Factors associated with sugar intake and sugar sources in European children from 1 to 8 years of age.
The World Health Organization recommends to limit intake of free sugars to 5% of total energy per day because of the great impact of high sugar intake on body fat deposition, adiposity and dental caries. However, little data exist about total intake and sources of sugar in European children. Therefore, this paper aims to describe sugar intake and dietary sugar sources and associated factors.



Three-day weighed dietary records were obtained at eight time points from children 1 to 8 years of age (n=995) in five European countries. Food items were classified into subgroups according to food composition. Linear mixed models were used to examine associated factors.



Total sugar intake increased from 65 g/day (30.0% of energy intake (E%)) at 12 months of age to 83 g/day (20.9 E%) at 96 months of age. Around 80% of children's sugar intake was derived from the following sources: milk and dairy products, fruits and fruit products, confectionary and sugar sweetened beverages (SSB). Total sugar intake and dietary sugar sources varied significantly by country of residence. Boys had a significantly (P=0.003) higher total sugar consumption than girls.SSB consumption was significantly higher in children from young mothers while sugar intake from fruit products was lower in children from mothers with lower educational status and those with higher birth order.



Sugar intake in our population was lower than in other studies. Total sugar intake was associated with country of residence and gender, while dietary sugar sources varied by country of residence, maternal age, education and birth order.
Department of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Pawellek
Department of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Grote
Department of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Theurich
Pediatrics Research Unit, Universitat Rovira i Virgili, IISPV, Reus, Spain.
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Closa-Monasterolo
Department of Gastroenterology, Hepatology and Eating Disorders, Children's Memorial Health Institute, Warsaw, Poland.
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Stolarczyk
Department of Pediatrics, San Paolo Hospital, University of Milan, Milano, Italy.
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Verduci
Department of Paediatrics and NICU, CHC St Vincent, Liège-Rocourt, Belgium.
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Xhonneux
Department of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Koletzko
D000367:Age Factors; D001628:Beverages / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003611:Dairy Products / Q000032:analysis; D015930:Diet Records; D000073417:Dietary Sugars / Q000008:administration & dosage*; D004435:Eating; D002149:Energy Intake; D005060:Europe; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D012737:Sex Factors; D013549:Sweetening Agents / Q000032:analysis; D044465:White People / Q000706:statistics & numerical data*
D000073417:Dietary Sugars; D013549:Sweetening Agents