Fulgoni Victor L, Gaine P Courtney, Scott Maria O, Ricciuto Laurie, DiFrancesco Loretta
Nutrition Impact, LLC, Battle Creek, MI, USA.
The Sugar Association, Inc., Washington, DC, USA.
Curr Dev Nutr. 2019 Nov 7;3(12):nzz126. doi: 10.1093/cdn/nzz126. eCollection 2019 Dec.
A concern about the excessive consumption of added sugars is the potential for micronutrient dilution, particularly in children and adolescents; however, the evidence is inconsistent.
We examined the associations between added sugars intake and micronutrient adequacy in US children and adolescents using data from NHANES 2009-2014.
Children and adolescents aged 2-18 ( = 7754), 2-8 ( = 3423), and 9-18 y ( = 4331) were assigned to deciles of added sugars intake based on the average of 2 d of dietary recall. Usual intake of micronutrients was determined using 2 dietary recalls and the National Cancer Institute method. Within each age group, regression analyses were used to assess the relationship between added sugars intake decile and percentage of the population below the estimated average requirements (EARs) for 17 micronutrients.
Deciles of added sugars intake (percentage of calories) ranged from <6.4 to >22.8 among children and adolescents aged 2-18 y, with a median intake of 13.3% of calories. Significant positive associations ( < 0.01) between added sugars intake and percentage of the population (aged 2-18 y) below the EAR were found only for calcium, magnesium, and vitamin D. These associations virtually disappeared after dropping the 2 highest and lowest deciles of intake, suggesting a threshold effect; intakes below approximately 19% of calories from added sugars were generally not associated with micronutrient inadequacy.
As added sugars intake increased, there was a threshold above which an increase in the prevalence of inadequate intakes for calcium, magnesium, and vitamin D among US children and adolescents was observed. However, even at the lower deciles of added sugars, large percentages of the population were below the EAR for these nutrients, suggesting that adequate intakes of these nutrients are difficult to achieve independent of added sugars intake.
对添加糖过量摄入的一个担忧是其可能导致微量营养素稀释，尤其是在儿童和青少年中；然而，证据并不一致。
我们使用2009 - 2014年美国国家健康与营养检查调查（NHANES）的数据，研究美国儿童和青少年中添加糖摄入量与微量营养素充足性之间的关联。
根据2天饮食回顾的平均值，将2 - 18岁（n = 7754）、2 - 8岁（n = 3423）和9 - 18岁（n = 4331）的儿童和青少年分为添加糖摄入量的十分位数组。使用2次饮食回顾和美国国立癌症研究所的方法确定微量营养素的通常摄入量。在每个年龄组内，采用回归分析评估添加糖摄入量十分位数与17种微量营养素低于估计平均需求量（EARs）的人群百分比之间的关系。
2 - 18岁儿童和青少年的添加糖摄入量十分位数（占卡路里的百分比）范围为<6.4至>22.8，中位数摄入量为卡路里的13.3%。仅在钙、镁和维生素D方面发现添加糖摄入量与2 - 18岁人群低于EAR的百分比之间存在显著正相关（P < 0.01）。在去掉摄入量最高和最低的两个十分位数组后，这些关联几乎消失，表明存在阈值效应；来自添加糖的热量摄入量低于约19%时，通常与微量营养素不足无关。
随着添加糖摄入量的增加，存在一个阈值，高于此阈值时，美国儿童和青少年中钙、镁和维生素D摄入不足患病率会增加。然而，即使在添加糖摄入量较低的十分位数组中，很大比例的人群这些营养素的摄入量也低于EAR，这表明独立于添加糖摄入量之外，要实现这些营养素的充足摄入是困难的。
