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Added Sugars in Adults’ Diet: What We Eat in America, NHANES 2015-2016

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Shanthy A Bowman at United States Department of Agriculture
Shanthy A Bowman
john clemens
john clemens
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James E Friday
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Abstract

Overall, 47 percent of adults, 20 years and over, met the 2015-2020 DGA recommendation for added sugars, by limiting added sugars intake to less than 10% of daily calories. • On average, the adults who met the recommendation obtained 5.1 percent, and the adults who did not meet the recommendation obtained 19.4 percent of total calories from added sugars. • On average, the adults who did not meet the DGA recommendation consumed about four times more added sugars than the adults who met the recommendation. • Sweetened beverages were the top source providing about one-third of added sugars in the males’ diets and about one-fourth of added sugars in the females’ diet.
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Highlights
Food Surveys Research Group
Dietary Data Brief No.
U.S. DEPARTMENT OF AGRICULTURE
Agricultural Research Service
Beltsville Human Nutrition Research Center
Food Surveys Research Group
www.ars.usda.gov/nea/bhnrc/fsrg
24
•Overall, 47 percent of adults,
20 years and over, met the
2015-2020 DGA
recommendation for added
sugars, by limiting added
sugars intake to less than 10%
of daily calories.
•On average, the adults who
met the recommendation
obtained 5.1 percent, and the
adults who did not meet the
recommendation obtained
19.4 percent of total calories
from added sugars.
•On average, the adults who
did not meet the DGA
recommendation consumed
about four times more added
sugars than the adults who
met the recommendation.
•Sweetened beverages were
the top source providing
about one-third of added
sugars in the males’ diets and
about one-fourth of added
sugars in the females’ diet.
October 2019
Added Sugars in Adults’ Diet: What We Eat
in America, NHANES 2015-2016
The Dietary Guidelines for Americans 2015-2020 (DGA) recommend that
Americans limit their added sugars intake to less than 10 percent of daily
calories [1]. This study focuses on foods and beverages that are major sources
of added sugars in the diets of adults in America. The study used What We
Eat in America (WWEIA), NHANES 2015-2016, day 1 dietary data and the
Food Patterns equivalents data 2015-2016 [2, 3]. WWEIA Food Categories
were used to group foods and beverages [4]. Mean amounts of added sugars
contributed to adults’ diets were estimated.
Overall, 47 percent of adults, 20 years and over (N=5017), met the DGA added
sugars recommendation by consuming <10 percent of calories from added
sugars. There was no significant difference between the percentages of males
(49%) and females (45%) meeting the recommendation, at P<0.01. In addition,
both males and females consumed similar percentages of calories from added
sugars (Figure 1).
What percentage of adults meet the Dietary Guidelines
added sugars recommendation?
Shanthy A Bowman, PhD; John C Clemens, MS; James E Friday, BS;
Randy P LaComb, MS; Devendra Paudel, MS; and Miyuki Shimizu, MS, RD.
Figure 1. Estimated mean percentage of total calories from added
sugars in adults’ diet, by added sugars intake status and sex, WWEIA,
NHANES 2015-2016
DATA SOURCE: WWEIA, NHANES 2015-2016, day 1, adults 20+ years and FPED 2015-2016 (N=5,017)
12.7 12.5 12.8
5.1 5.0 5.3
19.4 19.8
19.0
0
5
10
15
20
Percentage of calories from
added sugars
All <10% ≥10% All <10% ≥10% All <10% ≥10%
All Adults Males Females
All Consuming <10% of total calories from added sugars Consuming ≥10% of total calories from added sugars
FSRG Dietary Data Brief -- No. 24 -- October 2019
Figure 2. Comparison of mean amounts of added sugars in grams obtained from salient food and
beverage sources by males, 20 years and over, grouped by added sugars intake status
What are the salient sources of added sugars in adult males’ diet?
-2-
Males who did not meet the DGA recommendation consumed about four times more added sugars
than the males who met the recommendation (Figure. 2). Sweetened beverages such as soft drinks,
fruit drinks, and sports and energy drinks were the top source of added sugars. Sweet bakery
products such as cakes, pies, cookies, brownies, doughnuts, sweet rolls, and pastries were the
second highest source, followed by tea and then by coffee, each containing added sugars. Other
salient sources were candy and other desserts such as frozen dairy desserts.
