Identifying Main Dietary Sources of Fructose among Children and Adolescents: Results From the Hellenic National Nutrition and Health Survey

Background: Fructose consumption has been associated with increased total energy intake and metabolic diseases, including overweight and obesity. The aim of this study was to assess the fructose intake and identify the major food group contributors to mean fructose intake in Greek children and adolescents. Methods: Data from 738 children and adolescents (50.4% females) enrolled in the Hellenic National Nutrition and Health Survey were assessed. Fructose intakes were assessed using two 24-h recalls, and the main fructose contributors by age and sex were derived. Results: Daily fructose intake differed significantly across age groups ( P < 0.05), with school-aged children showing the highest intake (9.2 g/day) and adolescents the lowest (8.4 g/day; overall median: 8.7 g/day). When expressed as a percentage of total energy intake, toddlers demonstrated the highest relative consumption (2.4% vs. 2.0% in older children, P < 0.05). Fruits were the main fructose contributor in all groups, although this had a clear age-related decrease from toddlers to early childhood with a respective increase from sugar-sweetened beverages after 8 years (peaking in boys aged 8–12 years and girls >13 years). Conclusion: Our findings highlight early childhood as a period of higher relative fructose exposure and reveal an age-related shift from natural to added sugar fructose sources, underscoring the need for targeted age-specific family-based approaches and dietary guidance for Greek children and adolescents.