title: Added sugar intake that exceeds current recommendations is associated with nutrient dilution in older Australians.
abstract: OBJECTIVE
  A nutrient dilution effect of diets high in added sugar has been reported in some older populations, but the evidence is inconsistent. The aim of this study was to investigate the association between added sugar intakes (according to recommended guidelines) and nutrient intake, food consumption, and body mass index (BMI).
  
  
  METHODS
  A cross-sectional analysis of data collected between 2007 and 2009 from participants of the Blue Mountains Eye study 4 was performed (n = 879). Dietary intake was assessed using a semiquantitative food frequency questionnaire. Added sugar content of foods was determined by applying a systematic step-wise method. BMI was calculated from measured weight and height. Food and nutrient intakes and BMI were assessed according to categories of percentage energy from added sugar (EAS% < 5%, EAS% = 5%-10%, and EAS% >10%) using analysis of covariance for multivariate analysis.
  
  
  RESULTS
  Micronutrient intake including retinol equivalents, vitamins B6, B12, C, E, and D, and minerals including calcium, iron, and magnesium showed a significant inverse association with EAS% intakes (Ptrend < 0.05). In people with the lowest intake of added sugars (<5% energy) intake of alcohol, fruits, and vegetables were higher and intake of sugar sweetened beverages was lower compared to other participants (all Ptrend < 0.001). BMI was similar between the three EAS% categories.
  
  
  CONCLUSIONS
  Energy intake from added sugar greater than the recommended level of 10% is associated with lower micronutrient intakes, indicating micronutrient dilution. Conversely, added sugar intakes <5% of energy intake are associated with higher micronutrient intakes. This information may inform dietary messages targeted at optimizing diet quality in older adults.
authors.affiliation: School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Hanieh
authors.initials: H
authors.lastname: Moshtaghian
authors.affiliation: School of Life and Environmental Sciences, Faculty of Science, University of Sydney, Sydney, NSW, Australia; School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Jimmy Chun Yu
authors.initials: JC
authors.lastname: Louie
authors.affiliation: School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Charlton
authors.affiliation: School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Yasmine C
authors.initials: YC
authors.lastname: Probst
authors.affiliation: Center for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.affiliation: Center for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: St. Vincent's Hospital, Sydney, NSW, Australia; Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia. Electronic address: vicki.flood@sydney.edu.au.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Flood
mesh_terms: D000368:Aged; D001315:Australia; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet / Q000379:methods*; D019422:Dietary Sucrose / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D005502:Food / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D009752:Nutritional Status; D064167:Recommended Dietary Allowances
chemical_list: D019422:Dietary Sucrose; D018977:Micronutrients
keywords: Added sugar intake; Blue Mountains Eye Study; Energy from added sugar; Nutrient dilution; Older adults