Estimating added sugars intake in New Zealand
Background: Added sugars intake in New Zealand (NZ) cannot be accurately estimated, as the NZ Food Composition Database (NZFCD) does not distinguish between total sugar and added sugars in foods. Added sugars can be defined as sugars that are not intrinsic to fruits, vegetables and milk products and usually refers to sugars added during the processing of foods. High intakes of added sugars, such as those in sugar sweetened beverages (SSBs), have been associated with numerous adverse health outcomes including dental caries, cardiovascular disease (CVD), type two diabetes mellitus (T2DM), weight gain and obesity. Consequently, recent dietary guidelines from the United States Department of Agriculture (USDA) and World Health Organization (WHO) have recommended that added and free sugars provide less than ten percent (%) of total daily energy intake.Objective: Firstly to develop an added sugars estimate for all food items and recipes in the NZFCD, and secondly to determine added sugars intake of NZ adults using dietary intake data from the NZ Adult Nutrition Survey 2008/09 (ANS 08/09).Design: A ten-step systematic methodology developed by Louie et al was adapted and applied to FOODfiles, an electronic subset of the NZFCD, to estimate the added sugars content of all food items. Data obtained from the NZ ANS 08/09, a nationwide nutrition survey involving 4,271 participants was then used to estimate added sugars intake of NZ adults. These intakes were used to determine the proportion of the population that was meeting the USDA added sugars and WHO free sugars intake guidelines.Results: An added sugars estimate was developed for 2,779 unique food items and recipes contained in the FOODfiles database. In total 2,463 (89%) foods had added sugars estimated using objective steps 1-6, and 316 (11%) using subjective steps 7-10. Median usual daily intake of added sugars for NZ ANS 08/09 participants was 49 grams (g), which contributed 9.5% of total energy (TE) intake. The median total sugar intake of the population was 107g, and added sugars comprised almost half (46%) of total sugar intake. Younger people generally had higher intakes of added sugars than older people, and absolute added sugars intake was greater among men compared with women. By ethnicity, Māori people tended to have higher absolute added sugars intake, (median intake for Māori males 62g and for Māori females 48g) which contributed a greater proportion of total energy intake (10% TE intake for Māori males and 10.6% TE intake for Māori females) compared to NZEO and Pacific people. In comparison with the USDA recommendation for added sugars intake, almost half (46.2%) of the total population had intakes of added sugars that were greater than 10% of TE intake.Conclusion: The ten-step systematic methodology is currently the best available approach for estimating the added sugars content of foods in NZ, as approximately 90% of foods were estimated using objective measures. When applied to dietary intake data from the NZ ANS 08/09, almost half of the population was not meeting the USDA recommendations for less than 10% TE intake from added sugars. Given that high intakes of added sugars are associated with several negative health outcomes, these findings suggest there may be potential to reduce intakes of added sugars in NZ, particularly amongst young adults who reported the highest intakes.
Advisor: Te Morenga, Lisa; McLean, Rachael
Degree Name: Master of Dietetics
Degree Discipline: Human Nutrition
Publisher: University of Otago
Keywords: New Zealand; sugar; added sugar; dietary guidelines
Research Type: Thesis