Patterns of added sugars intake by eating occasion among a nationally representative sample of Australians.

Purpose: To examine the eating occasion (EO) where most added sugars (AS) were consumed using a nationally representative dataset.
Methods: Plausible dietary data from the Australian Health Survey respondents (n = 8202), collected by a multiple-pass 24-h recall, were analyzed. EO was self-reported during the recall. AS content of the foods reported was estimated using a previously published method. Proportion of daily AS consumed (%AS _daily ) and the main food sources, at each EO, were calculated. Differences between children/adolescents and adults were tested by one-way ANOVA. Further stratification by age group and sex was performed.
Results: The majority of the %AS _daily came from non-main meal occasions (NMMOs; 48.3 %, 95 % CI 47.5-49.0 %), followed by breakfast/brunch (20.6 %, 95 % CI 20.1-21.1 %). Children and adolescents consumed more %AS _daily during NMMOs compared with adults (52 vs. 47 %; p < 0.001), while girls/women consumed more %AS _daily during NMMO compared with boys (54 vs. 49 %; p = 0.002) and men (50 vs. 45 %; p < 0.001). Sugar-sweetened beverages were the top contributors to AS at lunch, dinner and NMMOs, while sugar and sweet spreads were the top contributor at breakfast/brunch. Other top contributors at NMMOs included "other foods," ice cream and cakes and biscuits, pastries and batter-based products.
Conclusion: Australians consumed nearly half of %AS _daily during NMMOs, most of which came from high-sugar energy-dense nutrient-poor foods. While the common perception that most AS come from snacks holds true, our results suggest that main meals are also important intervention targets.