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Micronutrient dilution associated with added sugar intake in elderly black South African women



To investigate the association between added sugar and macronutrient and micronutrient intakes, and to assess whether added sugar intake is related to biochemical indices of nutritional status, Mini-Nutritional Assessment (MNA) score, body mass index (BMI) and performance on physical function tests.


A cross-sectional, analytical study.

Setting and subjects:

Convenient sample of 285 institutionalised and community-dwelling black South African men and women aged 60+ y.


An interviewer-administered 24-h dietary recall and MNA were performed. Serum albumin, vitamin B12, ferritin, cholesterol, haemoglobin, red blood cell (RBC) folate and plasma vitamin C were measured. Handgrip strength, BMI, ‘sit-to-stand’ and ‘get-up-and-go’ tests were measured. Outcome variables were analysed according to tertiles of added sugar, in grams and as a percentage of total energy (% E).


In each tertile of sugar intake, mean MNA score fell in the ‘at-risk’ classification. In women, energy, protein, % E protein, fibre, thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin, vitamin C, calcium, iron, magnesium, phosphorus, zinc, copper and selenium intake were significantly lowest in subjects in the highest % E sugar tertile. In men, no differences were found for micronutrient intake according to tertiles of total added sugar or % E added sugar. Physical function declined with increasing sugar intake, and suboptimal RBC folate and plasma ascorbic acid status was associated with increasing sugar intake (in women). No relationship was found between added sugar intake and the very high prevalence (65%) of obesity in women.


A nutrient-diluting effect of added sugars intake was demonstrated in elderly black South African women. Further studies in this population are required in order to develop food-based dietary guidelines, which include messages on added sugar intake.

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Financial support for this study was provided by the Minimum Data Set (MDS) Project of the World Health Organization. Financial support for the MDS Project was provided under a grant from the Behavioral and Social Research Program of the US National Institute on Aging, within the US Department of Health and Human Services National Institutes of Health, through an Inter-agency Agreement with the World Health Organization.

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Correspondence to K E Charlton.

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Guarantor: KE Charlton.

Contributors: TLKA co-ordinated data collection, performed physical function tests and was responsible for subject recruitment. JHN performed data entry and statistical analyses.

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Charlton, K., Kolbe-Alexander, T. & Nel, J. Micronutrient dilution associated with added sugar intake in elderly black South African women. Eur J Clin Nutr 59, 1030–1042 (2005).

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  • micronutrient intake
  • added sugars
  • nutrient dilution
  • elderly
  • South Africans

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