1st year medical student McGill University Faculty of Medicine and Health Sciences Brossard, Quebec, Canada
Background: Free sugar includes sugar added to food or beverages, and sugar naturally present in honey, syrups, fruit juices, and fruit juice concentrates. The WHO recommends reducing consumption of free sugar to below 10% of daily energy consumption; an intake of below 5% is optimal. Despite these recommendations, children between the ages of 2 to 19 years old consume 18.5% of their total energy from free sugars. These consumption patterns are a potential threat to public health as research shows that a diet high in sugar-sweetened beverages in children is associated with increased obesity and other cardiometabolic risk factors. However, few studies have examined the associations of free sugar with childhood cardiometabolic or sleep health. The latter knowledge gap is important to fill as free sugars are highly pervasive in the North American food supply, found in 66% of packaged foods. Objective: To determine the association between free sugar intake and cardiometabolic risk factors, obesity, and sleep in youth. Design/Methods: We conducted a cross-sectional study among children participating in the TARGetKids! primary care practice-based research network in Toronto, Canada. We included healthy children (1 to 15 years old) who completed at least one 24-hour diet recall using the ASA-24 online survey, anthropometric measures, and survey data. For the main exposure (free sugar intake), we will use a previously developed algorithm to calculate free sugar intake based on added sugar intake (ASA24 output) and the free sugar content in syrups, honey, fruit juices, and concentrates. For the outcomes, we will include BMI z-score, waist circumference, blood pressure, lipids, glucose, sleep duration, and sleep quality (awakenings per night). Multivariate regression (linear, logistic, negative binomial regression) will be used to estimate the associations between free sugar intake and outcomes. Unity Health, SickKids and McGill University Health Center Research Ethics Boards approved the study. The data have been cleaned. Linkage and analyses will be completed by January 2024.
