Micronutrient dilution associated with added sugar intake in elderly black South African women.
OBJECTIVE
To investigate the association between added sugar and macronutrient and micronutrient intakes, and to assess whether added sugar intake is related to biochemical indices of nutritional status, Mini-Nutritional Assessment (MNA) score, body mass index (BMI) and performance on physical function tests.


METHODS
A cross-sectional, analytical study.


METHODS
Convenient sample of 285 institutionalised and community-dwelling black South African men and women aged 60+ y.


METHODS
An interviewer-administered 24-h dietary recall and MNA were performed. Serum albumin, vitamin B12, ferritin, cholesterol, haemoglobin, red blood cell (RBC) folate and plasma vitamin C were measured. Handgrip strength, BMI, 'sit-to-stand' and 'get-up-and-go' tests were measured. Outcome variables were analysed according to tertiles of added sugar, in grams and as a percentage of total energy (% E).


RESULTS
In each tertile of sugar intake, mean MNA score fell in the 'at-risk' classification. In women, energy, protein, % E protein, fibre, thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin, vitamin C, calcium, iron, magnesium, phosphorus, zinc, copper and selenium intake were significantly lowest in subjects in the highest % E sugar tertile. In men, no differences were found for micronutrient intake according to tertiles of total added sugar or % E added sugar. Physical function declined with increasing sugar intake, and suboptimal RBC folate and plasma ascorbic acid status was associated with increasing sugar intake (in women). No relationship was found between added sugar intake and the very high prevalence (65%) of obesity in women.


CONCLUSIONS
A nutrient-diluting effect of added sugars intake was demonstrated in elderly black South African women. Further studies in this population are required in order to develop food-based dietary guidelines, which include messages on added sugar intake.
Charlton
K E
KE
Chronic Diseases of Lifestyle Unit, South African Medical Research Council, Tygerberg, South Africa. w.scott@iafrica.com
Kolbe-Alexander
T L
TL
Nel
J H
JH
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005247:Feeding Behavior; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D011939:Mental Recall; D018977:Micronutrients / Q000008:administration & dosage / Q000378:metabolism*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012650:Self Disclosure; D013019:South Africa / Q000453:epidemiology
D004040:Dietary Carbohydrates; D018977:Micronutrients