|dc.description.abstract||Background: Sugar has been implicated as a cause or risk factor in a number of diseases. Recently the focus of research and recommendations have shifted to emphasise the potential importance of free or added sugars on health. In response to the literature which suggests a negative association between free sugars and health (particularly relating to dental caries) the World Health Organisation (WHO) updated their recommendations for intake of free sugars. Monitoring the extent to which populations are achieving these recommendations is difficult, primarily because free sugars are indistinguishable analytically from sugars inherent to a food. Thus, in the New Zealand (NZ) food composition database there is currently no nutrient information for free sugars and as a result, estimates have not been possible for free sugar intakes in NZ.
Objective: The first objective of this research project was to update the current New Zealand Food composition database (NZFCD) to include estimates of free sugars for every food. The second objective was to estimate intakes of free sugars in NZ adults using data from the New Zealand Adult Nutrition Survey 2008/09 (NZANS 08/09), with the intention of comparing these intakes with international recommendations for free sugars, such as those set by WHO.
Methods: Estimates of free sugars were created for each food record in the NZFCD, using a 10-step protocol. Intakes of free sugars in the NZANS 08/09 were estimated by matching free sugar estimates for each food item to the 24-hour recall data. Survey weighted estimates of free sugars intakes were calculated by age group, sex, and ethnicity. Usual intakes were estimated by adjusting for intra-individual variation using the Multiple Source Method (MSM). Population intakes were compared with the WHO recommendations for free sugars.
Results: Free sugars content (g/100g) of 2779 foods were estimated. Estimates for 2543 were calculated by objective measures and the remaining 236 foods from subjective measures. Estimated median intake of free sugars in NZ adults was 57 g/day (57g, 95%CI: 55, 59) which equated to 11.1% of total energy (TE), this was significantly higher than sucrose (48g, 95%CI: 46, 50) and added sugar (49g, 95%CI: 47, 51). Intakes were highest among younger age groups. Young males (15-18 years) had the highest intake (89g/day), and young females had the highest by %TE. An estimated 57.8% of the total population are estimated to be exceeding the WHO recommendation that free sugars intakes should be <10%TE and 90.5% of the population are exceeding the recommendation that free sugars intake should <5% TE.
Conclusions: This study offered valuable insight into the consumption of free sugars, improving the understanding of who may be at the greatest risk of poor health outcomes. It found that free sugar consumption of specific population groups (such as younger adults) was high in comparison with WHO recommendations, suggesting that public health strategies to reduce free sugars intakes would be strengthened by targeting younger adults. Updating the NZFCD to include free sugars will enable future research to investigate the relationships between consumption of free sugars and health outcomes, in a New Zealand setting.||