Methodology for the assessment of added/free sugar intake in epidemiological studies

Abstract

Purpose of review High-sugar intake has been linked to increased risk of diseases but an accurate assessment of added/free sugar intake has always been a challenge in research. This review summarizes the methodologies for assessing added/free sugar intake reported in recent literature. Recent findings Four different methods for added/free sugar-intake assessment are discussed, including the carbon isotope ratio (δ13C) method, Food Patterns Equivalent Database, disaggregation method and the 10-step systematic method. These methods have different strengths and limitations in terms of requirement for background knowledge, flexibility to sugar definition, level of subjectivity, accuracy and needs for recalculation/modification when used in different countries or food products. Summary Although advances have been made in the methodologies for assessing added/free sugar intake, accurate assessment continues to be difficult. Of the methods reviewed, the 10-step systematic method could be a simpler method to provide relatively accurate estimation of added/free sugar intake. Further improvements or combining with other methods may allow more accurate and flexible estimation. Development of a completely objective biomarker for added/free sugar intake is unlikely to be achievable, therefore future research may need to focus on developing correction equations for use with biomarkers such as δ13C to improve their specificity to added/free sugar intake.