Associations of free and added sugars intakes with nutrient intake and food consumption in Swedish adolescents

A limited intake of free and added sugars is recommended due to potential associations with adverse health effects and nutrient inadequacy. However, the impact of free and added sugars intakes on dietary intake is unknown in Swedish adolescents. This study investigated associations of free and added sugars intakes with nutrient and food consumption. Data were derived from the Riksmaten Adolescents 2016-17 cross-sectional survey, including a nationally representative sample of 3099 adolescents, aged around 12, 15 and 18 years, that provided two 24-hour recalls. Median nutrient and food group intakes were compared across sugars intake quintiles, with adjustments for sex, school year and energy misreporting. Inverse associations were observed for almost all micronutrients, dietary fibre, essential fats, and food groups commonly included in a healthy diet (e.g., vegetables, fruit, dairy, meat, fish). However, positive associations between free sugars and vitamin C intake were observed, with fruit juice influencing intake trends. Total energy intake was not positively associated with free or added sugars intakes. Higher intakes of free and added sugars (>12.9% and >11.3% of total energy intake) significantly reduced the likelihood of meeting nutrient reference values. Although, for critical nutrients within the adolescent diet (vitamin D, selenium, dietary fibre and polyunsaturated fats), lower odds of meeting reference values were observed even at lower intakes of free and added sugars. To conclude, with increasing sugars intake Swedish adolescents appear to displace nutrient-dense foods with sugar-rich foods, emphasising differences in dietary patterns between those with lower versus higher free and added sugars intake.