Adverse effect of high added sugar consumption on dietary intake in American preschoolers

OBJECTIVES: To assess the effect of Dietary Reference Intakes (DRI)-recommended added sugar intake levels on nutrient and food group consumption by preschoolers.

STUDY DESIGN: This was a cross-sectional study of 2- to 5-year-olds in the United States Department of Agriculture Continuing Survey of Food Intake by Individuals (CSFII), 1994 to 1996, and 1998 (n = 5437). Main food sources of added sugar were established. For five categories (< or =10% energy from added sugar, 11% to 15%, 16% to 20%, 21% to 25%, and >25%), mean nutrient and food group consumption and proportion of children not meeting the DRI were ascertained. The nonparametric test for trend indicated significance of changes. Analysis was stratified by age (2- to 3-year-olds versus 4- to 5-year-olds), and survey design corrected to maintain the nationally representative character of the data.

RESULTS: The majority of children consumed less than 25% of energy from added sugar; the main sources were fruit and or soft drinks and desserts. Increasing added sugar consumption was paralleled by decreasing nutrient and food group intakes and increasing proportions of children with intakes below the DRI. Calcium intake was insufficient in large proportions of children consuming 16% or more from added sugar.

CONCLUSIONS: In preschoolers, the new DRI for added sugar are reason for concern. Further research is needed to investigate the effects of the DRI on diet quality, body weight, and health status in young children.