European Journal of Nutrition

, Volume 58, Issue 3, pp 1247–1258 | Cite as

Urinary sucrose and fructose to validate self-reported sugar intake in children and adolescents: results from the I.Family study

  • Timm IntemannEmail author
  • Iris Pigeot
  • Stefaan De Henauw
  • Gabriele Eiben
  • Lauren Lissner
  • Vittorio Krogh
  • Katarzyna Dereń
  • Dénes Molnár
  • Luis A. Moreno
  • Paola Russo
  • Alfonso Siani
  • Ivana Sirangelo
  • Michael Tornaritis
  • Toomas Veidebaum
  • Valeria Pala
  • On behalf of the I.Family consortium
Original Contribution



Excessive consumption of free sugar increases the risk for non-communicable diseases where a proper assessment of this intake is necessary to correctly estimate its association with certain diseases. Urinary sugars have been suggested as objective biomarkers for total and free sugar intake in adults but less is known about this marker in children and adolescents. Therefore, the aim of this exploratory study is to evaluate the relative validity of self-reported intake using urinary sugars in children and adolescents.


The study was conducted in a convenience subsample of 228 participants aged 5–18 years of the I.Family study that investigates the determinants of food choices, lifestyle and health in European families. Total, free and intrinsic sugar intake (g/day) and sugar density (g/1000 kcal) were assessed using 24-h dietary recalls (24HDRs). Urinary sucrose (USUC) and urinary fructose (UFRU) were measured in morning urine samples and corrected for creatinine excretion (USUC/Cr, UFRU/Cr). Correlation coefficients, the method of triads and linear regression models were used to investigate the relationship between intake of different types of sugar and urinary sugars.


The correlation between usual sugar density calculated from multiple 24HDRs and the sum of USUC/Cr and UFRU/Cr (USUC/Cr + UFRU/Cr) was 0.38 (p < 0.001). The method of triads revealed validity coefficients for the 24HDR from 0.64 to 0.87. Linear regression models showed statistically significant positive associations between USUC/Cr + UFRU/Cr and the intake of total and free sugar.


These findings support the relative validity of total and free sugar intake assessed by self-reported 24HDRs in children and adolescents.


24-h dietary recall Dietary sugar Sugar biomarker Urine sugars Validity coefficient 



This work was done as part of the I.Family Study ( We gratefully acknowledge the financial support of the European Commission within the Seventh RTD Framework Programme Contract No. 266044. We thank the I.Family children and their parents for participating in this extensive examination. We are grateful for the support from school boards, headmasters and communities.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during this research. The study was approved by the local ethics committee in each center and has been conducted according to the guidelines laid down in the 1964 Declaration of Helsinki and its later amendments. Study participants did not undergo any procedures unless they (and their parents) had given consent for examinations, collection of samples, subsequent analysis and storage of personal data and collected samples. Study subjects and their parents could consent to single components of the study while abstaining from others.

Supplementary material

394_2018_1649_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 26 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Timm Intemann
    • 1
    • 2
    Email author
  • Iris Pigeot
    • 1
    • 2
  • Stefaan De Henauw
    • 3
  • Gabriele Eiben
    • 4
    • 5
  • Lauren Lissner
    • 4
  • Vittorio Krogh
    • 6
  • Katarzyna Dereń
    • 7
  • Dénes Molnár
    • 8
  • Luis A. Moreno
    • 9
  • Paola Russo
    • 10
  • Alfonso Siani
    • 10
  • Ivana Sirangelo
    • 11
  • Michael Tornaritis
    • 12
  • Toomas Veidebaum
    • 13
  • Valeria Pala
    • 6
  • On behalf of the I.Family consortium
  1. 1.Leibniz Institute for Prevention Research and Epidemiology–BIPSBremenGermany
  2. 2.Institute of StatisticsBremen UniversityBremenGermany
  3. 3.Department of Public HealthGhent UniversityGhentBelgium
  4. 4.Section for Epidemiology and Social Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  5. 5.Department of Biomedicine and Public Health, School of Health and EducationUniversity of SkövdeSkövdeSweden
  6. 6.Epidemiology and Prevention UnitFondazione IRCSS Istituto Nazionale dei TumoriMilanItaly
  7. 7.Institute of Nursing and Health Sciences, Medical FacultyUniversity of RzeszowRzeszówPoland
  8. 8.Department of PaediatricsUniversity of PécsPécsHungary
  9. 9.Growth, Exercise, Nutrition and Development (GENUD) Research GroupUniversidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN)ZaragozaSpain
  10. 10.Institute of Food SciencesNational Research CouncilAvellinoItaly
  11. 11.Department of Biochemistry, Biophysics and General PathologyUniversity of Campania “L. Vanvitelli”NaplesItaly
  12. 12.Research and Education Institute of Child HealthStrovolosCyprus
  13. 13.National Institute for Health DevelopmentTallinnEstonia

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