Our consumption of added sugars has been widely debated. Now, hot on the heels of the Lei et al (2016) paper from Sydney University we reported on last month, the ABS has released a secondary analysis 'Australian Health Survey: Consumption of Added Sugars' using the same methodology (modified slightly) and finds similar results.

As a nation we aren't doing too badly but our overconsumption of discretionary foods is a big nutritional issue.

How much 'free sugars' are Australians consuming?

'Free sugars' are any sugars added by the manufacturer, cook or consumer, plus the sugars in honey, fruit juice and fruit juice concentrates. This definition was developed by the World Health Organisation (WHO) and is broader than 'added sugars' used in the Dietary Guidelines.

Despite the ABS report's title, the reporting of results focuses on free sugars to enable comparison to WHO recommendations and added sugars data are included in the supplementary tables- the added sugars are lower, as you would expect.

In Australians aged 2 years and over:

• Mean usual intake is 10.9% daily total energy intake (kJ); similar to ~12% found by Lei et al (2016).
• Mean usual intake is 14 teaspoons per day (vs 13 teaspoons recommended by WHO).
• 52% exceed the WHO recommendation of less than 10% of total energy intake. It is unclear by how much the recommendation is exceeded.
• Teenage boys aged 14-18 years had the highest free sugars intake.
• Across both males and females, intake increased from age two to 14-18 and then slowly declined with age.
• Lowest consumers lived in major cities and higher consumers lived in regional and remote areas; highest intakes were in inner regional and remote Australia

Sources of free sugars

82% of free sugars were from discretionary foods. This supports the previous data released by the ABS which showed, on average, around 35% of our total energy intake comes from discretionary foods.

Highest contributors were:

• Soft drinks and sports drinks (19%)
• Pastries, biscuits, cakes, muffins, scones and cake-type desserts (14%)
• Fruit juice and fruit drinks (13%)
• Sugar, honey and syrups (11.6%)
• Confectionary and cereal/nut/fruit/seed bars (8.7%) - most are discretionary.

The sources of free sugars also changed across the life span with sugar sweetened beverages contribution decreasing with age past 14-18 and sugars added to beverages (think sugar in your coffee) increased.

How was this analysis done?

One of the key challenges in determining added or free sugars intake, as previously reported, is there is no analytical method to determine if the sugars in foods are intrinsic or free or added.

Therefore the ABS used a modified version of the Louie et al (2014) 10-step methodology to create two datasets from AUSNUT 2011-13 – one for free sugars and one for added sugars.

The adaptations they made to the method include using only the first four steps (and not the final four subjective steps), and the use of ABS standard recipes, probably explain the small differences in the results obtained (10.9% vs 12%E from free sugars).

As discussed previously, using food databases and standard recipes is not 100% accurate in reporting sugar content of the wide variety of foods consumed but these are the best estimate tools available.

Are we eating more or less added sugar than previously?

Free sugars intake has not previously been estimated so trends cannot be determined. If we look at added sugars since the 1995 National Nutrition Survey assessed by Cobiac et al (2003), intake has fallen has fallen for men aged 19 years and over from a mean intake of 74g/day to 59g/day. For women, mean intake has remained the same at 45g/d.

The usual disclaimers apply to this trend data; there are methodological differences between the national nutrition surveys and secondary analyses, and accuracy of self-report data in surveys is less than perfect

How do we compare to other countries?

In New Zealand, the latest data on added sugars intake is from the 2002 Health Survey. A secondary analysis of this survey by Parnell et al (2007) et al used sucrose intake as an indirect estimate of added sugars and found median sucrose intake was 42g/d for women and 55g/d for men. This represents 9-10% of total energy intake.

Both Australia and New Zealand's free sugars intake is similar to other western countries. The Dutch consume around 14% total energy from free sugars, 13% energy is from added sugar in the US, and the UK consumes 11.5% from non-milk extrinsic sugars.

What should we take from this?

This latest Report released by the ABS highlights the importance of reducing the high consumption of discretionary foods in the diet. Reducing discretionary food choices will reduce added sugars as well as excess kilojoules and other unfavourable nutrients like saturated fat and sodium.

When it comes to free sugars intake, interventions targeting teenagers, rural and remote communities and the most socially disadvantaged groups could improve the national average and performance against the global 10% target.