Age and time trends in sugar intake among children and adolescents: results from the DONALD study



To describe age and time trends in added sugar, free sugar and total sugar intake among German 3–18-year-olds.


Overall, 10,761 3-day dietary records kept between 1985 and 2016 by 1312 DONALD participants (660 boys, 652 girls) were analysed (%E) using polynomial mixed-effects regression models.


TS intake decreased with age (♂: linear, quadratic and cubic trend all p < 0.0098; ♀: linear trend p < 0.0001). While the oldest children had the lowest FS intake (linear, quadratic trend: p < 0.0001), the youngest children had the lowest AS intake (linear, quadratic trend p < 0.0001, cubic trend p = 0.0004). In terms of time trends, TS (♂: cubic trend p = 0.0052; ♀: quadratic trend p = 0.0608, cubic trend p = 0.0014) and FS (quadratic trend p = 0.0163, cubic trend p < 0.0001) intake increased between 1985 and 2005 and decreased thereafter, most notably since 2010. AS intake decreased between 1985 and 1995, increased slightly until 2005 and decreased thereafter, most notably since 2010 (linear, quadratic, cubic trend p < 0.0001). FS intake exceeded 10%E/day throughout the 30-year study period.


Our results do not support the common assumptions that sugar intake is on the rise and generally higher among adolescents than among younger children. Of note, TS, AS and FS intakes have decreased in the last decade among all age groups. Nevertheless, FS intake still exceeds the intake level recommended by the WHO.

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The DONALD Study is financially supported by the Ministry of Science and Research of North Rhine-Westphalia, Germany. The results presented in this article are part of a project funded by the German Federal Ministry of Food and Agriculture (BMEL) through the Federal Office for Agriculture and Food (BLE), grant 2816HS024. The participation of all children and their families in the DONALD Study is gratefully acknowledged. We also thank the DONALD staff for carrying out the anthropometric measurements, for administering the questionnaires, and for collecting and coding the dietary records.

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Correspondence to Ute Alexy.

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Conflict of interest

AEB is a member of the International Carbohydrate Quality Consortium (ICQC). IP, SS, KWDC and UA declare that they have no conflict of interest.

Ethical standard

The DONALD Study was approved by the Ethics Committee of the University of Bonn, Germany.

Informed consent

All assessments in the DONALD Study were performed with parental and later on participants’ written informed consent.

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Perrar, I., Schmitting, S., Della Corte, K.W. et al. Age and time trends in sugar intake among children and adolescents: results from the DONALD study. Eur J Nutr 59, 1043–1054 (2020).

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  • Sugar intake
  • Added sugar
  • Free sugar
  • Trends
  • Children
  • Adolescents