Dietary Sugar Research in Preschoolers: Methodological, Genetic, and Cardiometabolic Considerations.

Excess dietary sugar intake increases the risk of unhealthy weight gain, an important cardiometabolic risk factor in children. To further our understanding of this relationship, we performed a narrative review using two approaches. First, research examining dietary sugar intake, its associations with cardiometabolic health, impact of genetics on sweet taste perception and intake, and how genetics moderates the association of dietary sugar intake and cardiometabolic risk factors in preschool-aged children 1.5-5 years old is reviewed. Second, methodological considerations for collecting and analyzing dietary intake of sugar, genetic information, and markers of cardiometabolic health among young children are provided. Our key recommendations include the following for researchers: (1) Further longitudinal research on sugar intake and cardiometabolic risk factors is warranted to inform policy decisions and guidelines for healthy eating in preschool-aged children. (2) Consistency in sugar definitions is needed across research studies to aid with comparisons of results. (3) Select dietary collection tools specific to each study's aim and sugar definition(s). (4) Limit subjectivity of dietary assessment tools as this impacts interpretation of study results. (5) Choose non-invasive biomarkers of cardiometabolic disease until the strengths and limitations of available biomarkers in preschool-aged children are clarified. (6) Select approaches that account for the polygenic nature of cardiometabolic disease such as genome risk scores and genome wide association studies to assess how genetics moderates the relationship between dietary sugar intake and cardiometabolic risk. This review highlights potential recommendations that will support a research environment to help inform policy decisions and healthy eating policies to reduce cardiometabolic risk in young children.

Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics.

Purpose: To examine associations between preschoolers' diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children's diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the "needs improvement" category (51-80 out of a maximum of 100). Children's overall HEI-2015 score was inversely associated with children's age (ß = -0.19, 95% CI -0.37, -0.02). Parental education was positively associated with children's overall HEI score (ß = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (ß = 1.00, 95% CI 0.39, 1.76), vegetables (ß = 1.11, 95% CI 0.03, 2.18), total protein (ß = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (ß = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (ß = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (ß = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (ß = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers' diet quality needs improvement and that children's diet quality varies by children's age and parental education level.

Non-Nutritive Sweetener Intake Is Low in Preschool-Aged Children in the Guelph Family Health Pilot Study.

There is limited research on the intake of non-nutritive sweeteners (NNS) among preschool-aged children. Canada's Food Guide suggests limiting intake of NNS for all population groups and Health Canada recommends that young children (<2 years) avoid consuming beverages containing NNS. The aim of this study was to investigate the frequency and type of non-nutritive sweetener (NNS) intake in preschool-aged children participating in the Guelph Family Health Study pilots. Parents (n = 78 families) completed 3-day food records (n = 112 children; n = 55 females, n = 57 males; 3.6 years ± 1.3). Nineteen children (17%) reported consumption of foods or beverages containing NNS. Food sources with NNS included: freezies, oral nutritional supplements, flavored water, carbonated drinks, sugar free jam and protein powder. The majority of NNS contained in these foods were identified as stevia leaf extract, acesulfame K, sucralose, monk fruit extract and aspartame. Future research should continue to study NNS intake patterns longitudinally in children and examine the association of NNS intake with diet quality and health outcomes.

Dietary sugar intake among preschool-aged children: a cross-sectional study.

BACKGROUND: Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference. METHODS: The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures. RESULTS: We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (ß = -0.02, 95% confidence interval -0.04 to -0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures. INTERPRETATION: Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.