Early-Life Added Sugars (≤2 years): Intake Patterns, Contributors, and Key Associations

Investigators in the Nutrients report from the MAS‑Lactancia cohort examined added sugar (AS) intake across complementary-feeding ages and described how exposure related to parent-reported eating behaviors and measured anthropometrics.

The analysis included 248 mother–child pairs with dietary and outcome data spanning 6 to 24 months of age. The authors present descriptive intake patterns (including main sources of AS at different ages) alongside adjusted associations comparing children with higher versus lower AS exposure over the same follow-up window.

AS intake was estimated from interviewer-led 24-hour dietary recalls at 6, 9, 12, 18, and 24 months, using a multiple-pass approach and food-composition methods described by the authors. AS exposure was classified into tertiles: low (0 g/day), medium (0.01–6.96 g/day), and high (>6.96 g/day). The paper reports adjusted models comparing these intake categories while accounting for repeated measures within children and selected maternal and child covariates, then describes how AS intake and its sources changed over time.

Across ages, the authors report that AS intake increased and contributed a larger share of total energy as children approached 24 months, and that AS accounted for 6% of total energy intake at that age.

At 24 months, median AS intake was reported as 19.4 g/day. The article also describes leading food-group contributors identified from recall data, with infant formulas prominent early on and increasing contributions from table sugars and sweet baked goods as complementary foods diversified; industrialized fruit and vegetable juices and other sweet items are also listed among contributors at later visits.

In adjusted linear mixed models, the authors report that children in the highest AS tertile had higher scores on selected eating-behavior subscales and differences in certain anthropometric measures versus the low-intake group. For appetite/satiety indicators assessed with the Child Eating Behavior Questionnaire, reported estimates for high versus low intake included emotional overeating (β 0.58; 95% CI 0.04 to 1.12) and food fussiness (β 1.45; 95% CI 0.38 to 2.53). For anthropometrics, reported differences included waist circumference (β 2.02 cm; 95% CI 1.32 to 2.73) and length-for-age Z score (β −0.17; 95% CI −0.32 to −0.01). As presented, these associations span both behavioural measures and growth/adiposity-related measures.

The article also reports analyses evaluating breastfeeding duration measures as predictors of AS intake over 6 to 24 months, focusing on exposure rather than behavioural or anthropometric endpoints. In adjusted mixed-effects models, exclusive breastfeeding for more than 3 months was associated with lower AS intake (β −3.59 g/day; 95% CI −6.34 to −0.84), and continued breastfeeding was associated with lower AS intake (β −9.78 g/day; 95% CI −13.20 to −6.34).

The authors note limits to causal inference in this observational setting and state that reverse causation cannot be fully ruled out. Overall, the paper links longer breastfeeding duration measures with lower measured AS intake in this cohort.

Key Takeaways:

• AS intake from 6–24 months was estimated via repeated interviewer-led 24-hour recalls and analysed in tertiles, including a no-added-sugar group.
• In this cohort, the highest AS intake category was reported to be associated with higher scores on select Child Eating Behaviour Questionnaire subscales, higher waist circumference, and lower length-for-age.
• Longer exclusive and continued breastfeeding durations were reported to be associated with lower AS intake over the same follow-up period.