J Nutr Sci Vitaminol, 58, 1–0, 2012

Sugar Intakes from Snacks and Beverages in Japanese Children
Hitomi TAKEICHI1, Hiromi TANIGUCHI1, Mina FUKINBARA1, Nobuko TANAKA2, Saiko SHIKANAI1,
Nobuko SARUKURA1, Tzu-Fang HSU 3, Yueching WONG4 and Shigeru YAMAMOTO1, 5
1International Nutrition, Ochanomizu University Graduate School of Humanities and Sciences,
Tokyo, 112–8610, Japan2
Department of School Lunch Program, Ministry of Education, Culture, Sports, Science and Technology ofJapan, Tokyo 100–8959, Japan3
Hungkung University Applied Cosmetology and Graduate Institute of Cosmetic Science, Taichung, Taiwan
4Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
5International Nutrition, Graduate School of Human Life Sciences,Jumonji University, Saitama 352–8510, Japan(Received November 1, 2011)

Summary While sugar intake is an important factor for obesity, diabetes and dental caries, sugars are also important energy sources, especially for rapidly growing children. Children like sugar-rich sweet foods. However, intake for Japanese children is not known due toa lack of studies and sugar, composition data. This study was designed to determine sugar
intakes from snacks and beverages in Japanese school children. A nutrition survey was conducted for 3 weekdays for 283 Japanese school children (7, 10 and 13 y old) in 8 prefecturesfrom different areas of Japan. The methods for the survey were the weighing method forschool lunches and the 24 h recall method for other foods. To estimate sugar intakes, thesugar composition table that was recently compiled by us for 135 beverages, cakes andother sweets was used. Height and weight were measured. They were similar to Japanese
averages. Energy intakes were also similar to the results of the Japanese National Health andNutrition Surveys. Sugar eaten outside meals was 24.715.5 g/d. From the National
Health and Nutrition Surveys conducted in 2009, the mean sucrose intake from meals
including some home-made cookies for 7–14-y-old children was 5.5 g/d, suggesting themean total sugar intake of these children was about 30 g/d. This was within the range of
FAO/WHO recommendation (less than 10% of energy intake, 49 g for these children. Mean
intakes among age groups were not significantly different (p0.05), but the intake for girls
was lower than for boys in the oldest age group (p0.05). Contributions of each sugar tototal intake were sucrose 64%, fructose 14%, glucose 13% and lactose 9%. Fructose andglucose were mainly from isomerized sugar. Contributions of food groups to total intake
were beverages 25%, baked goods 19% and ice cream 17%, respectively, covering 61% of all.
In conclusion, we revealed that the average sugar intake of Japanese children was within therange of the FAO/WHO recommendation, though the effects of the kind of sugars on healthremain to be clarified.
Key Words Japanese children, sucrose, fructose, glucose, lactose, energy

Major sugars are sucrose, glucose, fructose and lactose. They convert to glucose, which plays an importantrole as the brain’s energy source. Sugars are tasty andpleasurable, especially for growing children. Such characteristics easily induce people to consume more sugars
than necessary and they can become a major factor in
obesity, diabetes and dental caries. Sugars are also an
important energy source, especially for rapidly growing
children. However, intakes for Japanese children are notknown due to the lack of a sugar composition table
other than one in which foreign data are used (1). Japanese traditional foods and their sugar concentrations
are quite different from those in other countries. We

therefore recognized the importance of a sugar composition table for Japanese food. We have measured concentrations of sugars (sucrose, glucose, fructose andlactose) in 135 sugar-rich foods (42 commercial beverages and chilled snacks, 29 home-made cookies, and 64
commercial cakes and cookies). More than 5 samples
from different manufacturers and home recipes of eachfood were analyzed and the average values were calculated and published (2, 3).
FAO/WHO recommend less than 10% of energy(about 50 g sugar), which is intended for the preventionof life-style related diseases and is used in 23 countries(4). Sheiham (5) recommends less than 40 g to prevent
dental caries. The FAO/WHO definition of sugar is freesugar (sugars plus concentrated sugars in honey, syrups
and fruit juices); the intrinsic sugars or milk sugars* To whom correspondence should be addressed.
E-mail: syamamototokushima@hotmail.com

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TAKEICHI H et al.

