During 2011 to 2016, 84.4% of infants (6-11 months) and toddlers (12-23 months) consumed added sugars on a given day, according to an analysis of NHANES dietary intake data published in the Journal of the Academy of Nutrition and Dietetics.
A greater proportion of toddlers (98.3%) consumed added sugars than infants (60.6%). The mean amount of added sugars decreased from 2005-2006 through 2015-2016 for both age groups; however, percent energy from added sugars only decreased among infants.
Researchers emphasized the impact early life nutrition has on eating patterns later in life.
"Our study, which is the first to look at trends in added sugars consumption by infants and toddlers, documents that most infants and toddlers consume added sugars. This has important public health implications since previous research has shown that eating patterns established early in life shape later eating patterns," noted lead researcher Kirsten A. Herrick, PhD, MSc, Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention.
An earlier study found that 6-year-olds who had consumed a sugar-sweetened beverage before the age of one were more than twice as likely to consume a sugar-sweetened beverage at least once a day compared to 6-year-olds who had not consumed any before the age of one.
"Previous research into the diets of children over two-years-old associated sugar consumption with the development of cavities, asthma, obesity, elevated blood pressure and altered lipid profiles," added Dr. Herrick.
Top food sources of added sugar for babies and toddlers?
The study analyzed data for 1,211 infants and toddlers (6-23 months) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Researchers used the Food Patterns Equivalents Database and the United States Department of Agriculture's What We Eat In America's list to categorize foods. Sugars contained in breast milk and formula were not included in the consumption estimates.
The results showed that infants consumed about 1 teaspoon (tsp) of added sugars daily (equivalent to about 2% of their daily caloric intake), while toddlers consumed about 6 tsp of sugars (about 8% of their daily caloric intake). The top food sources of added sugars for infants included yogurt, baby snacks and sweets, and sweet bakery products. For toddlers, the top sources included fruit drinks, sweet baked products, and sugar and candy.
‘More work is needed to understand this critical period’
The study recommends that parents be more mindful of added sugar in the foods they are feeding their infants and toddlers by discussing with their healthcare provider which solid foods to introduce into their child’s diet as they wean off of breast milk and infant formula.
"The transition from a milk-based diet (breast milk and formula) to table foods has an impact on nutrition, taste preference, and eating patterns. More work is needed to understand this critical period," said Dr. Herrick.
Avoiding sugar-sweetened beverages
Dr. Herrick also noted that parents can stay informed by paying closer attention to the added sugar level included on many food and beverage labels, and to avoid sugar-sweetened beverages whenever possible, as these products are a prevalent source of added sugar in many kids’ diets.
In September 2019, the Academy of Nutrition and Dietetics joined the American Heart Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics with funding from the Robert Wood Johnson Foundation to recommend breast milk, infant formula, water, and plain milk as part of a new set of comprehensive beverage recommendations for children, outlined by age (birth through age 5).
The guidelines caution against beverages that are sources of added sugars in young children's diets, including flavored milks (e.g., chocolate, strawberry) and sugar- and low-calorie sweetened beverages, in addition to a wide variety of beverages that are on the market and targeted to children that provide no unique nutritional value.