical dietary intakes and the major food group contributors of the antioxidants beta-carotene, vitamin C, and vitamin E by smoking status. DESIGN: The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the current sample (n = 6749), who were categorized as non- (n = 3231), former (n = 1684), and current (n = 1834) smokers. In the CSFII, individuals' food intakes were estimated with two 24-h dietary recalls. Data were analyzed by using a chi-square test with a simultaneous Fisher's z test, analysis of variance with Scheffe's test, multivariate analysis of covariance, and analysis of covariance with Bonferroni adjustment for multiple comparisons. RESULTS: The sample consisted of 3707 men and 3042 women. Current smokers tended to be younger with less education and lower incomes than nonsmokers and former smokers. The average body mass index (in kg/m(2)) of current smokers was 25.8, the lowest of the 3 groups. Current smokers had the lowest dietary antioxidant intake. Fatty foods such as luncheon meats, condiments and salad dressings, and ground beef contributed more to the antioxidant intakes of current smokers than to those of the other 2 groups, whereas fruit and vegetables contributed less. Current smokers consumed the fewest numbers of servings of all nutrient-bearing groups in the food guide pyramid, except the meat group. CONCLUSION: Future interventions should target the clustering of cigarette smoking and other unhealthy lifestyle habits, eg, an imprudent diet.     

Dietary nutrient intake and major food sources: the Nutrition and Health Survey of Taiwan Elementary School Children 2001-2002

The aim of the study was to investigate nutrient intake and their dietary sources in Taiwanese children ages 6-12 years by analyzing the 24-hour recall data of 2386 participants from a nationally representative sample. Results showed that children in Taiwan were slightly lower in mean proportion of energy intake from carbohydrates (53.5% of energy intake) and higher in those from fats (30.8%) and protein (15.8%) as based on the recommendations of Department of Health in Taiwan. The mean intake of vitamins and of minerals by children was equivalent to or exceeded Daily Reference Intake of Taiwan (DRI) or other recommended standards with the exception of a seriously insufficient calcium intake and extremely high sodium intake. A substantial proportion of children in different age/gender/location strata had lower mean vitamin and mineral intake by DRI and other recommended standards. These nutrient profiles were mainly related to dietary patterns with relatively low intake of fruits, vegetables, cereals/grains, and dairy products, but high intake of the protein-rich foods, salt/sauces, and fats/oils. According to the suboptimal dietary nutrient profiles of Taiwanese children, particularly in the underprivileged areas, recommendations are made in this article for policy makers and health practitioners to consider in order to improve dietary quality of elementary school children.     

Trends in energy intake among US children by eating location and food source, 1977-2006

Background

Little is known about the influence of location of food consumption and preparation upon daily energy intake of children.

Objective

To examine trends in daily energy intake by children for foods eaten at home or away from home, by source of preparation, and for combined categories of eating location and food source.

Subjects

The analysis uses data from 29,217 children aged 2 to 18 years from the 1977-1978 Nationwide Food Consumption Survey, 1989-1991 and 1994-1998 Continuing Survey of Food Intakes by Individuals, and 2003-2006 National Health and Nutrition Examination Surveys.

Methods

Nationally representative weighted percentages and means of daily energy intake by eating location were analyzed for trends from 1977 to 2006. Comparisons by food source were examined from 1994 to 2006. Analyses were repeated for three age groups: 2 to 6 years, 7 to 12 years, and 13 to 18 years. Difference testing was conducted using a t test.

Results

Increased energy intake (+179 kcal/day) by children from 1977-2006 was associated with a major increase in energy eaten away from home (+255 kcal/day). The percentage of daily energy eaten away from home increased from 23.4% to 33.9% from 1977-2006. No further increase was observed from 1994-2006, but the sources of energy shifted. The percentage of energy from fast food increased to surpass intake from schools and become the largest contributor to foods prepared away from home for all age groups. For foods eaten away from home, the percentage of daily energy from stores increased to become the largest source of energy eaten away from home. Fast food eaten at home and store-bought food eaten away from home increased significantly.

Conclusions

Eating location and food source significantly influence daily energy intake for children. Foods prepared away from home, including fast food eaten at home and store-prepared food eaten away from home, are fueling the increase in total energy intake. However, further research using alternative data sources is necessary to verify that store-bought foods eaten away from home are increasingly store-prepared.     

Dietary modeling shows that substitution of whole-grain for refined-grain ingredients of foods commonly consumed by US children and teens can increase intake of whole grains

Background

Currently available whole-grain foods are not frequently consumed, and few children achieve the whole-grain intake recommendation.

