Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Parents’ considerable underestimation of sugar and their child’s risk of overweight


High sugar intake is associated with an increased risk of overweight. For parents, as their children’s nutritional gatekeepers, knowledge about sugar is a prerequisite for regulating sugar consumption. Yet little is known about parental ability to estimate the sugar content of foods and beverages and how this ability is associated with children’s body mass index (BMI). In 305 parent–child pairs, we investigated to what extent parents systematically under- or overestimate the sugar content of foods and beverages commonly found in children’s diets as well as potential associations with children’s z-BMI. Parents considerably underestimated the sugar content of most foods and beverages (e.g., 92% of parents underestimated the sugar content of yogurt by, on average, seven sugar cubes). After controlling for parental education and BMI, parental sugar underestimation was significantly associated with a higher risk of their child being overweight or obese (odds ratio = 2.01). There was a small dose–response relationship between the degree of underestimation and the child’s z-BMI. These findings suggest that providing easily accessible and practicable knowledge about sugar content through, for instance, nutritional labeling may improve parents’ intuition about sugar. This could help curtail sugar intake in children and thus be a preventive measure for overweight.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout


  1. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013;346:e7492.

    Article  Google Scholar 

  2. World Health Organization. WHO guideline: sugars intake for adults and children. Geneva, Switzerland: World Health Organization; 2015.

  3. Powell ES, Smith-Taillie LP, Popkin BM. Added sugars intake across the distribution of US children and adult consumers: 1977-2012. J Acad Nutr Diet. 2016;116:1543–50.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Birch L, Savage JS, Ventura A. Influences on the development of children’s eating behaviours: from infancy to adolescence. Can J Diet Pract Res. 2007;68:s1–s56.

    PubMed  PubMed Central  Google Scholar 

  5. Wansink B. Nutritional gatekeepers and the 72% solution. J Am Diet Assoc. 2006;106:1324–7.

    Article  PubMed  Google Scholar 

  6. Hertwig R, Grüne-Yanoff T. Nudging and boosting: steering or empowering good decisions. Perspect Psychol Sci. 2017;12:973–86.

    Article  PubMed  Google Scholar 

  7. Gase LN, Robles B, Barragan NC, Kuo T. Relationship between nutritional knowledge and the amount of sugar-sweetened beverages consumed in Los Angeles county. Health Educ Behav. 2014;4:431–9.

    Article  Google Scholar 

  8. Jordan A, Piotrowski JT, Bleakley A, Mallya G. Developing media interventions to reduce household sugar-sweetened beverage consumption. Ann Am Acad Pol Soc Sci. 2012;640:118–35.

    Article  Google Scholar 

  9. Bleich SN, Herring BJ, Flagg DD, Gary-Webb TL. Reduction in purchases of sugar-sweetened beverages among low-income black adolescents after exposure to caloric information. Am J Public Health. 2012;102:329–225.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zahid A, Davey C, Reicks M. Beverage intake among children: associations with parent and home-related factors. Int J Environ Res Public Health. 2017;14:929–40.

    Article  PubMed Central  Google Scholar 

  11. Ferrer R, Klein WM. Risk perceptions and health behavior. Curr Opin Psychol. 2015;5:85–89.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Marx JJ, Gube C, Faldum A, Kuntze H, Nedelmann M, Haertle B, et al. An educational multimedia campaign improves stroke knowledge and risk perception in different stroke risk groups. Eur J Neurol. 2009;16:612–8.

    Article  PubMed  CAS  Google Scholar 

  13. Kromeyer-Hauschild M, Wabitsch M, Kunze D, Geller F, Geiß V, Hesse A, et al. Perzentile für den body-mass-index für das kindes- und jugendalter unter heranziehung verschiedener deutscher stichproben [body mass index percentiles for children and adolescents based on different German samples]. Mon Kinderheilkd. 2001;149:807–18.

    Article  Google Scholar 

  14. Centers for Disease Control and Prevention. A SAS program for the 2000 CDC growth charts (ages 0 to <20 years). Retrieved June 2017 from

  15. Mussweiler T, Strack F. Numeric judgments under uncertainty: the role of knowledge in anchoring. J Exp Soc Psychol. 2010;5:495–518.

    Google Scholar 

  16. Wills JM, Bonsmann SS, Kolka M, Grunert K. European consumers and health claims: attitudes, understanding and purchasing behavior. Proc Nutr Soc. 2012;71:229–36.

    Article  PubMed  Google Scholar 

  17. Ozen AE, Pons A, Josep AT. Worldwide consumption of functional foods: a systematic review. Nutr Rev. 2012;70:472–81.

    Article  PubMed  Google Scholar 

  18. Jasti S, Rubin R, Doak CM. Sugar-sweetened beverage knowledge and consumption in college students. Health Behav Policy Rev. 2017;4:73–45.

    Google Scholar 

  19. Hawley KL, Roberto CA, Bragg MA, Liu PJ, Schwartz MB, Brownell KD. The science on front-of-package food label use. Public Health Nutr. 2013;16:430–9.

    Article  PubMed  Google Scholar 

Download references


We thank Kai Kolpatzik for helpful discussions about the design of this study.


This study did not receive financial support from any third party.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Mattea Dallacker.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dallacker, M., Hertwig, R. & Mata, J. Parents’ considerable underestimation of sugar and their child’s risk of overweight. Int J Obes 42, 1097–1100 (2018).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links