CONSUMPTION OF ADDED SUGARS - A COMPARISON OF 1995 TO 2011-12

INTRODUCTION

As the role of dietary behaviour gains increasing recognition as having significant potential for both positive and negative influence on many of the most prevalent chronic diseases¹, there has naturally been great demand from researchers and policymakers on how consumption patterns have changed over time. Prior to the 2011-12 Australian Health Survey, the last national representative survey was the 1995 National Nutrition Survey conducted jointly by ABS and the then Commonwealth Department of Health and Family Services.

Limited comparison between 1995 and 2011-12 was given in the 2011-12 first results. While many methodological aspects of the surveys were similar, a side-by-side analysis of food consumption would not provide a true comparison between the two time periods without accounting for changes in food coding and classification and the increased level of under-reporting in 2011-12. These are discussed in detail the AHS Users’ Guide, available from the links below:

• Comparisons with 1995 NNS
• Under-reporting in Nutrition Surveys

The analysis in this chapter provides a comparison between the two time periods using a common basic food database and presenting comparisons on a per-unit of energy basis. While these data transformations are also subject to limitations, the magnitude of any remaining bias is considered to be minimal and within the bounds of the sampling error (margins of error).

The basic food database used in this analysis was the added and free sugars component of the AHS database developed by FSANZ for the NNPAS 2011-12, and an adaption of that database for the 1995 NNS. This enables comparisons of the consumption of added and free sugars.

Treatment of under-reporting

As outlined in Under-reporting in Nutrition Surveys, under-reporting of food consumption was estimated to be considerably higher in 2011-12 than 1995. In order to account for this, all comparisons made in this section are provided on a relative basis (such as proportion of energy from free sugars or grams of sugar per 10,000 kJ) rather than a direct comparison of the amount of grams consumed (for context, the average energy consumption was 9,343 kJ in 1995 and 8,522 kJ in 2011-12).

KEY FINDINGS

• Between 1995 and 2011-12, Australians had a relative decrease in their consumption of free sugars, with the average proportion of dietary energy from free sugars declining from 12.5% to 10.9%.
• While the average proportions of dietary energy from free sugars in each period were each higher than the recommended limit of 10% by the World Health Organisation (WHO), the proportion of people exceeding the 10% level on any given day fell from more than half (54%) of the population in 1995 to less than half (46%) in 2011-12.
• The largest declines (and contributing most to the overall declines) in free sugars were seen among children. Between 1995 and 2011-12, the average proportion of energy derived from free sugars by children aged 2-18 years decreased from 17% to 13%.
• Most of the decline of children’s free sugar consumption can be accounted for by the reduction in consumption of soft drinks, cordial and fruit juice/drinks. On a per 10,000 kJ of energy basis, total free sugars consumed by children aged 2-18 years dropped by an average 24 grams (from 105 grams to 81 grams per day). Over the same period the average daily consumption of free sugars from soft drinks, energy/electrolyte drinks, cordials and fruit juice/drinks dropped an average 22 grams (from 55 grams to 33 grams per 10,000 kJ).
• Soft drinks, energy/electrolyte drinks, cordials and fruit juice/drinks were the most common source of free sugars for the populations in both periods. However, Australians aged 2 years and over sourced a higher proportion of free sugars from these beverages in 1995 than in 2011-12 (44% compared with 37%).

DIETARY ENERGY FROM FREE SUGARS – 1995 AND 2011-12 COMPARISON

On average, Australians derived a higher proportion of their dietary energy from free sugars in 1995 (12.5%) compared with 2011-12 (10.9%), with both periods exceeding the WHO recommendation that adults and children consume less than 10% of energy from free sugars.^2,3

On any given day in 1995, more than half (54%) of the Australian population was estimated to exceed the WHO recommendation. By 2011-12, the proportion exceeding the recommendation on a typical day had fallen to less than half (46%). While six in ten (61%) children aged 2-18 years still exceeded the WHO guidelines on the day prior to interview in 2011-12, this was an improvement from the three quarters of children (75%) who derived 10% or more of their dietary energy intake from free sugars on the day prior to interview in 1995.

Children have experienced the largest shift between 2011-12 and 1995, with the proportion of energy derived from free sugars decreasing by four percentage points (from 17% to 13%). In particular, the contribution of free sugars to total daily energy for children aged 2-3 years decreased from 17% in 1995 to 11% in 2011-12.
In contrast to the change for children, the adult population (19 years and over) had a less appreciable decline of just 0.6 percentage points (most of which can be seen to come from the 19-30 years group). On the other hand, the older adults still had the lowest free sugar contribution to energy with 8.9% and 9.7% respectively for the 51-70 year olds and 71 years and over population in 2011-12.

The result of the declines in free sugars being limited to younger age groups is reflected in the contrasting age distributions of proportion of energy from free sugars, which shows that in 1995 energy derived from free sugars generally decreased with age, from 17% for children aged 2-3 years, to 9.8% for people aged 71 years and over. In 2011-12 by contrast, the highest consumption was for 14-18 year olds at 14%, although that was still a decrease from 17% in 1995.

FREE SUGARS PER 10,000 KJ – 1995 AND 2011-12 COMPARISON

Another way of presenting relative changes in free sugar consumption is in grams per 10,000 kJ. For children aged 2-18 years, average daily consumption of free sugars decreased by 24 grams per 10,000 kJ (from 105 to 81 grams per 10,000 kJ between 1995 and 2011-12). In contrast, adults declined 4 grams, from 69 grams to 65 grams per 10,000 kJ.

The larger declines in children can be seen as coming primarily from reductions in consumption of certain sugary beverages. Together, soft drinks, energy/electrolyte drinks, cordials and fruit juice/drinks accounted for over half children’s free sugar intake in 1995 at an average 55 grams per 10,000 kJ. By 2011-12, these beverages provided 33 grams per 10,000 kJ - a reduction of 22 grams - an amount which helps account for most of the entire decline in free sugars for children over the period.


SOURCES OF FREE SUGARS - 1995 AND 2011-12 COMPARISON

Non-alcoholic beverages (soft drinks, energy/electrolyte drinks, cordial and fruit juice/drinks in particular) were the most significant source of free sugars in both 1995 and 2011-12, although the share has shrunk over time. Consumption of these beverages accounted for 44% of free sugars in 1995 and 37% in 2011-12. This is consistent with previously published results, where 49% of people in 1995 reported consuming sweetened beverages on any given day, compared with 42% of people in 2011-12.

In particular, in 1995, children (2-18 years) consumed a greater proportion of their free sugar intake from soft drinks (20%) and cordials (15%) than children in 2011-12 who consumed 16% of their free sugars in the form of soft drinks, and 6.1% in the form of cordials.

One-quarter (26%) of total free sugars consumed by adults 71 years and over in 1995 were sourced from Sugar, Honey and Syrups (much of which was table sugar added to tea, coffee and breakfast cereals). This decreased to 19% in 2011-12 resulting in small proportional increases spread among a number of other foods including chocolate which increased from 1.9% to 3.7%.

ENDNOTES
1 Australian Institute of Health and Welfare 2016. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. BOD 4. Canberra: AIHW. Last accessed 07/12/2017
2 World Health Organization, 2015, Guideline: Sugars intake for adults and children. Geneva: WHO. <http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/>, Last accessed 07/12/2017
3 The percentage of energy from free and added sugars was estimated by multiplying each gram of free and added sugars by a conversion factor of 16 to determine the kilojoules of energy.