* <10% group (meet DGA recommendation) i s significantly different from the ≥10% group (does not DGA recommendation) at p<0.01
DATA SOURCE: WWEIA, NHANES 2015-2016, day 1, males 20+ years and FPED 2015-2016 (N=2,415)
Mean intake of added sugars: All males = 78.5g; <10% group = 31.2g; ≥10% group = 124.6g
4.9 2.0
7.8
0
10
20
30
40
50
60
All <10%≥10%
Added Sugars (g)
Coffee
3.3 1.6 4.9
0
10
20
30
40
50
60
All <10%≥10%
Added Sugars (g)
Other Desserts
*
3.6 1.8 5.3
0
10
20
30
40
50
60
All <10%≥10%
Added Sugars (g)
Candy
*
28.9
5.0
52.1
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
Sweetened Beverages
*
8.5 4.7
12.3
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
Sweet Bakery Products
*
8.1
1.5
14.6
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
Tea
*
Males 20+ years
*
All Consuming <10% of total calories from added sugars Consuming ≥10% of total calories from added sugars
FSRG Dietary Data Brief -- No. 24 -- October 2019
Figure 3. Comparison of mean amounts of added sugars in grams obtained from salient food and
beverage sources by females, 20 years and over, grouped by added sugars intake status
What are the salient sources of added sugars in adult females’ diet?
-3-
Females who did not meet the DGA recommendation consumed about four times more added sugars
than the females who met the recommendation (Figure. 3). Sweetened beverages such as soft
drinks, fruit drinks, and sports and energy drinks were the top source of added sugars. Sweet bakery
products such as cakes, pies, cookies, brownies, doughnuts, sweet rolls, and pastries were the second
highest source, followed by tea and then by coffee, each containing added sugars. Other salient
sources were candy and other desserts such as frozen dairy desserts.
*<10% group (meet DGA recommendation) is significantly different from the ≥10% group (does not DGA recommendation) at p<0.01
DATA SOURCE: WWEIA, NHANES 2015-2016, day 1, females 20+ years and FPED 2015-2016 (N=2,602)
Mean intake of added sugars: All females = 58.7g; <10% group = 23.6g; ≥10% group = 87.7g
3.8 1.8 5.5
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
3.4 1.5 4.9
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
*
3.4 1.6 4.9
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
*
16.2
3.0
27.1
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
*
8.9
4.1
12.9
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
*
6.2
0.9
10.7
0
10
20
30
40
50
60
All <10% ≥10%
Added Sugars (g)
*
Females 20+ years
Coffee Other DessertsCandy
Sweetened Beverages Sweet Bakery Products Tea
*
All Consuming <10% of total calories from added sugars Consuming ≥10% of total calories from added sugars
FSRG Dietary Data Brief -- No. 24 -- October 2019
Beverages such as sweetened beverages, tea, and coffee together supplied a high proportion of added
sugars in adult’s overall diet. On average, males obtained 37 percent and females, 28 percent of added
sugars from sweetened beverages; and both males and females obtained about 17 percent of added
sugars from tea and coffee, combined.
Sweet bakery products such as cakes, pies, cookies, brownies, doughnuts, sweet rolls, and pastries
provided 11 percent of added sugars in all males’ and 15 percent in all females’ diets.
What are the main sources of added sugars in adults’ diet?
-4-
What is the implication of the study?
This finding underscores the need for dietary interventions aimed to limit intakes of beverages that contain
added sugars.
What are the main findings of the study?
•On average, adults who did not meet the DGA added sugars recommendation consumed
about four times more added sugars than the adults who met the recommendation.
•Food and beverage sources of added sugars in the males’ and females’ diets followed a similar pattern,
though the mean amounts differed.
•Beverages provided about one-half of added sugars in adults’ diet.
FSRG Dietary Data Brief -- No. 24 -- October 2019
Added sugars are defined as caloric sweeteners that are added to foods as an ingredient during
preparation, processing, or at the table. Added sugars do not include naturally occurring sugars such as
lactose present in milk and fructose present in fruit and 100% fruit juice. Examples of added sugars
include brown sugar, cane sugar, confectioners sugar, dextrose, granulated sugar, white sugar, corn
syrup and corn syrup solids, undiluted fruit juice concentrates, honey, molasses, and all types of caloric
syrups such as maple syrup, table syrups, and pancake syrup. One teaspoon equivalent of added
sugars is defined as 4.2 grams of sugars, the amount present in one teaspoon of granulated sugar. For
details on the computation of added sugars and other Food Patterns food groups, see reference #3.