(lactose, galactose) are not included because they are
not considered to have adverse health outcomes (4).
In this study we conducted a nutrition survey covering various areas of Japan and tried to estimate children’s sugar intake.
METHODS
Subjects. The survey was conducted in about 350
children of 7, 10 and 13 y old in 8 prefectures from
north to south in Japan. The final available number wasfor 283. We tried random sampling as much as possible
in selecting areas, schools and classes so that the subjects would be close to representative for the country as
a whole.
Survey. The nutrition survey was conducted for
3 weekdays. An investigation of height and weight was
conducted before the commencement of the survey.
Regarding the intake of school lunches, researchers
measured the actual amount of each student’s portion,
while that of the other meals, including in-between
snacks, was measured by the 24-h recall method withthe cooperation of the students’ guardians. In the caseof incomplete items or unclear descriptions on the form,
the researchers confirmed details directly with the students or asked their guardians to fill out the items.
Estimation of sugar and energy intakes. Calculationsof energy intake were made in accordance with the data
listed in “Standard Tables of Food Composition in Japan,
5 revised and enlarged ed” and the table of processed
foods data (6–8). Sucrose, glucose, fructose and lactose
intakes from foods other than meals were calculated byusing the sugar composition table constructed by us
previously (2, 3).
Ethical considerations. This study was conductedwith the approval of the Ethics Committee of Ochanomizu University, and in accordance with the Declaration of Helsinki: Ethical principles for research involving
human subjects with special attention paid to the following: To prevent the identification of individuals,
each subject’s personal information was carefully codedand obtained data were strictly managed. We obtained
a statement that participation in the research was by
free will on the part of the participants and their guardians by providing explanations about the objectives andTable 2.
Age
(y)
7
10
13
Averagedetails of the investigation and the intention to use theresults for oral and written presentations. Even after
commencement, explanations were provided wheneversubjects dropped out of the study, either of their own
volition or at the guardian's behest; no subjects were
penalized in any way.
Statistical analysis. Analysis of the data was carriedout with SPSS (version 17.0) statistical software. Data
were assessed by one-way ANOVA and then Tukey’s
multiple comparison test and p values less than 0.05
were considered statistically significant. Correlation
between body weight and sugar intake was assessed by
Pearson’s correlation coefficient test.
RESULTS
Table 1 shows the height, weight and energy intakeof the children in this study. All values were similar
between our subjects and the Japanese average (9),indicating that our subjects were similar to the country
representative. Energy intakes were higher in boys thanin girls in all the age groups and increased by age except
for girls of 13 y old.
Table 2 shows sugar intakes. Sugar intakes in both
sexes in all the age groups were similar except the low
intake in 13-y-old girls. The average intake for all thechildren was 24.715.5 g/d.
Table 1. Characteristics of the subjects and energy
intake.
Age
Gender
(y)
7
10
13

boy
girl
boy
girl
boy
girl

n

Height(cm)

33 122.55.4a
42 120.95.2a
64 139.86.1b
64 140.46.9b
42 162.28.4c
38 156.25.3d

Weight(kg)

Energy/d(kcal)

23.63.7a 1,843310a
22.83.5a 1,668238a
34.88.4b 2,081385b
32.66.1b 1,896282a
52.511.5c 2,340446c
47.77.4d 1,871287a

Values are meanSD.
Figures with different superscript letters in the same column are significantly different as assessed by one-way
ANOVA and then TukeyÅfs multiple comparison test(p0.05).

Sugar intakes of Japanese children (g/d).
Gendern

Glucose(A)

Fructose(B)

Sucrose(C)

Lactose(D)

Total sugar(ABCD)

boy
girl
boy
girl
boy
girl

33
42
64
64
42
38

3.12.6abc
3.53.0abc
3.23.4abc
3.42.4abc
4.04.2b2.02.4c
3.23.1

3.53.3abc
3.83.6abc
3.43.7abc
3.62.8abc
4.44.6b2.12.7c
3.53.5

15.99.4
17.711.7
16.89.8
16.69.5
14.612.7
12.011.2
15.810.7

2.52.3
2.41.6
2.21.9
2.41.9
2.13.1
1.41.7
2.22.1

25.114.6ab
27.415.9a
25.714.2ab
26.012.7ab
25.020.7ab
17.514.3b
24.715.5

Values are mean SD.
Figures with different superscript letters in the same column are significantly different as assessed by one-way ANOVA andthen Tukey’s multiple comparison test (p0.05).

Sugar Intakes of Japanese Children

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Fig. 1. Relationships between body weight and sugar intake for 7-(A) and 10-(B) y-old children and 13-y-old boys (C) andgirls (D).

Fig. 2. Contributions of various food groups to total
sugar intake.