Objective

To investigate the influence on whole-grain consumption of substituting whole-grain for refined-grain ingredients of foods commonly consumed by children.

Design

Secondary cross-sectional analysis of publicly available food consumption data collected by the US Department of Agriculture.

Participants/setting

A nationally representative sample of US children aged 9 to 18 years (n=2,349) providing 24-hour dietary recall data in the 2003-2004 National Health and Nutrition Examination Survey.

Main outcome measures

Whole-grain intake was modeled by replacing varying proportions of refined flour contained in foods such as pizza crust, pasta, breads, and other baked goods with whole-wheat flour, and by replacing a proportion of white rice with brown rice. Replacement levels were based on the acceptability of whole-grain foods tested among children in elementary schools, and ranged from 15% to 50%; the majority were ≤25%.

Statistical analyses performed

Sample-weighted mean premodeled and postmodeled whole-grain intake, standard errors, and statistical significance of differences between demographic subgroups were determined using SUDAAN (version 9.0.3, 2007, Research Triangle Institute, Research Triangle Park, NC).

Result

Whole-grain intake increased 1.7 oz eq per day (from 0.5 to 2.2 oz eq/day). Premodeled and postmodeled whole-grain intakes were 6% and 28%, respectively, of total grain intake (7.7 oz eq/day). Major sources of postmodeled whole-grain intakes were breads/rolls (28.0%); pizza (14.2%); breakfast cereals (11.0%); rice/pasta (10.6%); quick breads such as tortillas, muffins, and waffles (10.8%); other baked goods (9.9%); and grain-based savory snacks other than popcorn (7.3%). Premodeled whole-grain intake differed by poverty level, but postmodeled whole-grain intake did not.

Conclusions

The substitution of whole grain for a specific proportion of refined grain ingredients of commonly consumed foods increased whole-grain intake and reduced disparities between demographic subgroups of children and teens.     

Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999-2000

Data from the 1999-2000 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey of US health and nutrition, were analyzed to assess prevalence of dietary supplement use overall and in relation to lifestyle and demographic characteristics. Fifty-two percent of adults reported taking a dietary supplement in the past month; 35% took a multivitamin/multimineral. Vitamin C, vitamin E, B-complex vitamins, calcium, and calcium-containing antacids were taken by more than 5% of adults. In bivariate analyses, female gender, older age, more education, non-Hispanic White race/ethnicity, any physical activity, normal/underweight, more frequent wine or distilled spirit consumption, former smoking, and excellent/very good self-reported health were associated with greater use of any supplement and of multivitamin/multiminerals; in multivariable comparisons, the latter three characteristics were not associated with supplement use. Most supplements were taken daily and for at least 2 years. Forty-seven percent of adult supplement users took just one supplement; 55% of women and 63% of adults aged >or=60 years took more than one. These findings suggest that, to minimize possible spurious associations, epidemiologic studies of diet, demography, or lifestyle and health take dietary supplement use into account because of 1) supplements' large contribution to nutrient intake and 2) differential use of supplements by demographic and lifestyle characteristics.     

Dairy consumption and related nutrient intake in African-American adults and children in the United States: continuing survey of food intakes by individuals 1994-1996, 1998, and the National Health And Nutrition Examination Survey 1999-2000

OBJECTIVE: To establish the first baseline of dairy and related nutrient intake in African Americans, an at-risk population of public health concern in the United States. To document dairy consumption in African Americans by age and sex during 1994-1998 and 1999-2000 and compare it with concomitant dairy, calcium, and related nutrient intakes in non-African-American adults and children. DESIGN: Duplicate and single 24-hour recalls were analyzed to determine dietary intake during the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998 (CSFII), and the National Health and Nutrition Examination Survey 1999-2000 (NHANES), respectively. SUBJECTS: African Americans and non-African Americans of all ages who participated in CSFII 1994-1996, 1998, and in NHANES 1999-2000; both surveys are a stratified random sample of the total civilian, noninstitutionalized US population. STATISTICAL ANALYSIS: Dairy food and nutrient intake per day were quantified according to age, sex, and ethnicity/race from CSFII 1994-1996, 1998, and NHANES 1999-2000. For NHANES, mean intakes from 1-day food records were sample-weighted, and standard errors estimated by the Taylor linearization method of SUDAAN (version 9.0, 2004, RTI International, Research Triangle Park, NC). Usual daily intakes of calcium, magnesium, and phosphorus were based on 2-day intake data from CSFII 1994-1996, 1998, and calculated using Software for Intake Distribution from Iowa State University. The percentage of individuals categorized as not meeting the Estimated Average Requirement for magnesium and phosphorus were calculated in the same way. RESULTS: CSFII 1994-1996, 1998, and NHANES 1999-2000 data both show that African Americans in all age groups consume fewer mean servings per day of total dairy, milk, cheese, and yogurt than non-African Americans, and have lower mean intakes of calcium, magnesium, and phosphorus. Significant differences were seen for men and women. CONCLUSIONS: In this analysis, young African-American women did not meet Dietary Reference Intakes for phosphorus, and all African Americans did not meet Dietary Reference Intakes for calcium and magnesium. African Americans in all age groups did not meet dairy recommendations from the 2005 US Dietary Guidelines and the 2004 National Medical Association Consensus Report on the role of dairy and dairy nutrients in the diet of African Americans.     

