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.
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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.
World Health Organization. WHO guideline: sugars intake for adults and children. Geneva, Switzerland: World Health Organization; 2015.
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.
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.
Wansink B. Nutritional gatekeepers and the 72% solution. J Am Diet Assoc. 2006;106:1324–7.
Hertwig R, Grüne-Yanoff T. Nudging and boosting: steering or empowering good decisions. Perspect Psychol Sci. 2017;12:973–86. https://doi.org/10.1177/1745691617702496.
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.
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.
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.
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.
Ferrer R, Klein WM. Risk perceptions and health behavior. Curr Opin Psychol. 2015;5:85–89.
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.
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.
Centers for Disease Control and Prevention. A SAS program for the 2000 CDC growth charts (ages 0 to <20 years). Retrieved June 2017 from https://www.cdc.gov/nccdphp/dnpao/growthcharts/resources/sas.htm#reference.
Mussweiler T, Strack F. Numeric judgments under uncertainty: the role of knowledge in anchoring. J Exp Soc Psychol. 2010;5:495–518.
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.
Ozen AE, Pons A, Josep AT. Worldwide consumption of functional foods: a systematic review. Nutr Rev. 2012;70:472–81.
Jasti S, Rubin R, Doak CM. Sugar-sweetened beverage knowledge and consumption in college students. Health Behav Policy Rev. 2017;4:73–45.
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.
We thank Kai Kolpatzik for helpful discussions about the design of this study.
This study did not receive financial support from any third party.
Conflict of interest
The authors declare that they have no conflict of interest.
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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). https://doi.org/10.1038/s41366-018-0021-5
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