Where Do Kids Get Their Added Sugars

Did you know that U.S. Department of Agriculture (USDA) has been reporting food supply data for over 100 years?! And for over 30 years, USDA has been monitoring actual intakes of Americans. This extensive history provides us important insights into dietary intake trends and changes in the food supply.

One important report that USDA publishes is its dietary status report, “What We Eat in America (WWEIA).” The WWEIA report comes out every two years with data from the National Health and Nutrition Examination Survey (NHANES), assessing the health status and dietary intakes of Americans. This report includes data on added sugars intake, and the findings from the last 20 years may surprise you. The most recent report shows that the percent of total calories from added sugars fell from 18.1% in 2000 to 12.6% in 2016.1,2,3 For reference, the 2015 – 2020 Dietary Guidelines for Americans recommend that added sugars are limited to 10% of total calories.4

While the total added sugars intake data is always interesting, there were more questions we had, like where do people get their added sugars? And, do people who eat very little added sugars avoid all treats? Do people who eat lots of added sugars get their added sugars from a different place? Because we at the Sugar Association believe that increasing our knowledge about sugar is beneficial to understanding its role in the diet, we asked researchers to take a deeper dive into the NHANES data from 2009 – 2012 to look at patterns of the sources of added sugars in children (ages 2 – 8) and adolescents and teens (ages 9 – 18)5.  The researchers split the participants into 10 equal groups (deciles) to see how these patterns differed across that range of intakes (low to high). The mean intake of added sugars was 14.3% of total calories for children (ages 2-8), with the lowest consumers (decile 1) at <11.2% and the highest (decile 10) at >18.2%. For adolescents and teens, the mean intake of added sugars was 16.2% of total calories, with the lowest consumers at <12.8%, the highest at >20.4%. So, did the sources of added sugars differ across intakes? Let’s look a little closer at what the researchers found.

Sweetened beverages are the primary source of added sugars for both of these groups, except for the lowest added sugars consumers. 5

In children, sweetened beverages made up a little more than a third (37%) of the total added sugars calories in the highest added sugars consumers, less than half (23%) for the middle consumers and about 12% for the lowest consumers. As far as the types of sweetened beverages children are drinking, juice-based and fruit beverages are key contributors.

In adolescents and teens, over half (53%) of total added sugars calories come from sweetened beverages for the highest added sugars consumers. Sweetened beverages contribute less than a quarter (23%) of total added sugars calories for the middle consumers in this age group and about 12% for the lowest consumers. Soft-drinks are the primary contributor of these calories; however, sports and energy drinks are increasingly prevalent with adolescents and teens who have higher added sugars intakes.

The second main source of added sugars across both age groups was sweet bakery products. Candy was also among the top 10 sources, ranking increasingly higher following increasing added sugars intake.

The list of top 10 sources of added sugars also includes foods that contribute important nutrients.5

One important finding is that among the top sources of added sugars are food categories that are also important sources of nutrients, such as dietary fiber and vitamins and minerals, like ready-to-eat cereal, flavored milk and yogurt. All three of these food categories were in the top ten for children. Both ready-to-eat cereal and flavored milk were in the top 10 for adolescents and teens.

When looking at these data, it is important to keep in mind that making it into the top sources is a combination of how many added sugars are in the product, along with how frequently the products are consumed. The charts below list the percentage each food source contributes to added sugars calories, they are not percentages of overall calories.

