Association of free sugar intake with blood pressure and obesity measures in Australian adults

  • Rabia Ahmad
  • Angelique Mok
  • Anna M. Rangan
  • Jimmy Chun Yu LouieEmail author
Original Contribution



This study examined the association of free sugar (FS) intake with obesity measures and blood pressure (BP) among a nationally representative sample of Australian adults.


Data from adults (weighted n = 5136) who completed 2 × 24-h recalls and had complete data for BP, waist circumference (WC), waist-to-height ratio (WHtR), and body mass index (BMI) were analyzed. Associations between percentage energy of FS from all food sources (%EFStotal), beverages only (%EFSbeverages), and non-beverages sources only (%EFSnon-beverages) and obesity measures and BP were examined using linear and non-linear regressions. Logistic regression was used to calculate the odds ratios (OR) of being classified as overweight and/or obese, having increased cardiometabolic risks, and elevated BP per 5% point increase in %EFStotal, %EFSbeverages, and %EFSnon-beverages. All regression analyses were adjusted for known socio-economic and lifestyle confounders.


%EFSbeverage was positively associated with BMI, WC, and WHtR (all p < 0.05), while %EFSnon-beverage was inversely associated with these outcomes. Increases in odds of having an undesirable WC/WHtR were found with increasing %EFSbeverages (OR per 5% point increase in %EFSbeverages: 1.19 for WC; 1.23 for WHtR, both p < 0.001). %EFStotal and %EFSnon-beverages were weakly and negatively associated with diastolic BP. A 5% point increase in %EFStotal and %EFSnon-beverage was associated with a 10–25% reduction in odds of having elevated BP.


Our results suggested that only a higher FS intake from beverages may be associated with obesity, and higher FS intake was associated with reduced odds of having elevated BP.


Free sugar Obesity Overweight Blood pressure Diet quality 



We would like to acknowledge that the original data of 2011-12 National Nutrition and Physical Activity Survey were collected by the Australian Bureau of Statistics. The authors declare that those who carried out the original analysis and collection of data bear no responsibility for further analysis and interpretation.

Author contributions

The authors’ responsibilities were as follows—JCYL and AR: jointly designed, supervised, and guided the study. RA: coded foods in the AUSNUT2012-13 database as beverages and non-beverages. RA, JCYL, and AM: involved in calculating usual intake of nutrients. RA and JCYL: analyzed the data. RA: wrote the first draft of the manuscript. AM, RA, JCYL, and AR: interpretation of data, contributed to the discussion, and critically reviewed the final manuscript. JCYL had primary responsibility for the final content.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflicts of interest. No specific funding was received from any agency in the public, commercial, or not-for-profit sectors.

Supplementary material

394_2019_1932_MOESM1_ESM.pptx (46 kb)
Supplementary material 1 (PPTX 45 KB)
394_2019_1932_MOESM2_ESM.docx (47 kb)
Supplementary material 2 (DOCX 46 KB)


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Copyright information

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

Authors and Affiliations

  1. 1.School of Life and Environmental Sciences and Charles Perkins Centre, Faculty of ScienceThe University of SydneySydneyAustralia
  2. 2.School of Biological Sciences, Faculty of ScienceThe University of Hong KongHong KongChina

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