Sugar and children — sweets as a daily poison?

Aim of the study: Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs.

Results: In the entire sample, 44.44% (95% CI: 27.73−61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.

Aim of the study: Background: Dental caries, as a multi-factorial problem, is prevalent among children. The aim of this review was to assess the association between dietary free sugars (DFS) consumption and dental caries in 6- to 12-year-old children in the recent longitudinal e vidence.

Results: However, some studies reported non-significant association between consumption of different sugary items and dental caries. The quality of included studies was moderate. Heterogeneity was observed in the measurement of caries outcome, and data collection tool for diet assessment, and statistical measure, which impeded the meta-analysis of data. Conclusion: The methodology and results in the longitudinal studies on the association of dietary free sugar consumption and dental caries in schoolchildren were heterogeneous, which urge the need for further standard research protocols in this area.

Aim of the study: The consumption of sugars, particularly sugar-sweetened beverages (SSBs; beverages or drinks that contain added caloric sweeteners (ie, sucrose, high-fructose corn syrup, fruit juice concentrates), in European children and adolescents exceeds current recommendations.

Results: Sugar should preferably be consumed as part of a main meal and in a natural form as human milk, milk, unsweetened dairy products, and fresh fruits, rather than as SSBs, fruit juices, smoothies, and/or sweetened milk products. Free sugars in liquid form should be replaced by water or unsweetened milk drinks. National Authorities should adopt policies aimed at reducing the intake of free sugars in infants, children and adolescents. This may include education, improved labelling, restriction of advertising, introducing standards for kindergarten and school meals, and fiscal measures, depending on local circumstances.

Aim of the study: Child undernutrition persists in Cambodia despite recent progress. As Cambodia undergoes a shift in dietary consumption that coincides with economic, demographic, and epidemiologic changes, there is risk of ultra-processed foods and sugar-sweetened beverages displacing nutrient-dense foods during the critical period of infant growth in the first 24 months.

Results: Cross-sectional analyses of a 24-h dietary recall from a sample (n = 377) of 24-month-olds found that the majority of infants had been introduced to packaged salty snacks and sweets by 12 months of age and to sugar-sweetened beverages by 15 months. By 24 months of age, 78% of children had consumed foods of low nutritional value and 57% consumed a sugar-sweetened beverage on the previous day. Multivariate logistic regression analyses demonstrated that infant intake of a flavored sugary drink on the previous day was associated with over two times the odds of both stunting and wasting, and consumption of packaged sweets on the previous day was associated with over two times the odds of wasting, but no association was found with stunting. These findings underscore the need to improve educational and policy interventions to support healthy feeding practices for infants and young children.

Aim of the study: To describe current findings on sugar intake in children worldwide, including sugar sources and their impact on child health focusing on cardiometabolic alterations usually associated to obesity.

Results: In children less than 4 years, intakes of added sugars across countries ranged from 9.8 to 11.2% of total energy; in children 4-10 years, it ranged from less than 3-18%; and in adolescents, it ranged from 13.6 to 16.6%. For most countries, intakes of added sugars were greater than the recommended upper limit of 10% of total energy for children and adolescents and less or around 10% in infants. In most studies, soft drinks and fruit-based drinks accounted for the greatest proportion of the added sugars intake, followed by milk products and sweet bakery products. High added sugar intake has been associated with increased obesity risk and fat deposition in the liver, contributing to dyslipidemia, high blood pressure, insulin resistance and cardio-metabolic risk.

Aim of the study: Dietary behaviour is determined by community, family and individual factors, including availability and costs of foods. Preference for sweetness starts early in life and remains throughout childhood, and starts declining to adult levels only during mid-adolescence.

Results: These statements have influenced organisations such as the American Hearth Association (AHA), the American Academy of Pediatrics (AAP) and the World Health Organization (WHO), who recommend to limit free sugars intake to less than 10% of the total energy intake for adults and children, observing that a further reduction of 5% would provide additional health benefits [WHO, 2015]. The first few months of life are crucial for the flavour learning process in humans. Early experience with different tastes is very important for later acceptance of foods, especially the healthy ones. Clinicians and parents can and should support in synergy the healthy development of children's taste preference and eating behaviour.

Aim of the study: Previous research shows a longitudinal relationship between poor sleep and obesity in adolescents, highlighting the need to identify shared modifiable determinants to strengthen health-promoting interventions. The aim of this study was to investigate the determinants at 10 and 12 years associated with short sleep and body mass index percentile (BMIp) at 14 years, using data from the Growing Up in Scotland (GUS) study.

Results: Data from 4157 participants (50.2% male) were analysed. In adjusted models, having tried smoking and having tried alcohol at 12 years and being allowed to eat whenever the child wanted at 10 years were meaningfully associated with shorter sleep duration and higher BMIp at 14 years. Maternal BMI was meaningfully associated with BMIp only, while poorer emotional wellbeing and sugar-sweetened beverage consumption were meaningfully associated with shorter sleep only. Smoking and alcohol experimentation and less structured eating timing were identified as shared determinants of shorter sleep and higher BMIp in adolescence. These findings suggest that risk-taking behaviours and eating routines may be important targets for future research and health-promoting interventions addressing sleep and weight-related outcomes.

Aim of the study: Dietary diversity (DD) assesses the access and consumption of varieties of food types, there are few studies conducted on DD, the current study targeted adolescent girls in high schools in Addis Ababa, Ethiopia. To assess the magnitude of DD and its associated factors among high school adolescent girls in Addis Ababa, Ethiopia.

Results: The prevalence of inadequate dietary diversity score (DDS) among adolescent girls was 33.4%, 95%CI [29.66%, 37.14%] with average of 6.48 food groups consumed daily. Grains/roots and tubers (77.7%) were the most commonly consumed food groups in the last 24 h dietary recall. Maternal education [adjusted odds ratio (AOR) = 1.42, 95%CI, (1.12-2.99)], Meal frequency [AOR = 1.54, 95%CI, (1.06-2.25)], Nutritional education [AOR = 1.53, 95%CI, (1.35-1.80)] and Consumption of sweet foods [AOR = 1.71, 95%CI, (1.17-2.50)] were independent predictors of inadequate DDS. One third of female adolescents had inadequate DDS. Grains/tubers and roots were the most consumed food groups. Maternal education, meal frequency, nutritional education, and nonconsumption of more sweet foods/drinks were significantly associated with the inadequate DDS.