Top 10 food sources of added sugars for children 2-8 years by decile of intake5

Rank Decile 1 Decile 5 Decile 10
Food Group % Total Added Sugars from Food Category Food Category % Total Added Sugars from Food Category Food Category % Total Added Sugars from Food Category
1 Ready-to-Eat Cereals 14.8 Sweetened Beverages 22.8 Sweetened Beverages 36.8
2 Sweet Bakery Products 14.7 Sweet Bakery Products 16.1 Sweet Bakery Products 14.3
3 Sweetened Beverages 12.4 Other Desserts 8.8 Candy 9.1
4 Other Desserts 7.7 Flavored Milk 7.7 Other Desserts 7.6
5 Breads, Rolls, Tortillas 7.3 Ready-to-Eat Cereals 6.5 Flavored Milk 5.7
6 Sugars 6.6 Candy 6.3 Other Desserts 4.8
7 Candy 5.4 Sugars 5.9 Ready-to-Eat Cereals 4.3
8 Yogurt 4.2 Yogurt 5.5 Coffee and Tea 3.3
9 Quick Breads and Bread Products 3.4 Fats and Oils 3.0 Yogurt 2.6
10 Snack/Meal Bars 3.1 Quick Breads and Bread Products 2.6 Quick Breads and Bread Products 1.8

Top 10 food sources of added sugars for adolescents and teens 9-18 years by decile of intake5

Rank Decile 1 Decile 5 Decile 10
Food Category % Total Added Sugars from Food Category Food Category % Total Added Sugars from Food Category Food Category % Total Added Sugars from Food Category
1 Ready-to-Eat Cereals 12.5 Sweetened Beverages 33.1 Sweetened Beverages 53.3
2 Sweetened Beverages 12.3 Sweet Bakery Products 9.4 Sweet Bakery Products 11.4
3 Breads, Rolls, Tortillas 10.4 Other Desserts 7.1 Candy 5.6
4 Sweet Bakery Products 8.0 Sugars 6.7 Other Desserts 5.5
5 Mixed Dishes-Pizza 6.7 Ready-to-Eat Cereals 6.1 Coffee and Tea 4.9
6 Flavored Milk 6.3 Coffee and Tea 5.9 Ready-to-Eat Cereals 4.7
7 Other Desserts 5.6 Candy 4.2 Sugars 3.1
8 Candy 5.2 Breads, Rolls, Tortillas 4.0 Flavored Milk 1.5
9 Sugars 4.5 Flavored Milk 3.9 Breads, Rolls, Tortillas 1.4
10 Coffee and Tea 4.1 Quick Breads and Bread Products 3.5 Quick Breads and Bread Products 1.2

About the Author

Courtney Gaine, Ph.D., R.D., is the President and CEO for the Sugar Association in Washington, D.C. Prior to this appointment in January 2016, Dr. Gaine served as the Vice President of Scientific Affairs at the association. Dr. Gaine previously served as senior science program manager at the North American branch of the International Life Sciences Institute (ILSI North America), a public, nonprofit scientific foundation that advances the understanding and application of science related to the nutritional quality and safety of the food supply. Prior to ILSI, Dr. Gaine held positions of project director, nutrition and wellness, at the nonprofit organization Convergence and science manager at FoodMinds, a public relations firm. She began her career in academia as an assistant professor at East Carolina University. A native Washingtonian, Dr. Gaine obtained her Ph.D. in nutritional sciences and biochemistry and bachelor’s degree in dietetics from the University of Connecticut, where she was also a co-captain of the UConn women’s basketball team.

References:

  1. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr. 2011;94(3):726–734.
  2. U.S. Department of Agriculture Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group. Food Patterns Equivalents Databases and Datasets. Available at: https://www.ars.usda.gov/Services/docs.htm?docid=23869. Updated September 20, 2018. Accessed October 10, 2018.
  3. U.S. Department of Agriculture Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group. WWEIA data tables. Available at: https:// http://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research- center/food-surveys-research-group/docs/wweia-data-tables/. Updated July 31, 2018. Accessed October 10, 2018.
  4. U.S. Department of Health and Human Services, U.S. Department of Agriculture. 2015 - 2020 Dietary Guidelines for Americans. 8th ed. Available at: http://health.gov/dietaryguidelines/2015/guidelines/. Published December 2015. Accessed April 10, 2018.
  5. Bailey RL, Fulgoni VL, Cowan AE, Gaine PC. Sources of added sugars in young children, adolescents, and adults with low and high intakes of added sugars. Nutrients. 2018;10(1):E102.

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