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The data are from the 2004 Canadian Community Health Survey (CCHS)―Nutrition, which collected information about the food and nutrient intake of the household population aged 0 or older.  The 2004 CCHS excluded members of the regular Canadian Forces and residents of the three territories, Indian reserves, institutions and some remote areas, as well as all residents (military and civilian) of Canadian Forces bases.  Detailed descriptions of the survey design, sample and interview procedures are available in a published report.8

This article is based on data from the "24-hour dietary recall" component of the 2004 CCHS.  Respondents were asked to list all foods and beverages that they consumed during the 24 hours before the day of their interview (midnight to midnight).  Interviewers used the "Automated Multiple Pass Method," 9,10 with a five-step approach to help respondents remember what they had to eat and drink:

  • quick list (respondents reported all foods and beverages consumed in whatever order they wished);
  • questions about specific food categories and frequently forgotten foods;
  • questions about the time of consumption and type of meal (for example, lunch, dinner);
  • questions seeking more detailed, precise descriptions of foods and beverages and quantities consumed; and
  • a final review.

A total of 35,107 people completed the initial 24-hour dietary recall, and a subsample of 10,786 completed a second recall three to ten days later, which aimed to assess day-to-day variations in intake.  The response rates were 76.5% and 72.8%, respectively.  This study uses data from the first recall only.  Children younger than age 1 (n=289), respondents with "null" or invalid dietary recalls (n=62), pregnant (n=175) or breastfeeding (n=92) women, and children who were being breastfed (n=104) were excluded.  Consequently, this analysis is based on 34,386 respondents aged 1 or older.

Information about children younger than age 6 was collected from their parents, and interviews for children aged 6 to 11 were conducted with parental help.  Sugar intake was based on all foods and beverages reported (ingredients not recipes), the composition of which was calculated using Health Canada's Canadian Nutrient File (Supplement 2001b).6  Approximately 4% of the food and recipe items were missing sugar information; missing values were set to zero when analyzed.  More information on this derived variable can be found in the survey documentation.11

Respondents were asked about specific "long-term" health conditions that had lasted or were expected to last at least 6 months and had been diagnosed by a health professional.  Those who replied "yes" to the question, "Do you have diabetes," were classified as diabetic.

Food groups were categorized according to Canada's Food Guide:  grain products, vegetables and fruit, meat and alternatives, milk products, and other.12

The top ten sources of sugar were examined.  Milk included all forms of milk reported: whole, 2%, 1%, skim, evaporated, condensed, and other types of milk (soya, goat, whey, buttermilk).  Fruit included citrus fruits (oranges, grapefruits, etc. ), apples, bananas, cherries, grapes and raisins, melons (canteloup, honeydew, watermelon), peaches, nectarines, pears, pineapple, plums and prunes, strawberries, and other fruits (blueberries, dates, kiwis, fruit salads, dry fruit, etc. ).  Confectionary included candy, gum, popsicles, sherbert, jello, dessert toppings, pudding mixes, and chocolate bars. Cereals, grains and pasta included pasta, rice, cereal grains and flours, whole grain, oats, and high-fibre bread, and breakfast cereals (other).  Vegetables included beans, broccoli, cabbage and kale, cauliflower, carrots, celery, corn, lettuce and leafy greens (spinach, mustard greens, etc. ), mushrooms, onions, green onions, leeks, garlic, peas and snow peas, red and green peppers, squashes, tomatoes, tomato and vegetable juices, potatoes, and other vegetables (cucumber, immature beans, brussel sprouts, beets, turnips).

To account for the complex survey design, bootstrap weights were used to estimate standard errors, coefficients of variation, and confidence intervals.13,14  T-tests were used to test differences between estimates.  The significance level was set at p < 0.05.

This article has a number of limitations.  The 2004 CCHS did not distinguish between added sugars and naturally occurring sugars.  As well, sugar intake was self-reported, and so may be prone to recall bias or selective under-reporting.  An earlier analysis15 showed an almost 10% difference in total sugar intake among plausible respondents, compared with respondents who under-reported the calories they consumed.  The data are seven years old (2004), but they are the most recent that are available on Canadians' sugar consumption.  Data from the United States show a 10% decrease in sugar consumption from 2003/2004 to 2007/2008 among Americans.