As shown in Fig. 1, no significant relationship wasobserved between body weight and sugar intakes in 3
age groups. The data for 13-y-olds were separated into
boys and girls because only in this age group theheight, weight and sugar intake were different in thetwo genders. The standard weight was established fromthe health statistics of school children in 2000 (10).
Figure 2 shows the contribution of major foods tosugar intake. Sugars from beverages contributed about
25% and baked goods and ice cream each about 19%
and 17%, respectively. These 3 items contributed about
61% of the sugar intake.
DISCUSSION
We found in this study that average sugar intake ofJapanese children from snacks and beverages was about
25 g. To our knowledge, this is the first study to esti-

mate sugar intake in Japanese children. The limitationof this study was that the sugar intake from meals could
not be estimated, because for estimating sugar content
of a meal, another study in which the amount of sugar
used before cooking world have to be measured. However, in Japan, luckily the nationwide Health and Nutrition Survey has been conducted every year since 1946
and the amount of sugar used in meals and some homemade cakes were estimated, although sugar-rich snacks
and beverages are shown only by weight but not by
their sugar content. According to the most recent survey in 2009 (9), mean sugar intake from meals in children aged 7–14 y was reported to be 5.5 g/d. From theresult of the present study and that of Japanese Healthand Nutrition Survey, the sum of sugar intake was estimated as 30 g. However, the sugar from some homemade cakes is doubly calculated in both studies, suggesting the sugar intake may be less than 30 g/d.
The FAO/WHO recommendation of sugar intake isless than 10% of energy (4). In this study we also measured the energy intake. It was 1,960 kcal/d and 10%of it (196 kcal) was equivalent to 49 g of sugar. The
standard deviation of sugar intake was about 15 g.
Thus the mean sugar intake1SD is about 45 g whichis smaller than 49 g. When the distribution is normal,mean1SD covers about 85% of the age population.
Therefore, sugar intake for most of the Japanese children may be within a desirable level.
There are reports about sugar intake from various
countries: American male children of 6–12 y old consume 124 g/d (11), English 84 g/d (12), Dutch 135 g/d

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TAKEICHI H et al.

(13), South African 43 g/d (14) and Filipino 60 g/d(15). These data are much higher than our present
result. Nutrition surveys often underestimate intakes(16). To prevent such problems, in this study we used
the weighing method for school lunches and carefully
checked other meals and foods. There are seasonal variations in the intakes; however, this study was conducted in summer and in this season sugar intake frombeverages is thought to be usually higher than in otherseasons because people drink more cold sweet beverages, which decreases the underestimation problem. To
verify the reliability of the present nutrition survey, we
compared the energy intakes in the present subjects
with those reported by the National Health and Nutrition Survey (9). Energy intake was 1,960388 kcal in
our subjects and 1,936 kcal in the children reported in
the nationwide nutrition survey (9). Both sets of data
were similar.
Our present result is also supported by the FAO reporton sugar intakes by countries estimated from eachcountry’s annual supply of sugar (17). From thereports, the sugar intakes per person (g/d) were 48.8 g
for Japanese, 84.5 g for Americans, 139.4 g for Cubans,
138.6 g for Brazilians, 100.4 g for British, 96.2 g forGermans, 47.1 g for Koreans, 17.2 g for Chinese,
79.6 g for Thais, 31.7 g for Vietnamese, and 66.0 g for
Filipinos.
The contribution of each sugar to the total sugar
intake (about 24.7 g) in the present study was 64% forsucrose, 14% for fructose, 13% for glucose and 9% forlactose (Table 2). From the data shown in Fig. 2, sugarfrom beverages was 25% and the highest. These results
indicate that fructose and glucose (total 27%) weremainly from beverages. From our finding, most of thebeverages contain isomerized sugar, commonly called
high-fructose corn syrup. It is produced by the hydrolysis of corn starch and other starches and is cheaper
than sucrose. It is in soluble form and is usually used inbeverages. The different physiological effecs of glucose
and fructose are known. For example, fructose
increases blood triglyceride concentration and causes
obesity more than glucose (18–21). Therefore, we may
have to determine what kind of sugar we are taking andthe effects of them on health.
The lower sugar intake by 13-y-old girls was perhaps
due to over-concerns about body weight.Å@In Japan
most adolescent girls think that a slim body is beautiful.
Such an image on the part of Japanese girls seems to be
more serious than for girls in other countries (22).
In conclusion, the sugar intake of most Japanese children is supposed to be within the proper range.
Acknowledgments
The authors wish to thank the subjects and theirfamily members for their cooperation in participating inthis study, as well as everyone in the institutions fortheir kind help. The research for this paper was supported by a Grant-in-Aid for Scientific Research, as apart of the project in 2008 “Implementation of investigation of eating habits of schoolchildren at school andat home” (Principal Researcher: Shigeru Yamamoto)commissioned by the Ministry of Education, Culture,
Sports, Science and Technology in Japan.
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