Commentary: Lessons learned from the development of Dietary Reference Intakes and Dietary Guidelines among different countries

The compilations of papers derived from the presentations at the 2nd Asian Network Symposium that are published concurrently in this issue offer an opportunity for the reader to gain a better understanding of the processes used for the development of country-specific nutrient reference intake recommendations and national dietary guidelines. This commentary offers a perspective of lessons learned from both the similarities and differences of approaches used among the Asian countries. Additionally, selected comparisons are made to actions and considerations related to nutrient requirements and national guidelines within the United States. It is hoped that continued dialogue among different countries on these topics should further harmonization of nutritional recommendations and provide an understanding for differences when they may occur.     

Anthocyanins in the diet of children and adolescents: intake, sources and trends

Purpose

Anthocyanin intake estimations in large cohorts include almost exclusively adults. For the purpose of early dietary prevention, however, it is of great interest to estimate anthocyanin intake of children and adolescents.

Methods

Anthocyanidin content values from the USDA Database (excluding the values for bananas and nuts) were assigned to foods consumed by 4–18-year-old participants of the DONALD Study. Between 1990 and 2009, 920 participants provided 6,707 3-day weighed dietary records. Intake of anthocyanins (expressed as their aglycones anthocyanidins) and their food sources were determined. For investigating age and time trends in anthocyanidin density (mg/MJ), a polynomial mixed regression model was built.

Results

We found the estimated median anthocyanidin intake to be around 6 mg/day, strawberries representing the main source. Anthocyanidin density of the diet was about 0.2 mg/MJ higher in girls than in boys, decreased with age, decreased over time in the first half of the study period and increased over time thereafter.

Conclusions

Anthocyanin intake in the young is characterised by differences in anthocyanidin density of the diet between girls and boys and by decreasing density from young childhood to adolescence. Observations in this German study population should be extended by further studies in other countries.     

Changes in calcium intake and association with beverage consumption and demographics: comparing data from CSFII 1994-1996, 1998 and NHANES 1999-2002

BACKGROUND: Consumption of soft drinks has been hypothesized to be negatively associated with calcium intake. However, fortification of some foods and beverages may have affected calcium intake. OBJECTIVE: The purpose of this study was to examine changes in calcium intake and the association of milk consumption with key beverage consumption and demographic variables using the most current data available. DESIGN: Several techniques were used to describe how age, gender, race/ethnicity, and beverage consumption were associated with milk and calcium intake using the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII) and the National Health and Nutrition Examination Survey 1999-2002 (NHANES). Using bivariate and multivariate regression analyses, we examined the independent relationships of total non-beverage energy intake, fluid milk consumption, non-milk beverage consumption, and demographics with calcium intake. RESULTS: During the time period between CSFII and NHANES, milk consumption decreased and RCSD consumption increased among children 6-11 y. Calcium intake was unaffected. Among other age categories, milk consumption either did not change or increased (females 40-59 y), while RCSD consumption increased. Calcium intake either did not change or increased in most age-gender categories, including adolescent females. Fluid milk consumption exhibited the strongest association with calcium intake. Fruit juice consumption was also positively associated with calcium intake in most age-gender categories. Consumption of other beverages, including RCSD, had little or no association with calcium intake. CONCLUSIONS: Consumption of low-fat milk should be encouraged, but calcium fortification of certain foods and beverages and calcium supplementation may be needed to further increase calcium intake.     

