Associations between attitudes towards and reported intakes of sugars, low/no-calorie sweeteners, and sweet-tasting foods in a UK sample.

Public health initiatives are currently aiming to lower free sugar intakes for health benefits, but attitudes towards sugars, their alternatives such as low/no-calorie sweeteners (LNCS), and towards sweet-tasting foods may be hampering efforts. This work investigated associations between attitudes towards and the reported intakes of sugars, LNCS and sweet-tasting foods, and identified latent attitude profiles in subpopulations of adults in the United Kingdom. A total of 581 adults completed a questionnaire assessing their usual intake of sugars, LNCS and sweet-tasting foods, attitudes towards these foods and various demographic characteristics. Six principal components explained 39.1% of the variance in the attitude responses, named: 'Personal Impact', 'Personal Management', 'Apathy', 'Negativity', 'Perceived Understanding' and 'Perceived Nonautonomy'. Personal Impact was negatively associated with reported consumption of sugar-food and sweet-tasting food groups more frequently (smallest ß = -0.24, p < .01). Personal Management was positively associated with reporting adding sugar and consuming sugar-food and sweet-tasting food groups more frequently (smallest ß = 0.14, p < .01). Three latent classes of participants with distinct patterns of attitudes were identified, labelled: 'Feeling Ill-equipped' (n = 52), 'Actively Engaged' (n = 162) or 'Unopinionated' (n = 367). Individuals who were classed as Actively Engaged reported adding LNCS more frequently than those classed as Feeling Ill-equipped (t(212) = -2.14, p<.01), who reported consuming sweet-tasting food groups more frequently than those classed as Unopinionated (t(417) = 2.65, p < .01). These findings suggest the need for personalised approaches within public health initiatives, to reduce free sugar intakes.

Study protocol of the sweet tooth study, randomized controlled trial with partial food provision on the effect of low, regular and high dietary sweetness exposure on sweetness preferences in Dutch adults.

BACKGROUND: Several health organizations recommend lowering the consumption of sweet-tasting foods. The rationale behind this recommendation is that a lower exposure to sweet foods may reduce preferences for sweet tasting foods, thus lowering sugar and energy intake, and in turn aiding in obesity prevention. However, empirical data supporting this narrative are lacking. In fact, relatively little is known about the contribution of long-term sweet taste exposure on one's sweetness preferences. METHODS: The primary objective of this randomized controlled trial is to assess the effect of low, regular and high dietary sweetness exposure on preference for sweet foods and beverages, and to compare these effects between intervention groups. One hundred and eighty adults aged 18-65 years with a BMI of 18.5-30.0 kg/m2 will be recruited and randomly allocated to either: low dietary sweetness exposure (LSE) (10-15% daily energy from sweet tasting foods), regular dietary sweetness exposure (RSE) (25-30% daily energy from sweet tasting foods), or high dietary sweetness exposure (HSE) (40-45% daily energy from sweet tasting foods), for 6 months, followed by a 4-month follow up. Intervention foods are provided ad libitum, covering approximately 50% of the daily number of food items, to include sugar-sweetened, low-calorie-sweetener-sweetened and non-sweet foods. The primary outcome measure is the difference in change in sweetness preference from baseline to 6 months between intervention groups. Secondary outcomes include: change in sweet taste preferences at different time-points; taste intensity perception; behavioral outcomes: food choice and intake, sweet-liker type, food cravings, dietary taste preferences and dietary taste patterns; anthropometric outcomes: body composition, waist-hip circumference, body weight; and biochemical outcomes: glucose variability and biomarkers related to CVD and diabetes. DISCUSSION: This study will generate important data on the effect of dietary sweetness exposure on sweetness preferences in terms of effect size and change, duration of change and its impact on food intake, body weight status and associated health outcomes. TRIAL REGISTRATION: The study protocol has been registered on ClinicalTrials.gov (ID no. NCT04497974, Registered 4 August 2020, https://clinicaltrials.gov/ct2/show/NCT04497974 ) and approved by Wageningen's Medical Ethical Committee (ABR no. NL72134).

Sweet Talk: A Qualitative Study Exploring Attitudes towards Sugar, Sweeteners and Sweet-Tasting Foods in the United Kingdom.

Worldwide initiatives currently aim to reduce free sugar intakes, but success will depend on consumer attitudes towards sugar and the alternatives. This work aimed to explore attitudes towards sugar, sweeteners and sweet-tasting foods, towards consumption and related policies, in a sample of the general public of the UK. Focus groups and interviews were conducted with 34 adults (7 males, ages: 18-65 years). Thematic analysis identified six themes: 'Value' (e.g., pleasure, emotions), 'Angle' (e.g., disinterest), 'Personal Relevance' (to be concerned and/or change one's own behavior), 'Personal Responsibility' (one has an active relationship with these food items), 'Understanding' (the acquisition, comprehension and application of information) and 'It's Not Up to Me' (a passive approach, because intake is subjected to other factors). Both positive and negative attitudes towards sugar, sweeteners and sweet-tasting foods were expressed in all themes. Participants also reported varied engagement with and motivations towards all food items, with implications for intakes. Suggested challenges and potential strategies for reducing free sugar intakes highlighted the need for differing approaches. Future work should assess associations between attitudes and intakes. For greatest population benefit, evidence of the dominant attitudes in those in greatest need of reduced free sugar intakes would be of value.