Foods and beverages included in selected WWEIA food categories
Sweetened beverages include non-diet soft drinks, fruit drinks, and sports and energy drinks.
Sweet bakery products include cakes, pies, cookies, brownies, doughnuts, sweet rolls, and pastries.
Other desserts include ice creams and frozen dairy desserts, puddings, gelatins, ices, and sorbets.
Candy include candy containing chocolate and candy not containing chocolate.
Added sugars added to coffee and tea are included in the respective beverages.
Definition of added sugars
(1) What We Eat in America, NHANES 2015-2016, day 1 dietary data were used to estimate Food
Patterns equivalents intakes. The study sample included 5,017 adults ages 20 years and over with
complete and reliable intake records in the survey. Sample weights were applied in the analysis to
produce nationally representative estimates.
(2) Food Patterns Equivalents Database and the corresponding data sets 2015-2016 provided USDA
Food Patterns equivalents intake data, including added sugars data.
(3) WWEIA Food Categories 2015-2016.
Data sources
1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020
Dietary Guidelines for Americans. 8th Edition. December 2015. Available at
http://health.gov/dietaryguidelines/2015/guidelines/. Accessed October 25, 2019.
2. U.S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition
Research Center, Food Surveys Research Group, Beltsville, Maryland, 2015-2016 Food Patterns
Equivalents Databases and Datasets. Available at: http://www.ars.usda.gov/nea/bhnrc/fsrg.
Accessed October 25, 2019.
3. Bowman SA, Clemens JC, Shimizu M, Friday JE, and Moshfegh AJ. 2018. Food Patterns
Equivalents Database 2015-2016: Methodology and User Guide [Online]. Food Surveys Research
Group, Beltsville Human Nutrition Research Center, Agricultural Research Service, U.S.
Department of Agriculture, Beltsville, Maryland. September 2018. Available at:
http://www.ars.usda.gov/nea/bhnrc/fsrg. Accessed October 25, 2019.
4. U.S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition
Research Center, Food Surveys Research Group, Beltsville, Maryland. WWEIA Food Categories
2015-2016. Available at: http://www.ars.usda.gov/nea/bhnrc/fsrg. Accessed October 25, 2019.
References
-5-
www.ars.usda.gov/nea/bhnrc/fsrg
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin,
age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political
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FSRG Dietary Data Brief -- No.
U.S. DEPARTMENT OF AGRICULTURE
Agricultural Research Service
Beltsville Human Nutrition Research Center
Food Surveys Research Group
All material appearing in this report is in the public domain and may be reproduced or copied without
permission. However, citation as to source is appreciated.
Copyright information
24 -- October 2019
Bowman SA, Clemens JC, Friday JE, LaComb RP, Paudel D, and Shimizu M. Added sugars in
adults’ diet: What We Eat in America, NHANES 2015-2016. Food Surveys Research Group. Dietary
Data Brief No. 24. October 2019.
Suggested citation
Shanthy A. Bowman, John C. Clemens, James E. Friday, Randy P. LaComb, Devendra Paudel, and
Miyuki Shimizu are with Food Surveys Research Group, Beltsville Human Nutrition Research Center,
Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland.
About the authors
... T he U.S. Food and Drug Administration's definition of added sugars includes sugars that are added during the processing of foods (such as sucrose or dextrose), foods packaged as sweeteners (such as table sugar), sugars from syrups and honey, and sugars from concentrated fruit or vegetable juices; naturally occurring sugars found in milk, fruits, and vegetables are not included. 1 Sugar-sweetened beverages (SSBs), sweet bakery products, candy, other desserts, and ready-to-eat cereals are top sources of added sugars in the diets of children and adults in the U.S. 2,3 Diets high in added sugars can contribute to adverse health outcomes, including cardiovascular disease, dental caries, weight gain/obesity, and Type 2 diabetes. 4−10 Although added sugar consumption has declined in the U.S., many Americans still consume too much. ...
