Spanish children consume 55.7 grams/day of added sugars, more than twice the amount recommended by the World Health Organization (WHO), which is 25 grams/day. This becomes clear in an observational study carried out by researchers from the ‘José Mataix Verdú’ Institute of Nutrition and Food Technology, of the University of Granada (UGR)and that was recently published in the North American magazine Nutrients.
A diet high in free sugars is associated with an increased risk of obesity, metabolic syndrome and cardiovascular disease. Indeed, childhood obesity figures continue to rise year after year around the world, with prevalence of overweight and obesity in children 23.3% and 17%, respectively.
The authors of the article ‘Consumption of added sugar in Spanish children (7-12 years old) and nutritional density of foods that contribute to this consumption’ constructed an index to assess the nutritional value of the foods under study. In it, they reflected the density of nutrients present in each portion of each food (NDIS) and the daily intake of nutrients (DNII) consumed.
According to the authors, it is necessary to review the diet of minors to favor foods with greater nutritional density and less added sugars.
The survey, which involved the participation of 1,775 parents with children aged 7 to 12 years, through an online distributed survey, was conducted by Jesús Francisco Rodríguez Huertas, Professor of Physiology at the UGR. Researchers from the Department of Biochemistry and Molecular Biology at the UGR, the Institute of Biosanitary Research of Granada (ibs.Granada), the Ricors Network of the Carlos III Health Institute SAMID Network (Maternal and Child Health and Development), the Institute of Nutrition and Technology Alimentar ‘José Mataix Verdú’ and the Biomedical Research Center of the UGR.
Among the conclusions, specialists point out that it is necessary to review the diet of minors to privilege the presence of foods with greater nutritional density and lower contribution of added sugars, as well as to persevere in the strategy of product reformulation by the food industry .
65% comes from foods with low nutritional density
According to the results, 65% of the added sugars consumed daily by Spanish children come from foods and/or products with low nutritional density: white sugar, jellies, sauces, sweets, cocoa powder, soft drinks, ice cream, biscuits, fruit nectars , pastries and industrial pastries, chocolate bars, biscuits and homemade pastries, energy and/or sports drinks.
The remaining 35% of added sugars consumed daily come, on the contrary, from foods and/or products with greater nutritional density: medium density, such as dairy desserts, vegetable drinks and sugary or flavored yogurts, and high density (this is the case of packaged shakes with at least 90% milk, breakfast cereals and fortified infant milk).
According to data from the study and the NDIS index, milk is the food most consumed by Spanish children and has a very high nutritional density, surpassed only by fortified infant milk, which is the food with the highest amount of essential nutrients per serving. —. Milk provides proteins of high biological value, calcium, phosphorus, magnesium, potassium, zinc, vitamin A, riboflavin and niacin, essential nutrients for its development and growth phase.
In the case of breakfast cereals, they have a high nutritional value and contribute 5.9% of the added sugars consumed daily (3.3 g/day). The same occurs with shakes with at least 90% milk, which also provide these nutrients in similar amounts, with the difference that they contain added sugars —they provide 6% of the added sugars consumed daily (3.4 g/day) —, therefore they could be kept in the diet, as they have a high nutritional density index, as long as there is a global consumption of added sugars below the recommendations established by the WHO.
On the contrary, biscuits and cocoa powder, which contain more than 10.3g/serving and 7.3g/serving of added sugars, respectively, are consumed very frequently (between 4 and 6 times a week) and, consequently, , are the two foods that contribute the highest daily amount of added sugar to the diet of Spanish children. None of these foods contribute significantly to the supply of essential nutrients due to their low nutritional density.
The study reveals that not all parents have a clear view of the nutritional profile of the foods their children consume. In fact, it is significant that products that provide a high amount of added sugar per serving (above 15 g/serving) and that have a low nutritional density (<1.5 in the NDIS index), in the case of energy drinks or isotonic drinks, chocolate bars, fruit nectars, cocoa powder or ice cream, are perceived by parents as of normal nutritional quality, equivalent to other foods with low added sugar content and high nutritional density, such as fortified infant formulas, non-dairy beverages, breakfast cereal or smoothies with at least 90% milk.
The case of homemade cookies and pastries is noteworthy, which parents value as having a good nutritional profile, equivalent to that of fortified infant milk or vegetable drinks, when they provide 17 g of added sugar per serving and have a low nutritional density index. . . Or biscuits, widely consumed by most children, which are perceived positively despite providing more than 10 g of added sugar per serving.
Milk is the food most consumed by Spanish children and has a very high nutritional density.
Fortified infant milks are the most nutrient-dense category among those analyzed—twice as much as staple milk in terms of nutrients—as they provide a low amount of added sugars (<5 g per serving), so they represent a potential opportunity to improve the dietary pattern of children, considering deficits in the intake of some essential nutrients.
To classify foods according to their NDIS, the authors considered milk as a quality reference food, with a calculated NDIS of 3, as it provides a significant amount of nutrients without added sugars. Therefore, foods with NDIS close to that of milk (NDIS > 2.5) were considered of high nutritional value. Foods with NDIS between 1.5 and 2.5 were considered of medium nutritional density and foods with NDIS less than 1.5 were considered of low nutritional density.
As for the added sugar content, products with a low added sugar content were those with less than 5 g per serving, moderate added sugar content those with 5-10 g per serving, high added sugar content those with 10-15 g per serving, and those with more than 15 g per serving have a very high added sugar content.
The indices described above were also calculated, which assess the quality of food, such as the SAIN (Nutritional Adequacy Score for Individual Foods) which considers the protein, fiber, iron, calcium and vitamin C content, and the LIM (Nutrient to be limited) which considers unhealthy nutrients: sodium, added sugars and saturated fatty acids. A food with a SAIN index > 5 is considered to have good nutritional density. A food with a LIM index >7.50 is considered rich in nutrients that are harmful to health.
Proposals to reduce consumption
One of the main conclusions of this work is that the nutritional value of a food should not be evaluated only based on the sugar it contains, but one should consider the rest of the nutrients that it can contribute to the diet, that is, its nutritional value. density.
“It is necessary to make the population aware of the need to reduce the consumption of all products that contain added sugars, especially those of low nutritional quality. As part of a healthy and nutritionally adequate diet, occasional consumption (1-2 servings/week) of products of low nutritional quality can be maintained, as long as the added sugar content is low or moderate”, says Jesús Francisco Rodríguez Huertas . , studio manager.
On the other hand, he adds, “a lower presence in the diet of products that provide significant amounts of added sugars should be encouraged in favor of other similar or equivalent ones without added sugars, for example, natural yogurt instead of sweetened or flavored yogurt; the reformulation of products that provide added sugars and are highly consumed; and the improvement of nutritional labeling, which should provide more information about the real contribution of added sugars and minimize confusion with naturally occurring sugars”. In this sense, according to the researcher, “nutritional education campaigns aimed at both parents and children are necessary.
Rodríguez Huertas, JF et al. “Added sugar consumption in Spanish children (7 to 12 years old) and nutrient density of foods contributing to this consumption: an observational study”. Nutrients (2023).