Intakes & dietary sources

Intakes and dietary sources of sugars

The amount of total, added and free sugars consumed in diets across the globe varies by country (1). The greatest contributors to total, added and free sugars intakes also varies by region and country. In industrialized countries, beverages, cereal products including cakes and biscuits, and confectionery and chocolates, make the most significant contribution to added sugars intake (2, 3).

There has been a considerable amount of research on the possible relationship between consuming sugars and various health outcomes. Understanding the amount of sugars consumed in diets across the globe can help to put this research into context. It can also be useful for tracking trends in intakes over time.

What are dietary intake measurements?

Dietary intake measurements are estimates of the foods and drinks, and energy and nutrients, that are consumed by a particular population group of interest.

Information on foods and drinks consumed by a population group, over a defined period of time, is collected using a chosen dietary assessment method (see “How is this information collected?”).

Per capita availability data vs. dietary intake data

Dietary intake data are often the most accurate data available when assessing the diet and nutrient intake of a population. Dietary intake data are collected from individuals through one-on-one interviews/surveys/apps (reflecting the actual foods and drinks consumed by each person). Per capita availability data (or apparent consumption data, disappearance data, or sales data) estimates on average what is available to consume or purchased across a population group.

Per capita availability data do not accurately take into account food wastage, storage and purchases across a country/region border. It does not measure what is actually consumed. The distribution of food items consumed across a country/region and within different population groups (e.g., children, males, lower socioeconomic groups) is also unknown. As such, dietary intake data is a more suitable source of accurate and reliable information for estimating nutrient intakes.

Why are dietary intakes measured?

It’s important to know what foods and drinks different population groups consume, along with how much energy (calories) and nutrients different groups of people consume. The data collected are used in research relating diet to health status, particularly in epidemiology (the study of health states of populations, communities, and groups). Data are also used to identify and address nutritional issues in the population and compare intakes against population dietary recommendations, guidelines and goals.

Who collects this information?

Dietary intake data are collected by research scientists or health professionals and used in their independent research or as part of public health governmental research. Depending on the research question, dietary intakes can be estimated from particular sub-groups of the population e.g., students or adults with type 2 diabetes, or a nationally representative sample. A nationally representative sample is one that strongly resembles the population of interest (e.g., to the country being studied). This means the sample represents the country’s population across key demographic characteristics (e.g., gender, age, race, socioeconomic status, urbanisation, region). The process from dietary intake data collection and analysis, to publication, can take a number of years to complete. Data can be published on a government or research organisation website or in a scientific journal.

How is this information collected?

A wide variety of dietary assessment methods are available to collect dietary information, each one with different strengths and weaknesses.

Commonly used dietary assessment methods that assess an individual's intake include the 24-hour or 48-hour dietary recall, dietary record, and food frequency questionnaire (FFQ). Data are collected with the help of a trained interviewer or are self-reported.

Things to consider

Nationally representative dietary sugars intake data are the best estimates we have for determining how much sugars the average person consumes in a given country or population group.

Collecting, imputing and analysing this data is time and resource intensive.

This limits if, or how often, the data are collected within a particular country. Because of the length of time it takes, collected data can take a couple of years to be published. This means that intake data published most recently are from surveys carried out at least a few years ago and may no longer reflect current dietary patterns and food and nutrient intakes. They are, however, usually the best available data.

Measurement errors are possible

Some surveys require an individual to recall what they have eaten which can mean some foods and drinks can be accidently forgotten.
Participants can distort the truth about what they have eaten to fit with social pressures or make reporting less burdensome.
Food composition databases contain estimates of the amount of nutrients in a food. Food composition databases are used to understand how much of the different nutrients an individual is consuming from the foods and drinks in their diet. However, they can’t be completely accurate as not all variations of foods are contained within the database and recipes can change over time (for example, recent reformulations of foods and drinks to reduce salt or free sugars reduction, are not always captured). Portion sizes of the foods and drinks consumed are also sometimes estimated.

It is difficult to compare data from different countries or surveys.

This is due to the differences in methodology used, how ages of participants are grouped and how sugars are defined (some report total sugars, added sugars or free sugars). Some of the surveys just report on the foods consumed (e.g., cakes) rather than break it down into nutrients (e.g., total sugars).

Advances in technology

There have been advances in technology which may help to revolutionize intake data, including information gathered from biomarkers. A dietary intake biomarker is something which can be measured in a biological sample (e.g., breath, blood or urine) which indicates how much of a food or nutrient someone has recently eaten. There are biomarkers for sugars intake which are under development. If in the future these can be rolled out with enough scale and accuracy, this could reduce some of the limitations outlined above. Apps which make dietary reporting quicker, easier and more accurate may also help this field – scanning barcodes, taking pictures of portion sizes for example, could increase the accuracy of this data. There is also the potential to reach more people and generate big databases containing lots of information from lots of people.

References

Walton J, Bell H, Re R, Nugent AP. Current perspectives on global sugar consumption: definitions, recommendations, population intakes, challenges and future direction. Nutrition Research Reviews. Cambridge University Press; 2023;36(1):1–22.
Azaïs-Braesco V, Sluik D, Maillot M. et al. A review of total & added sugar intakes and dietary sources in Europe. Nutrition journal; 2017;16(6).
Bailey RL, Fulgoni VL, Cowan AE, Gaine PC. Sources of Added Sugars in Young Children, Adolescents, and Adults with Low and High Intakes of Added Sugars. Nutrients. 2018 Jan 17;10(1):102. doi: 10.3390/nu10010102.