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... According to the global survey data (including Europe and the United States), an increasing number of people are consuming more sugar than the recommended level of added sugar. The National Health and Nutrition Examination Survey (NHANES) (2015)(2016) has also demonstrated that people of all ages consume, on average, more than 10 % of the recommended dietary energy from added sugar (Bowman et al., 2019). Studies have shown that SSB are the major contributor of added sugars to the American diet (Bleich & Vercammen, 2018). ...
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Objectives Examine differences in perceptions of tap water (TW) and bottled water (BW) safety and TW taste and their associations with plain water (PW) and sugar-sweetened beverage (SSB) intake. Design Quantitative, cross-sectional study. Setting United States. Subjects 4,041 U.S. adults (≥18 years) in the 2018 SummerStyles survey data. Measures Outcomes were intake of TW, BW, PW (tap and bottled water), and SSB. Exposures were perceptions of TW and BW safety and TW taste (disagree, neutral, or agree). Covariates included sociodemographics. Analysis We used chi-square analysis to examine sociodemographic differences in perceptions and multivariable logistic regressions to estimate adjusted odds ratios (AOR) for consuming TW ≤ 1 cup/day, BW > 1 cup/day, PW ≤ 3 cups/day, and SSB ≥ 1 time/day by water perceptions. Results One in 7 (15.1%) of adults did not think their home TW was safe to drink, 39.0% thought BW was safer than TW, and 25.9% did not think their local TW tasted good. Adults who did not think local TW was safe to drink had higher odds of drinking TW ≤ 1 cup/day (AOR = 3.12) and BW >1 cup/day (AOR = 2.69). Adults who thought BW was safer than TW had higher odds of drinking TW ≤1 cup/day (AOR = 2.38), BW > 1 cup/day (AOR = 5.80), and SSB ≥ 1 time/day (AOR = 1.39). Adults who did not think TW tasted good had higher odds of drinking TW ≤ 1 cup/day (AOR = 4.39) and BW > 1 cup/day (AOR = 2.91). Conclusions Negative perceptions of TW safety and taste and a belief BW is safer than TW were common and associated with low TW intake. Perceiving BW is safer than TW increased the likelihood of daily SSB intake. These findings can guide programs and services to support water quality to improve perceptions of TW safety and taste, which might increase TW intake and decrease SSB intake.
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The 2020–2025 Dietary Guidelines for Americans (DGA) recommends less than 10% of total daily calories come from added sugars. However, many adults overconsume added sugars putting them at risk for poor health outcomes. We examined characteristics of high added sugars consumers among US adults (≥20 years) and described their top 10 sources of added sugars intake using National Health and Nutrition Examination Survey 2015–2018 data (n = 9647). We defined high consumers as consuming >15% of daily calories from added sugars (1.5 times higher than the DGA). We used the National Cancer Institute method to estimate usual intake of energy and percent of calories from added sugars. Top 10 sources were identified based on their percentage contribution to total added sugars intake on a given day. T-tests were used to examine differences by age, sex, race/ethnicity, education, income, marital status, and weight status. Overall, mean usual total energy intake and added sugars intake was 2068 kcal/day and 264 kcal/day, respectively, and 30% of adults were classified as high consumers. The prevalence of high added sugars consumers was significantly higher among 20–30-year-olds (29%), 31–50-year-olds (33%), and 51–70-year-olds (29%) than those aged ≥70 years (22%); non-Hispanic Black (39%) and non-Hispanic White (31%) adults than Hispanics (26%); adults with <high school (37%), high school/GED (38%), or some college (34%) than adults with college or higher (15%); adults living in lower-income households (39% for federal poverty income ratio < 130% and 35% for 130%–<350%) than high-income households (21%). The prevalence of high consumers did not differ by sex or weight status. Top sources of added sugars were sweetened beverages (42%), tea (12%), sweet bakery products (11%), and jams/syrups/sugars (7%). Our findings can inform intervention efforts to decrease added sugars intake to support health.
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Food Patterns Equivalents Database 2015-2016: Methodology and User Guide Acknowledgement of Reviewers
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Provides information on the methodology used to develop USDA Food Patterns Equivalents for the NHANES 2015-2016 dietary data
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