• Won O Song, Ying Wang, Chin E Chung, Bonita Song, Wutae Lee, and Ock K Chun.
• Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA.
• Nutrition. 2012 Nov 1;28(11-12):1137-41.

ObjectiveIn the public health arena, a single component of total dietary intake, such as sugar intake, has been questioned as the health risk of obesity. This study aimed to investigate if the uptrend of obesity prevalence in the USA is associated with dietary sugar intake when other dietary intakes are controlled.MethodsIn this cross-sectional study, National Health and Nutrition Examination Surveys I (1971-1975, n = 20 195) and III (1988-1994, n = 28 663) were investigated. Multivariate predictive models were used to determine if body mass index was predicted by the daily intakes of total energy, carbohydrate (CHO), and total sugars and the percentages of energy from CHO, fat, total sugar, and added sugars.ResultsFrom 1970 through 1990, the contribution of sugars to total CHO intake decreased in the 1 to 18 y and ≥19 y subgroups, and the contribution of added sugars to the total energy intake did not change. Multivariate predictive models identified energy intake as a positive predictor, CHO as a negative predictor, and total sugar intake as a non-predictor for body mass index in the 1 to 18 y and ≥19 y age subgroups. Daily energy intake was positively predicted by CHO and fat intakes but not with total and added sugar intakes in the two age subgroups.ConclusionEnergy intake was the primary contributor to body mass index in all age groups in this study. The major energy sources of children and adolescents differed from those of adults. The implicated associations between energy and macronutrient intakes indicate that keeping energy balance is the primary strategy to avoid obesity.Copyright © 2012 Elsevier Inc. All rights reserved.

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