Changes in dietary intake and food sources of saturated and cis and trans unsaturated fatty acids in Costa Rican adolescents: 1996 versus 2006

ObjectiveTo identify how dietary intake and food sources of saturated (SFA) and cis (PUFA) and trans (TFA) unsaturated fatty acids in the diet of Costa Rican adolescents changed from 1996 to 2006—a period with several public health nutrition changes.MethodsCross-sectional comparisons used data from measured food records of 133 adolescents (ages 12–17 y) surveyed in 1996 and a similar group of adolescents surveyed in 2006. Values obtained in 1996 and 2006 were compared with the current World Health Organization guidelines for chronic disease prevention.ResultsAdolescents surveyed in 2006 reported a significantly higher mean daily energy intake from linoleic acid (LA) and alpha-linolenic acid (ALA) (0.9% and 7.8%, respectively) compared with the 1996 cohort, whereas SFA and TFA were significantly lower (9.5% and 1.3%, respectively). Food sources of fat also changed. In 2006, 2% of SFA in the diet came from palm shortening (compared with 34% in 1996); 39% of TFA came from ruminant-derived foods (in 1996, soybean oil was the main contributor of TFA, 34%), and bakery products (mainly pre-packaged cookies) provided 25% of the source of TFA, compared with only 11% in 1996. Dietary fatty intake of Costa Rican adolescents in 2006 is closer to WHO guidelines compared with 1996.ConclusionsAfter public health initiatives that changed fatty acid profile of most foods, intakes of TFA, SFA, and food sources of fatty acids in adolescents’ diets improved. Public health nutrition efforts should continue to strengthen diets that are low in SFA and TFA and higher in ALA content among Costa Rican adolescents.     

电白县1996～2004年儿童少年传染病发病动态分析

学校是儿童少年聚集的特殊场所,也是传染病的集散场所,因此传染病一旦在学校发生,很容易引起流行。为了解电白县儿童少年传染病的发病规律,防止传染病在学校的发生与流行,现将1996~2004年电白县儿童少年传染病发病情况分析如下。1材料和方法资料由电白县疾病预防控制中心档案室     

Assessment of the effect of fat-modified foods on diet quality in adults, 19 to 50 years, using data from the Continuing Survey of Food Intake by Individuals

Fat-reduction strategies and the role of fat-modified foods in the US diet were assessed using a nationally representative survey: the 1996 US Department of Agriculture Continuing Survey of Food Intakes by Individuals. A sample of 878 men and 853 women was included. The sample was divided into low fat and high fat based on the Dietary Guideline's cutoff poin of 30% or less of energy from total fat. The survey sample was further stratified in nonusers, low-users or high-users of fat-modified foods. Approximately 10% of 7,000 foods were classified as fat-modified. There was a 400 to 500 kcal difference in energy intake of individuals consuming low-fat compared with high-fat diets. Adults who were users of fat-modified foods consumed more nutrient-dense diets, with higher intakes of vitamin A, folate, and iron. Not all fat-reduction strategies were equally effective in reducing fat and maintaining nutrient intake. Nonusers of fat-modified foods who consumed a low-fat diet tended to do so by substituting carbohydrate, in part from carbonated beverages, for fat. Both men and women consuming a low-fat diet had lower average BMIs; this difference between individuals consuming low-fat vs high-fat diets was significant for women who were high-users of fat-modified foods. The data suggest that a low-fat diet with high use of fat-modified foods may be one strategy for achieving adequate nutrient intake while maintaining weight in the desirable BMI range of 19 to 25.     

Age and time trends in sugar intake among children and adolescents: results from the DONALD study

To describe age and time trends in added sugar, free sugar and total sugar intake among German 3–18-year-olds. Overall, 10,761 3-day dietary records kept between 1985 and 2016 by 1312 DONALD participants (660 boys, 652 girls) were analysed (%E) using polynomial mixed-effects regression models. TS intake decreased with age (♂: linear, quadratic and cubic trend all p < 0.0098; ♀: linear trend p < 0.0001). While the oldest children had the lowest FS intake (linear, quadratic trend: p < 0.0001), the youngest children had the lowest AS intake (linear, quadratic trend p < 0.0001, cubic trend p = 0.0004). In terms of time trends, TS (♂: cubic trend p = 0.0052; ♀: quadratic trend p = 0.0608, cubic trend p = 0.0014) and FS (quadratic trend p = 0.0163, cubic trend p < 0.0001) intake increased between 1985 and 2005 and decreased thereafter, most notably since 2010. AS intake decreased between 1985 and 1995, increased slightly until 2005 and decreased thereafter, most notably since 2010 (linear, quadratic, cubic trend p < 0.0001). FS intake exceeded 10%E/day throughout the 30-year study period. Our results do not support the common assumptions that sugar intake is on the rise and generally higher among adolescents than among younger children. Of note, TS, AS and FS intakes have decreased in the last decade among all age groups. Nevertheless, FS intake still exceeds the intake level recommended by the WHO.