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Intake of free sugar and micronutrient dilution in Australian children and adolescents



This cross-sectional analysis aimed to investigate the association between free sugar intake and micronutrient intake in Australian children and adolescents and to assess the effectiveness of the cut-off of < 10% energy intake from free sugar (%EFS) as recommended by the World Health Organization (WHO).


Dietary data of children and adolescents from the Australian Health Survey 2011–12 were analyzed (n = 1466). Free sugar intake was estimated using a published methodology with modification to suit the definition of free sugar. Six cut-offs for %EFS were created in 5% increments. Participants’ mean intakes of 18 micronutrients, as well as their intakes of core (healthy) and discretionary (unhealthy) foods, at different cut-offs were compared using ANCOVA, with age, sex, and socioeconomic status measures as covariates. The odds ratios of not meeting the nutrient reference values (NRVs) for Australia and New Zealand of each micronutrient were calculated using logistic regression.


Micronutrient intake decreased with increasing %EFS and the peak intakes of most micronutrients appeared between 0–15%EFS. The absolute intakes of most micronutrients were not significantly different between participants who consumed < 10%EFS and ≥ 10%EFS. Those with > 20%EFS were less likely to meet the NRVs of more than half of the micronutrients. Additionally, as %EFS increased, intakes of core food groups decreased, while intakes of discretionary food groups increased.


The dilution effect in micronutrient intake with increasing free sugar intake was evident in Australian children and adolescents. However, meeting the WHO cut-off was associated with limited improvement in micronutrient adequacy.

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We would like to acknowledge that the original data of the 2011–12 AHS were collected by the Australian Bureau of Statistics and Department of Health and Aged Care. The authors declare that those who carried out the original analysis and collection of data bear no responsibility for further analysis and interpretation.


This work did not receive any funding.

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The authors’ responsibilities were as follows—AR and JCYL: jointly designed, supervised, and guided the study. THTW and AM: conducted statistical analyses including the Pearson’s χ2 test, ANOVA, ANCOVA and logistic regression on nutrients. TWHT, AM and RA: conducted statistical analyses ANCOVA on food groups. THTW and AM: wrote the first draft of the manuscript. All authors: interpretation of data, contributed to the discussion, and critically reviewed the final manuscript. JCYL has the primary responsibility for the content of this manuscript.

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Correspondence to Jimmy Chun Yu Louie.

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Wong, T.H.T., Mok, A., Ahmad, R. et al. Intake of free sugar and micronutrient dilution in Australian children and adolescents. Eur J Nutr 58, 2485–2495 (2019).

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  • Free sugars
  • Micronutrient dilution
  • Australia
  • Diet quality
  • National Nutrition Survey