Free sugar consumption was measured in children enrolled in the Barwon Infant Study at age 18-months and 4-years. The exposure, free sugar intake was quantified as continuous and binary variables indicating less than 5% of total energy intake (TEI) at 18-months and 4-years of age. The prevalence of dental caries was obtained from dental records. Multiple logistic regression estimated the effect of the exposure variables on the presence of dental caries at 4-6 years of age, adjusting for potential confounders.

Of the original birth cohort, dietary data (N=863) and dental caries data (N=368) were available. 70.4% and 36.7% participants consumed less than 5% TEI from free sugars at 18-months and 4-years, respectively. Dental caries affected 46.7% of children. In fully adjusted models, free sugar at 18-months (OR 1.74; 95% CI 1.06, 2.86 per 5% of TEI) and at 4-years of age (OR 1.43; 95% CI 0.90, 2.28, per 5% of TEI) increased dental caries risk at 4-6 years. The estimated effect of consuming less than 5% free sugars of TEI at 18-months and 4-years of age on dental caries prevalence at 4-6 years was an OR 0.71, 95% CI 0.42, 1.19 and OR: 0.61; 95% CI 0.38, 0.97 respectively. The estimated effect of lowering free sugars to less than 5% of TEI at both timepoints compared to exceeding 5% TEI at one or both timepoints, on dental caries risk at 4-6 years was an OR 0.55; 95% CI 0.33, 0.93.

The authors concluded that between 18-months and 4-years, free sugar consumption increased markedly with two thirds of children exceeding 5% of TEI at 4-years of age. Early free sugar intake increases the risk of dental caries at 4-6-years of age.

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