Peer reviewed
Manuscript (original) submitted: 11 August 2025; revision accepted: 23 January 2026
Results of KiESEL and EsKiMo II
Introduction
A high sugar intake during childhood and adolescence can shape dietary habits [1] and may lead to an increased risk for health problems such as obesity, cardiovascular diseases, and dental caries up to adulthood [2, 3]. According to the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS = Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland) Wave 2, 15.4% of children and adolescents aged 3–17 years are affected by overweight and 5.9% by obesity [4]. Childhood overweight or obesity often persists into adolescence and adulthood [5, 6].
According to EU Regulation No. 1169/2011 [7], the term “sugar” refers to “all monosaccharides and disaccharides present in food, but excludes polyols” and must be declared on food packaging. However, this does not consider the respective food matrix, which is relevant from a nutritional perspective [8]. For this reason, recommendations on sugar intake refer to the amount of “free sugars”. According to the definition by the World Health Organization (WHO), these include mono- and
disaccharides added to food and beverages by manufacturers, cooks, or consumers, as well as sugars naturally present in honey, syrup, fruit juices, and fruit juice concentrates [9]. For free sugar intake, there is a strong association with adverse health effects such as obesity and dental caries [9, 10].
Abstract
Based on health risks, the WHO recommends a free sugar intake of less than 10% of total energy intake (En%). Using data from the Children’s Nutrition Survey to Record Food Consumption (KiESEL) and the Eating Study as a KiGGS module in KiGGS Wave 2 (EsKiMo II), free sugar intake in children and adolescents in Germany was analysed and main sources of intake were identified. Food intake was assessed using food records for 1–11-year-olds and diet-history-interviews for 12–17-year-olds. Free sugar intake was calculated based on mono-/disaccharides using the German Nutrient Database 3.02 and LEBTAB. In all age groups, the intake was above the WHO recommendation: 11.7 En% and 11.9 En% for 1–2-year-olds and between 16.7 En% and 18.8 En% for 3–17-year-olds. Confectionary and fruit juices contributed most to free sugar intake, followed by milk products in the younger and sugar-sweetened beverages in the older age groups. The results show that measures to reduce sugar intake should already start in early childhood.
