Relationship between the intake of added sugars and dietary adequacy in adolescents from the municipality of Sao Paulo, Brazil

Objective This study assessed the relationship between intake of added sugars and intake adequacy of nutrients and food groups in adolescents from Sao Paulo. Methods The study sample comprised 793 adolescents selected from a population-based cross-sectional study conducted in 2003. Food intake was assessed by 24-hour food recalls and an adjustment approach was subsequently administered using a subsample of 195 subjects. Sugar intake was considered appropriate or inappropriate when it represented <= 10% or > 10% of total energy intake, respectively. Acceptable distribution ranges were used to assess macronutrient intake adequacy. The prevalence of micronutrient inadequacy was estimated using the Estimated Average Requirements as cutoffs. Median food intake and the 25th and 75th percentiles were estimated. The chi-square, Wald and median tests were used to analyze the data. The significance level was set at 5%. Results A larger proportion of adolescents with adequate carbohydrate intake were seen among those with higher added sugar intake. Protein intake by all adolescents was within the recommended ranges. A statistically significant association was found between adequacy of fat intake and added sugar intake among male adolescents. A higher median percent intake of milk, meat, fruit, processed juice, soft drink and chocolate milk was seen among adolescents with excess sugar intake. Conclusion Excessive consumption of added sugars was associated with lower adequacy of nutrient intake and lower intake of nutrient-dense foods.