Consumption of added sugars among US children and adults by food purchase location and food source


Background: The proposed changes to the Nutrition Facts Label by the US Food and Drug Administration will include information on added sugars for the first time.

Objective: The objective was to evaluate the sources of added sugars in the diets of a representative sample of US children and adults by food purchase location and food source (eg, food group).

Design: This cross-sectional study among 31,035 children, adolescents, and adults aged ≥6 y from the 2003–2004, 2005–2006, 2007–2008, and 2009–2010 NHANES used data from a 24-h dietary recall to evaluate consumption of added sugars. Food locations of origin were identified as stores (supermarket or grocery store), quick-service restaurants (QSRs)/pizza, full-service restaurants (FSRs), schools, and others (eg, vending machines or gifts). Added sugars consumption by food purchase location was evaluated by age, family income-to-poverty ratio, and race-ethnicity. Food group sources of added sugars were identified by using the National Cancer Institute food categories.

Results: Added sugars accounted for 14.1% of total dietary energy. Between 65% and 76% of added sugars came from stores, 6% and 12% from QSRs, and 4% and 6% from FSRs, depending on age. Older adults (aged ≥51 y) obtained a significantly greater proportion of added sugars from stores than did younger adults. Lower-income adults obtained a significantly greater proportion of added sugars from stores than did higher-income adults. Intake of added sugars did not vary by family income among children/adolescents. Soda and energy and sports drinks were the largest food group sources of added sugars (34.4%), followed by grain desserts (12.7%), fruit drinks (8.0%), candy (6.7%), and dairy desserts (5.6%).

Conclusions: Most added sugars came from foods obtained from stores. The proposed changes to the Nutrition Facts Label should capture the bulk of added sugars in the US food supply, which suggests that the recommended changes have the potential to reduce added sugars consumption.


Alex’s Notes: More sugar goodness! This is a very brief study that I thought was interesting, as it brings light to where Westerners are getting their added sugars from. The study itself is spurred by the sad, sad fact that added sugars represent about 15% of the total energy intake of children and about 13% among adults. Collectively, soda and energy and sports drinks, grain-based desserts, fruit drinks, dairy desserts, and candy contributed 66% of the total added sugars.

The study at hand looked at the NHANES data from 2003-2010, and ultimately aggregated information on over 31,000 persons over six years of age. Needless to say, the results clearly demonstrate that people are poor decision makers when it comes to eating, as demonstrated by the fact that 71% of the added sugars came from stores, while only 15% came from restaurants. At least 2/3rds of added sugars came from stores regardless of age-group. So for everyone who blames McDonald’s and co. for the current health status of the nation, just know that self-selected grocery store purchases are the main source of added sugars and thus probably of junk food and snacks as well.

Not surprisingly, lower income families consumed statistically significantly more added sugars, although this was only in adults and not children, and the absolute difference is minor. Sugar from restaurants was relatively constant, but store-bought added sugars decreased by about 4g daily per $15,000 of income, and the highest amount was 67g in those below the poverty level.

 Again not surprisingly, soda and energy drinks were the largest single source of added sugars at 34%, followed by grain desserts at 13%, and instead of continuing to list things I will just show you this lovely picture below.


It is blatantly clear that the bulk of added sugars in the American diet come from foods and beverages that people buy in stores. Added sugars include all sugars used as ingredients in processed foods, and thus people are buying the bulk of their sugar as processed junk food. The FDA has been considering a nutrition label overhaul that would separate out added from naturally occurring sugars on the label. Whether or not this would help reduce junk-food consumption I do not know. However, it is clear that most don’t use the label – let alone the ingredient list – currently when buying food. Do they not care? Or do they simply not know? Hopefully the label changes will help.


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