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Different methods for determining the effect of added sugars intake among children and adults on meeting recommended nutrient intakes were compared using 24 h dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2011&ndash, 2014. Four methods were used to determine deciles of added sugars intake (as the percentage of total calories): 1 day intake, 2 day average intake, and individual usual intake (UI) determined with the National Cancer Institute (NCI) and the multivariate Markov Chain Monte Carlo methods. Percentages of the population below the Estimated Average Requirement (EAR) for calcium and vitamin D/above the Adequate Intake (AI) for potassium and dietary fiber for each decile of added sugars intake were assessed with the NCI method. Using regression analyses, added sugars intake deciles (by any method) in children were inversely associated (p &lt, 0.001) with percentages below the EAR/above the AI of vitamin D, calcium, potassium, and fiber. In adults, added sugars intake deciles were inversely associated with meeting recommendations for vitamin D, potassium, and fiber. There were no significant between-method differences for regression coefficients for any nutrients investigated. Overall, these methods showed a similar association of added sugars intake with nutrient inadequacy/adequacy, therefore, method preference may depend more on practical reasons.

There is inconsistent evidence regarding the impact of added sugars consumption on micronutrient dilution of the diet. We examined the associations between added sugars intake deciles and nutrient adequacy for 17 micronutrients in U.S. adults 19+ (n = 13,949), 19&ndash, 50 (n = 7424), and 51+ y (n = 6525) using two days of 24 hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2009&ndash, 2014 and regression analysis. Added sugars intake deciles ranged from &lt, 3.8 to &gt, 23.3% of calories among adults 19+ y, with a median intake of 11.0% of calories. Significant associations (p &le, 0.01) between added sugars intake deciles and percentage of the population below the Estimated Average Requirement (EAR) were found for magnesium, vitamin C, vitamin D, and vitamin E, only the association with magnesium remained significant after dropping the two highest and lowest deciles of intake, suggesting a threshold effect. Intakes below approximately 18% of calories from added sugars were generally not associated with micronutrient inadequacy. However, even at the lower deciles of added sugars, large percentages of the population were below the EAR for these four micronutrients, suggesting that adequate intakes are difficult to achieve regardless of added sugars intake.

High intake of added sugars is associated with excess energy intake and poorer diet quality. The objective of this cross-sectional study (n = 16,806) was to estimate usual intakes and the primary food sources of added sugars across the range of intakes (i.e., deciles) among U.S. children (2–8 years), adolescents and teens (9–18 years), and adults (≥19 years) using the National Health and Nutrition Examination (NHANES) data from 2009–2012. The percent energy contributed by added sugars was 14.3 ± 0.2% (2–8 years), 16.2 ± 0.2% (9–18 years), and 13.1 ± 0.2% (≥19 years), suggesting the highest intakes are among adolescents and teens. However, the primary foods/beverages that contribute to added sugars were remarkably consistent across the range of intakes, with the exception of the lowest decile, and include sweetened beverages and sweet bakery products. Interestingly across all age groups, even those in the lowest decile of added sugars exceed the 10% guidelines. Additional foods contributing to high intakes were candy and other desserts (e.g., ice cream) in children and adolescents, and coffee and teas in adults. Tailoring public health messaging to reduce intakes of these identified food groups may be of utility in designing effective strategies to reduce added sugar intake in the U.S.