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Association between free sugars intake and nutrient dilution among Japanese adults: the 2016 National Health and Nutrition Survey, Japan

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Abstract

Purpose

The association between free sugars and nutrient intake is unclear in Japanese adults with relatively low free sugars intake. This cross-sectional study aimed to elucidate this relationship using data from the 2016 National Health and Nutrition Survey, Japan, and according to the current World Health Organization (WHO) guidelines for the prevention of nutrient dilution [< 5% or < 10% of energy (%E)].

Methods

Dietary intake of Japanese adults (aged ≥ 20 years; n = 16,652) was assessed using a 1-day weighed dietary record. Mean intakes for selected nutrients and food groups were compared among categories of free sugars intake (i.e., < 2.5%E, 2.5 to < 5%E, 5 to < 10%E, and ≥ 10%E) by adjusting for sex, age, weight status, smoking status, habitual drinking, and occupation.

Results

Free sugars intake was inversely associated with the intake of 16 of 24 micronutrients investigated. Compared to its lower categories of free sugars intake, significant reductions in intake were identified for almost all micronutrients at ≥ 10%E, whereas ten micronutrients were reduced at 5 to < 10%E. The intake of dietary fibre, sodium, potassium, calcium, and iron was lower at < 2.5%E than at 2.5 to < 5%E and/or 5 to < 10%E. Free sugars intake was also positively associated with sugars and jams, confectionaries, fruit and vegetable juices, and soft drinks and inversely with pulses and nuts and vegetables.

Conclusions

This study identified nutrient dilution among Japanese adults with higher free sugars intake and confirmed the significance of the WHO guidelines for preventing nutrient dilution in Japanese.

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Acknowledgement

We thank the participants of the 2016 NHNS and the staff who supported the survey in each local centre and the central office for their valuable contribution.

Funding

This work received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan

    Aya Fujiwara, Emiko Okada, Chika Okada, Mai Matsumoto & Hidemi Takimoto

  2. Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Aya Fujiwara

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  1. Aya Fujiwara
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Contributions

AF developed research questions, analysed and interpreted the data, and wrote the first draft of the manuscript. EO, CO, and HT contributed data collection and assisted in the writing of the manuscript. MM assisted in the writing of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hidemi Takimoto.

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Conflict of interest

All authors declare that there was no conflict of interest.

Ethical standards

This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and verbal informed consent was obtained from all individual participants. Under Article 33 of the Statistics Act, the Ministry of Health, Labour and Welfare anonymised individual level NHNS data, and provided the first author with datasets for this study. This analysis was exempted from the need for ethical review and institutional review board approval because, according to the Ethical Guidelines of Epidemiological Research established by the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour and Welfare [21], only anonymized data were used.

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Fujiwara, A., Okada, E., Okada, C. et al. Association between free sugars intake and nutrient dilution among Japanese adults: the 2016 National Health and Nutrition Survey, Japan. Eur J Nutr 59, 3827–3839 (2020). https://doi.org/10.1007/s00394-020-02213-4

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