Abstract
Background
Despite associations of dietary added sugar with excess weight gain and chronic disease
risk, intake among most Americans exceeds the recommended limits (<10% total energy).
Maternal diet plays an important role in pregnancy-related outcomes, but little is
known about the extent of added sugar intake during pregnancy.
Objective
To assess intake and identify the top sources of added sugars in the diets of pregnant
vs nonpregnant women in the United States.
Design
Cross-sectional analysis of data from the National Health and Nutrition Examination
Survey (NHANES), 2003-2004 to 2011-2012.
Participants
Four thousand one hundred seventy-nine pregnant and nonpregnant women (aged 20 to
39 years) who completed a dietary recall.
Statistical analyses performed
Survey-weighted analyses were used to estimate means (95% CIs) in total grams and
as percentage of total energy for added sugar intake by pregnancy status and by demographic
subgroup and to identify leading sources of added sugar.
Results
Added sugar intake trended toward being higher in pregnant compared with nonpregnant
women in absolute grams, 85.1 g (95% CI: 77.4 to 92.7) vs 76.7 g (95% CI: 73.6 to
79.9), respectively (P=0.06), but was lower among pregnant women when total energy intake was accounted
for, 14.8% (95% CI: 13.8 to 15.7) vs 15.9% (95% CI: 15.2 to 16.6) of total energy,
respectively (P=0.03). Among pregnant women, added sugar intake was similar among demographic subgroups.
However, in multivariable regression, pregnancy status significantly modified the
associations of education and income with added sugar intake, whereby less educated
and lower-income women who were pregnant had lower added sugar intakes compared with
those who were not pregnant, but more educated or higher-income women did not exhibit
this pattern. The top five sources of added sugar for all women were sugar-sweetened
beverages; cakes, cookies, and pastries; sugars and sweets; juice drinks and smoothies;
and milk-based desserts.
Conclusions
Although pregnant women had higher energy intakes, this was not attributed to higher
intakes of added sugar. Although education and income affected consumption during
pregnancy, intake of added sugar among all women, regardless of pregnancy status,
exceeded recommendations.
Keywords
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Biography
C. E. Cioffi is a registered dietitian and a doctoral candidate, Laney Graduate School, Emory University, Atlanta, GA.
Biography
J. Figueroa is a biostatistician, Strong4Life Initiative, Children’s Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Biography
J. A. Welsh is an assistant professor, Department of Pediatrics, Emory University School of Medicine, and research director, Strong4Life Initiative, Children's Healthcare of Atlanta, Atlanta, GA.
Article info
Publication history
Published online: January 09, 2018
Accepted:
October 22,
2017
Received:
July 10,
2017
Footnotes
Supplementary materials: Table 2 is available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT C. E. Cioffi was funded by an institutional T32 training grant (NIH-DK007734) when the research was conducted.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
