Association of low-calorie sweetened product consumption and intakes of free sugar and dietary patterns in UK adults: a national study from 2008 to 2019
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction: Evidence on the effects of low- and no-calorie sweetened (LCS) product consumption on overall dietary patterns remains limited, despite their frequent promotion as healthier alternatives. This study assessed the association between LCS product consumption and both the levels and temporal trends in free sugar intake and overall dietary patterns among UK adults.
Methods: Annual cross-sectional data from the National Diet and Nutrition Survey (NDNS) from 2008/09 to 2018/19 were analyzed. Adults aged ≥18 years (N = 8,304) were categorized into four levels of LCS product consumption: non-consumers (No-LCS) and three tertiles of consumers (Low-LCS: ≤75.0 g/day, Mid-LCS: >75.0–216.8 g/day, and High-LCS: >216.8 g/day), as measured by four-day food diaries. The associations between LCS product consumption and intakes of free sugar, energy, and minimally processed and ultra-processed foods as determined by the Nova classification were analyzed using multivariable linear regression, adjusted for sociodemographic factors.
Results: In 2008/09, 45.9% of participants consumed LCS products, and this proportion remained stable over the 11-year period. Among LCS product consumers, the median LCS product intake increased significantly from 132.0 g/d in 2008/09 to 170.0 g/d in 2018/19. In the No-LCS group, free sugar and energy intakes decreased by −1.0 g/d (95% CI, −1.4 to −0.6) and −6.7 kcal/d (95% CI, −11.4 to −2.1) per year, respectively, with similar declines observed for the High-LCS group. In 2008/09, the mean water and minimally processed food consumption was lower in the High-LCS than the No-LCS group, by −141.2 g/d (95% CI, −203.8 to −78.6) and −306.3 g/d (95% CI, −359.5 to −216.7), respectively, and this difference persisted throughout the study period.
Discussion: LCS consumption does not appear to align with potentially beneficial dietary patterns regarding free sugar, ultra-processed food and beverage, and minimally processed food and beverage intakes. These findings underline the importance of policies to consider overall dietary patterns that also address LCS consumption alongside reducing free sugar intake.
Methods: Annual cross-sectional data from the National Diet and Nutrition Survey (NDNS) from 2008/09 to 2018/19 were analyzed. Adults aged ≥18 years (N = 8,304) were categorized into four levels of LCS product consumption: non-consumers (No-LCS) and three tertiles of consumers (Low-LCS: ≤75.0 g/day, Mid-LCS: >75.0–216.8 g/day, and High-LCS: >216.8 g/day), as measured by four-day food diaries. The associations between LCS product consumption and intakes of free sugar, energy, and minimally processed and ultra-processed foods as determined by the Nova classification were analyzed using multivariable linear regression, adjusted for sociodemographic factors.
Results: In 2008/09, 45.9% of participants consumed LCS products, and this proportion remained stable over the 11-year period. Among LCS product consumers, the median LCS product intake increased significantly from 132.0 g/d in 2008/09 to 170.0 g/d in 2018/19. In the No-LCS group, free sugar and energy intakes decreased by −1.0 g/d (95% CI, −1.4 to −0.6) and −6.7 kcal/d (95% CI, −11.4 to −2.1) per year, respectively, with similar declines observed for the High-LCS group. In 2008/09, the mean water and minimally processed food consumption was lower in the High-LCS than the No-LCS group, by −141.2 g/d (95% CI, −203.8 to −78.6) and −306.3 g/d (95% CI, −359.5 to −216.7), respectively, and this difference persisted throughout the study period.
Discussion: LCS consumption does not appear to align with potentially beneficial dietary patterns regarding free sugar, ultra-processed food and beverage, and minimally processed food and beverage intakes. These findings underline the importance of policies to consider overall dietary patterns that also address LCS consumption alongside reducing free sugar intake.
Date Issued
2026-05-14
Date Acceptance
2026-04-30
Citation
Frontiers in Nutrition, 2026, 13
ISSN
2296-861X
Publisher
Frontiers Media S.A.
Journal / Book Title
Frontiers in Nutrition
Volume
13
Copyright Statement
© 2026 Seesen, Chang, Millett, Rauber, Levy, Touvier, Gregg and Vamos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
10.3389/fnut.2026.1797836
Subjects
UK, United Kingdom
LCS, Low and no-calorie sweetened
NDNS, National Diet and Nutrition Survey
UPFs, Ultra-processed foods
IMD, Index of Multiple Deprivation
g, Grams
kcal, Kilocalories
BMI, Body mass index
IQR, Interquartile range
SD, Standard deviation
US, United States
WHO, World Health Organization
Publication Status
Published
Article Number
1797836