J Nutr Health.  2014 Aug;47(4):268-276. 10.4163/jnh.2014.47.4.268.

Dietary total sugar intake of Koreans: Based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011

• Lee HS
• Kwon SO
• Yon M
• Kim D
• Lee JY
• Nam J
• Park SJ
• Yeon JY
• Lee SK
• Lee HY
• Kwon OS
• Kim CI

• KMID: 2327160
• DOI: http://doi.org/10.4163/jnh.2014.47.4.268

Abstract

PURPOSE
The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population.
METHODS
Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS.
RESULTS
Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake.
CONCLUSION
This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.

Keyword

total sugar intake; beverage; Koreans

MeSH Terms

Adolescent
Agriculture
Asian Continental Ancestry Group
Beverages
Bread
Carbonated Beverages
Coffee
Diet
Energy Intake
Food Labeling
Fruit
Humans
Korea
Nutrition Surveys*
Recommended Dietary Allowances
Vegetables
Young Adult
Coffee

Figure

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  Fig. 1 Total sugar intake as a percentage of daily energy intake by age in Koreans.

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  Fig. 2 Distribution of total sugar intake among different food groups by age in Koreans.

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  Fig. 3 Distribution of total sugar intake from beverage among different beverage sources by age in Koreans.

Reference

1. Korea Health Industry Development Institute. 2013 food industry analysis report. Cheongju: Korea Health Industry Development Institute;2013.

2. Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001; 9(3):171–178.

3. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001; 357(9255):505–508.

4. Millar L, Rowland B, Nichols M, Swinburn B, Bennett C, Skouteris H, Allender S. Relationship between raised BMI and sugar sweetened beverage and high fat food consumption among children. Obesity (Silver Spring). 2014; 22(5):E96–E103.

5. Gibson S, Neate D. Sugar intake, soft drink consumption and body weight among British children: further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity. Int J Food Sci Nutr. 2007; 58(6):445–460.

6. Gross LS, Li L, Ford ES, Liu S. Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment. Am J Clin Nutr. 2004; 79(5):774–779.

7. Kosova EC, Auinger P, Bremer AA. The relationships between sugar-sweetened beverage intake and cardiometabolic markers in young children. J Acad Nutr Diet. 2013; 113(2):219–227.

8. Feig DI. Sugar-sweetened beverages and hypertension. Future Cardiol. 2010; 6(6):773–776.

9. Kim Y, Chang H. Correlation between attention deficit hyperactivity disorder and sugar consumption, quality of diet, and dietary behavior in school children. Nutr Res Pract. 2011; 5(3):236–245.

10. World Health Organization (CH). WHO technical report series 916. Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. Geneva: World Health Organization;2002.

11. World Health Organization (CH). WHO opens public consultation on draft sugars guideline [Internet]. Geneva: World Health Organization;2014. cited 2014 Jul 29. Available from: http://www.who.int/mediacentre/news/notes/2014/consultation-sugar-guideline/en/.

12. U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2010. 7th Edition. Washington, DC: U.S. Government Printing, USA;2010.

13. Food Standards Agency (GB). FSA nutrient and food based guidelines for UK institutions. London: Food Standards Agency;2006.

14. The Korean Nutrition Society. Dietary reference intakes for Koreans. Seoul: The Korean Nutrition Society;2010.

15. Cho SH, Chung CE, Kim SH, Chung HK. Establishment of total sugar reference value for Koreans. Korean J Nutr. 2007; 40:Suppl. 3–8.

16. Chung CE. Association of total sugar intakes and metabolic syndrome from Korean National Health and Nutrition Examination Survey 2001-2002. Korean J Nutr. 2007; 40:Suppl. 29–38.

17. Chung CE. Dietary intakes and food sources of total sugars from Korean National Health and Nutrition Examination Survey 2001-2002. Korean J Nutr. 2007; 40:Suppl. 9–21.

18. Korea Food and Drug Administration. Press release: campaign to reduce sugar intake. Cheongju: Korea Food and Drug Administration;2012. 05. 24.

19. United States Department of Agriculture, Agricultural Research Service. USDA national nutrient database for standard reference, release 25. Washington, D.C.: United States Department of Agriculture;2012.

20. Korea Food and Drug Administration. Food code: notification No. 2011-16 of the Ministry of Finance and Economy. Cheongju: Korea Food and Drug Administration;2011. 04. 01.

21. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr. 2011; 94(3):726–734.

22. Langlois K, Garrigue D. Sugar consumption among Canadians of all ages. Health Rep. 2011; 22(3):23–27.

23. Bates B, Lennox A, Bates C, Swan G. Department of Health. Food Standard Agency. National diet and nutrition survey: headline results from years 1 and 2 (combined) of the rolling programme (2008/2009-2009/10). London: Food Standard Agency;2010.

24. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Cheongwon: Korea Centers for Disease Control and Prevention;2013.

25. Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014; 174(4):516–524.

26. Hess J, Latulippe ME, Ayoob K, Slavin J. The confusing world of dietary sugars: definitions, intakes, food sources and international dietary recommendations. Food Funct. 2012; 3(5):477–486.

27. Review of labelling reference intake values: scientific opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from the commission related to the review of labelling reference intake values for selected nutritional elements. (Question No EFSA-Q-2008-772). EFSA J. 2009; 1008.

28. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA). Scientific opinion on dietary reference values for carbohydrates and dietary fibre. EFSA J. 2010; 8(3):1462.

29. Ministry of Health Malaysia, National Coordinating Committee on Food and Nutrition. Malaysia dietary guildline. Putrajaya: National Coordinating Committee on Food and Nutrition;2010.

30. Saeland M, Haugen M, Eriksen FL, Wandel M, Smehaugen A, Böhmer T, Oshaug A. High sugar consumption and poor nutrient intake among drug addicts in Oslo, Norway. Br J Nutr. 2011; 105(4):618–624.

31. Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr. 2011; 14(1):5–13.

32. Olsen NJ, Andersen LB, Wedderkopp N, Kristensen PL, Heitmann BL. Intake of liquid and solid sucrose in relation to changes in body fatness over 6 years among 8- to 10-year-old children: the European Youth Heart Study. Obes Facts. 2012; 5(4):506–512.

33. United States Department of Agriculture, Food and Nutrition Service. 7 CFR Parts 210 and 220. National school lunch program and school breakfast program: nutrition standards for all foods sold in school as required by the healthy, hunger-free kids act of 2010: interim final rule. Fed Regist. 2013; 78(125):39068–39120.

34. Centers for Disease Control and Prevention (US). The CDC guide to strategies for reducing the consumption of sugar-sweetened beverages. Atlanta (GA): Centers for Disease Control and Prevention;2010.

35. Food Standard Agency (GB). Recommendations to industry on saturated fat and added sugar reductions, and portion size availability for biscuits, cakes, buns, chocolate confectionery and soft drinks. London: Food Standard Agency;2010.

36. Academy of Medical Royal Colleges (GB). Measuring up: the medical profession's prescription for the nation's obesity crisis. London: Academy of Medical Royal Colleges;2013.

37. Ministry of Food and Drug Safety. Special act on safety control of children's dietary life. Law No. 12671 (May 21 2005).