Early Life Added Sugars and Associated Appetite, Satiety, Growth and Adiposity in the First 2 Years of Life

Introduction: Added sugar (AS) intake has been linked to chronic diseases, yet evidence in children under 2 years remains limited. Aim: Characterise AS intake in children ≤ 2 years with associated appetite, satiety, growth, adiposity, and breastfeeding duration. Methods: We analysed data from 248 mother-child pairs from the MAS-Lactancia birth cohort. Intake of AS and energy was estimated using data from 24 h dietary recalls. AS intake was classified in tertiles as low (0 g), medium (0.01-6.96 g), and high (>6.96 g). Major food group contributors to AS intake were identified. Appetite and satiety indicators were measured using the Child Eating Behaviour Questionnaire. Adiposity was evaluated using body mass index-for-age Z score, waist circumference, and skinfold thickness. Growth was assessed using length-for-age Z score (ZLA). Linear mixed-effects models were fitted. Results: AS intake and its contribution to total energy increased with age. Major contributors to AS intake were infant formulas, table sugars, and sweet baked goods. Longer exclusive and continued breastfeeding were associated with lower AS intake. Compared to low intake, children with high AS intake had higher scores for emotional overeating (β = 0.58, 95% CI: 0.04, 1.12) and food fussiness (β = 1.45, 95% CI: 0.38, 2.53). High AS intake was also associated with lower ZLA (β = -0.17 z, 95% CI: -0.32, -0.01) and higher waist circumference (β = 2.02 cm, 95% CI: 1.32, 2.73). Conclusions: Among children ≤ 2 years, AS intake ≥ 7 g/d was associated with suboptimal growth, central adiposity, and less favourable eating behaviours. Longer breastfeeding duration may protect against AS exposure.