Abstract/Summary

Trend analyses based on dietary records suggest decreases in the intakes of total (TS), added (AS) and free sugar (FS) since 2005 among children and adolescents in Germany. In terms of age trends, TS intake decreased with increasing age. However, self-reported sugar intake in epidemiological studies is criticized, as it may be prone to bias due to selective underreporting. Furthermore, adolescents are more susceptible to underreporting than children. We thus analyzed time and age trends in urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE+SE) as biomarkers for sugar intake among 8.5-16.5-year-old adolescents. Urinary sugar excretion was measured by UPLC-MS/MS in 997 24-h urine samples collected from 239 boys and 253 girls participating in the DONALD study cohort between 1990 and 2016. Time and age trends of log-transformed FE, SE and FE+SE were analyzed using polynomial mixed-effects regression models. Between 1990 and 2016 FE as well as FE+SE decreased (linear time trend: p=0.0272 and p<0.0001, respectively). A minor increase in excretion during adolescence was confined to FE (linear age trend: p=0.0017). The present 24-h excretion measurements support a previously reported dietary-record based decline in sugar intake since 2005. However, the previous seen dietary record-based decrease in TS from childhood to late adolescence was not confirmed by our biomarker analysis, suggesting a constant sugar intake for the period of adolescence.