Dietary sources of free sugars in the diet of European children: the IDEFICS Study

  • María Isabel Mesana GraffeEmail author
  • V. Pala
  • S. De Henauw
  • G. Eiben
  • C. Hadjigeorgiou
  • L. Iacoviello
  • T. Intemann
  • H. Jilani
  • D. Molnar
  • P. Russo
  • T. Veidebaum
  • L. A. Moreno
Original Contribution



To report dietary free sugars consumption and their different types and food sources in European children.


The present study is based on the IDEFICS study, a European multicenter cohort study in children (2–9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database.


Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were “Fruit juices”, “Soft drinks”, “Dairy” and “Sweets and candies”.


The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages (“Fruit juices” and “Soft drinks”). It is especially important to reduce children’s intake of free sugars, focusing in target population on certain foods and food groups.


Children Free sugars Food sources Sugar sweetened beverages Sugar recommendations 



This study was conducted as part of the IDEFICS study ( We are grateful for the support provided by school boards, headmasters and communities. We thank the IDEFICS children and their parents for participating in this extensive examination.

Author contributions

All authors contributed to conception and design, acquisition of data, analysis or interpretation of data. Each author has seen and approved the contents of the submitted manuscript. Final approval of the version published was given by all authors.


This study was supported by the European Commission within the Sixth RTD Framework Programme Contract no. 016181 (FOOD) and by the grant from EU for the IDEFICS study. This analysis was also supported by the Spanish Ministry of Science and Innovation (JCI-2010-07055) with the contribution of the European Regional Development Fund (FEDER). The study is supported by a grant from the Spanish Carlos III Health Institute: RD08/0072/0025 (Red SAMID: Maternal, Child Health and Development Research Network) and CIBEROBN. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have declared that no competing interests exist. The content of this article reflects only the author’s views and the European Commission is not liable for any use that may be made of the information contained herein.

Supplementary material

394_2019_1957_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 23 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • María Isabel Mesana Graffe
    • 1
    • 2
    • 3
    • 4
    Email author
  • V. Pala
    • 5
  • S. De Henauw
    • 6
  • G. Eiben
    • 7
    • 8
  • C. Hadjigeorgiou
    • 9
  • L. Iacoviello
    • 10
  • T. Intemann
    • 11
    • 12
  • H. Jilani
    • 11
    • 12
  • D. Molnar
    • 13
  • P. Russo
    • 14
  • T. Veidebaum
    • 15
  • L. A. Moreno
    • 1
    • 2
    • 3
    • 16
  1. 1.Growth, Exercise, NUtrition and Development (GENUD) Research GroupUniversity of ZaragozaSaragossaSpain
  2. 2.Instituto Agroalimentario de Aragón (IA2)SaragossaSpain
  3. 3.Instituto de Investigación Sanitaria Aragón (IIS Aragón)SaragossaSpain
  4. 4.Red de Salud Materno-infantil y del Desarrollo (SAMID)BarakaldoSpain
  5. 5.Epidemiology and Prevention Unit, Department of ResearchFondazione IRCCS Istituto Nazionale Dei TumoriMilanItaly
  6. 6.Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  7. 7.Section for Epidemiology and Social Medicine, Institute of Medicine Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  8. 8.Department of Biomedicine and Public Health, School of Health and EducationUniversity of SkövdeSkövdeSweden
  9. 9.Research and Education Institute of Child HealthStrovolosCyprus
  10. 10.Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and PreventionIRCCS Istituto Neurologico Mediterraneo NeuromedPozzilliItaly
  11. 11.Department of Epidemiological Methods and Etiological ResearchLeibniz Institute for Prevention Research and Epidemiology, BIPSBremenGermany
  12. 12.Institute for Public Health and Nursing– IPPBremen UniversityBremenGermany
  13. 13.Department of Paediatrics, Medical FacultyUniversity of PécsPecsHungary
  14. 14.Institute of Food SciencesNational Research CouncilAvellinoItaly
  15. 15.National Institute for Health DevelopmentTallinnEstonia
  16. 16.Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)MadridSpain

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