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Dietary sugar intake and dietary behaviors in Korea: a pooled study of 2,599 children and adolescents aged 9-14 years

  • Ha, Kyungho (Department of Public Health Nutrition, Graduate School of Public Health, Seoul National University) ;
  • Chung, Sangwon (Department of Public Health Nutrition, Graduate School of Public Health, Seoul National University) ;
  • Joung, Hyojee (Department of Public Health Nutrition, Graduate School of Public Health, Seoul National University) ;
  • Song, YoonJu (Major of Food and Nutrition, School of Human Ecology, The Catholic University of Korea)
  • Received : 2016.04.12
  • Accepted : 2016.06.09
  • Published : 2016.10.01

Abstract

BACKGROUND/OBJECTIVES: Dietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents. SUBJECTS/METHODS: We pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records. RESULTS: Mean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls). CONCLUSIONS: These results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.

Keywords

References

  1. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 2012;346:e7492. https://doi.org/10.1136/bmj.e7492
  2. Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J Clin Nutr 2014;100:65-79. https://doi.org/10.3945/ajcn.113.081521
  3. Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 2010;33:2477-83. https://doi.org/10.2337/dc10-1079
  4. Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010;121:1356-64. https://doi.org/10.1161/CIRCULATIONAHA.109.876185
  5. World Health Organization. Guideline: Sugars Intake for Adults and Children. Geneva: World Health Organization; 2015.
  6. U.S. Department of Agriculture; U.S. Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans. Washington (D.C.): U.S. Department of Agriculture; 2000.
  7. Chun OK, Chung CE, Wang Y, Padgitt A, Song WO. Changes in intakes of total and added sugar and their contribution to energy intake in the U.S. Nutrients 2010;2:834-54. https://doi.org/10.3390/nu2080834
  8. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr 2011;94:726-34. https://doi.org/10.3945/ajcn.111.018366
  9. Brisbois TD, Marsden SL, Anderson GH, Sievenpiper JL. Estimated intakes and sources of total and added sugars in the Canadian diet. Nutrients 2014;6:1899-912. https://doi.org/10.3390/nu6051899
  10. Lei L, Rangan A, Flood VM, Louie JC. Dietary intake and food sources of added sugar in the Australian population. Br J Nutr 2016;115:868-77. https://doi.org/10.1017/S0007114515005255
  11. Pereira RA, Duffey KJ, Sichieri R, Popkin BM. Sources of excessive saturated fat, trans fat and sugar consumption in Brazil: an analysis of the first Brazilian nationwide individual dietary survey. Public Health Nutr 2014;17:113-21. https://doi.org/10.1017/S1368980012004892
  12. Louie JC, Tapsell LC. Association between intake of total vs added sugar on diet quality: a systematic review. Nutr Rev 2015;73:837-57. https://doi.org/10.1093/nutrit/nuv044
  13. Colucci AC, Cesar CL, Marchioni DM, Fisberg RM. Factors associated with added sugars intake among adolescents living in Sao Paulo, Brazil. J Am Coll Nutr 2012;31:259-67. https://doi.org/10.1080/07315724.2012.10720429
  14. Chan TF, Lin WT, Huang HL, Lee CY, Wu PW, Chiu YW, Huang CC, Tsai S, Lin CL, Lee CH. Consumption of sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents. Nutrients 2014;6:2088-103. https://doi.org/10.3390/nu6052088
  15. Park YG, Lee EM, Kim CS, Eom JH, Byun JA, Sun NK, Lee JH, Heo OS. Survey on the content and intake pattern of sugar from elementary and middle school foodservices in Daejeon and Chungcheong province. J Korean Soc Food Sci Nutr 2010;39:1545-54. https://doi.org/10.3746/jkfn.2010.39.10.1545
  16. Jung HR, Park YB, Lee MJ, Kim KC, Kim JB, Kim DH, Kang SH, Park IB, Park JS, Kwon KI, Kim MH. A survey on sugar intake in meals from nursery schools in Gyeonggi-do. Korean J Food Sci Technol 2011;43:182-8. https://doi.org/10.9721/KJFST.2011.43.2.182
  17. Kim HY, Park SJ, Chung SY, Choi SH, Oh SW, Lee JS, Choi IS, Shin MS, Song JS. Monitoring the sugar content and intake in school meals from Incheon and Chuncheon. Korean J Food Sci Technol 2011;43:58-64. https://doi.org/10.9721/KJFST.2011.43.1.058
  18. Kang MH, Yoon KS. Elementary school students' amounts of sugar, sodium, and fats exposure through intake of processed food. J Korean Soc Food Sci Nutr 2009;38:52-61. https://doi.org/10.3746/jkfn.2009.38.1.052
  19. Kim HJ, Kim SH. A survey on added sugar intakes from snacks and participation behaviors of special event days sharing sweet foods among adolescents in Korea. Korean J Nutr 2009;42:135-45. https://doi.org/10.4163/kjn.2009.42.2.135
  20. Ko YS, Kim EM, Lee HS. A study of dietary intake of total sugars by elementary students in Jeju province. J Nutr Health 2015;48: 81-93. https://doi.org/10.4163/jnh.2015.48.1.81
  21. Ko YS, Kim EM, Chae IS, Lee HS. A study of total sugar intake by middle school students in Jeju province. J Nutr Health 2015;48:248-57. https://doi.org/10.4163/jnh.2015.48.3.248
