A limited intake of free and added sugars is recommended due to potential associations with adverse health effects and nutrient inadequacy. However, the impact of free and added sugars intakes on dietary intake is unknown in Swedish adolescents. This study investigated associations of free and added sugars intakes with nutrient and food consumption. Data were derived from the Riksmaten Adolescents 2016–2017 cross-sectional survey, including a nationally representative sample of 3099 adolescents, aged around 12, 15 and 18 years, which provided two 24-h recalls. Median nutrient and food group intakes were compared across sugars intake quintiles, with adjustments for sex, school year and energy misreporting. Inverse associations were observed for almost all micronutrients, dietary fibre, essential fats and food groups commonly included in a healthy diet (e.g. vegetables, fruit, dairy products, meat, fish). However, positive associations between free sugars and vitamin C intake were observed, with fruit juice influencing intake trends. Total energy intake was not positively associated with free or added sugars intakes. Higher intakes of free and added sugars (> 12·9 and > 11·3 % of total energy intake) significantly reduced the likelihood of meeting nutrient reference values. However, for critical nutrients within the adolescent diet (vitamin D, Se, dietary fibre and polyunsaturated fats), lower odds of meeting reference values were observed even at lower intakes of free and added sugars. To conclude, with increasing sugars intake, Swedish adolescents appear to displace nutrient-dense foods with sugars-rich foods, emphasising differences in dietary patterns between those with lower v. higher free and added sugars intake.

The influence of free sugar intake on nutrient intake remains unclear in Japanese children and adolescents with relatively low free sugar intake. This cross-sectional study aimed to investigate the relationship between free sugar and selected nutrient intakes using data from the 2016 National Health and Nutrition Survey, Japan, based on the WHO recommendations (<5 % or <10 % of energy (%E)) for free sugar intake. A 1-d weighed dietary record was assessed in Japanese children and adolescents (aged 1–19 years; n 2919). Mean intakes for selected nutrients and food groups were compared according to free sugar intake categories (<2·5 %E, 2·5 to <5 %E, 5 to <10 %E and ≥10 %E) with adjustment for sex, age and weight status. Inverse associations were observed between intakes of free sugars and twenty-one of twenty-four micronutrients assessed, except for vitamins A and C and Ca. Significantly reduced intakes were identified for twenty-two and fourteen micronutrients in the ≥10 %E and 5 to <0 %E categories, respectively, compared with the lower categories. Mean micronutrient intakes at the <2·5 %E category did not differ from those at the 2·5 to <5 %E category. Free sugar intake had positive associations with intakes of sugars and jams, confectioneries, fruit and vegetable juices, and soft drinks and negative associations with intakes of pulses and nuts and vegetables. This study showed that nutrient dilution was associated with higher free sugar intake among Japanese children and adolescents. The findings suggest that the WHO recommendations might help prevent nutrient dilution in Japanese children and adolescents.