  22. Lee HS, Kwon SO, Yon M, Kim D, Lee JY, Nam J, Park SJ, Yeon JY, Lee SK, Lee HY, Kwon OS, Kim CI. Dietary total sugar intake of Koreans: based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. J Nutr Health 2014;47:268-76. https://doi.org/10.4163/jnh.2014.47.4.268
  23. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002;13:3-9. https://doi.org/10.1097/00041433-200202000-00002
  24. Story M, Neumark-Sztainer D, French S. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 2002;102:S40-51. https://doi.org/10.1016/S0002-8223(02)90421-9
  25. Story M, Stang J. Understanding adolescent eating behaviors. In: Stang J, Story M, editors. Guidelines for Adolescent Nutrition Services. Minneapolis (MN): Center for Leadership, Education and Training in Maternal and Child Nutrition; 2005. p. 9-19.
  26. Song Y, Park MJ, Paik HY, Joung H. Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged 10-19 years. Int J Obes (Lond) 2010;34:48-56. https://doi.org/10.1038/ijo.2009.203
  27. Ministry of Education, Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The 11th Korea Youth Risk Behavior Web-Based Survey. Cheongju: Korea Centers for Disease Control and Prevention; 2015.
  28. Li SJ, Paik HY, Joung H. Dietary patterns are associated with sexual maturation in Korean children. Br J Nutr 2006;95:817-23. https://doi.org/10.1079/BJN20051675
  29. Shin S, Hong K, Kang SW, Joung H. A milk and cereal dietary pattern is associated with a reduced likelihood of having a low bone mineral density of the lumbar spine in Korean adolescents. Nutr Res 2013;33:59-66. https://doi.org/10.1016/j.nutres.2012.11.003
  30. Lee K, Jeong S, Joung H. Effects of food allergy and dietary factors on atopic dermatitis among children. Poster session presented at: the Experimental Biology 2009; 2009 Apr 18-22; New Orleans, LA.
  31. Kim J, Kim S, Huh K, Kim Y, Joung H, Park M. High serum isoflavone concentrations are associated with the risk of precocious puberty in Korean girls. Clin Endocrinol (Oxf) 2011;75:831-5. https://doi.org/10.1111/j.1365-2265.2011.04127.x
  32. Yu SH, Song Y, Park M, Kim SH, Shin S, Joung H. Relationship between adhering to dietary guidelines and the risk of obesity in Korean children. Nutr Res Pract 2014;8:705-12. https://doi.org/10.4162/nrp.2014.8.6.705
  33. Ha K, Chung S, Lee HS, Kim CI, Joung H, Paik HY, Song Y. Association of dietary sugars and sugar-sweetened beverage intake with obesity in Korean children and adolescents. Nutrients 2016;8:E31. https://doi.org/10.3390/nu8010031
  34. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongju: Korea Centers for Disease Control and Prevention; 2014.
  35. Public Health England; Food Standard Agency (UK). National Diet and Nutrition Survey. Results from Years 1,2,3 and 4 (Combined) of the Rolling Programme (2008/2009-2011/2012). London: Public Health England; 2014.
  36. Langlois K, Garriguet D. Sugar consumption among Canadians of all ages. Health Rep 2011;22:23-7.
  37. Chung CE. Dietary intakes and food sources of total sugars from Korean National Health and Nutrition Examination Survey 2001-2002. Korean J Nutr 2007;40:9-21.
  38. Hur YI, Park H, Kang JH, Lee HA, Song HJ, Lee HJ, Kim OH. Associations between sugar intake from different food sources and adiposity or cardio-metabolic risk in childhood and adolescence: the Korean child-adolescent cohort study. Nutrients 2015;8:E20. https://doi.org/10.3390/nu8010020
  39. Zhai FY, Du SF, Wang ZH, Zhang JG, Du WW, Popkin BM. Dynamics of the Chinese diet and the role of urbanicity, 1991-2011. Obes Rev 2014;15 Suppl 1:16-26. https://doi.org/10.1111/obr.12124
  40. Leech RM, McNaughton SA, Timperio A. The clustering of diet, physical activity and sedentary behavior in children and adolescents: a review. Int J Behav Nutr Phys Act 2014;11:4. https://doi.org/10.1186/1479-5868-11-4
  41. Kim MJ, Song S, Park SH, Song Y. The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents. J Nutr Health 2015;48:228-35. https://doi.org/10.4163/jnh.2015.48.3.228
  42. van Ansem WJ, van Lenthe FJ, Schrijvers CT, Rodenburg G, van de Mheen D. Socio-economic inequalities in children's snack consumption and sugar-sweetened beverage consumption: the contribution of home environmental factors. Br J Nutr 2014;112:467-76. https://doi.org/10.1017/S0007114514001007
  43. Shi Z, Lien N, Kumar BN, Holmboe-Ottesen G. Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China. Eur J Clin Nutr 2005;59:1439-48. https://doi.org/10.1038/sj.ejcn.1602259
  44. Larson N, Story M, Eisenberg ME, Neumark-Sztainer D. Secular trends in meal and snack patterns among adolescents from 1999 to 2010. J Acad Nutr Diet 2016;116:240-250.e2. https://doi.org/10.1016/j.jand.2015.09.013
  45. Kim K, Park SM, Oh KW. The impact of nutritional policy on socioeconomic disparity in the unhealthy food intake among Korean adolescents. Appetite 2013;71:388-95. https://doi.org/10.1016/j.appet.2013.09.010

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