IMR Press / RCM / Volume 24 / Issue 9 / DOI: 10.31083/j.rcm2409259
Open Access Review
Dietary Sugar Research in Preschoolers: Methodological, Genetic, and Cardiometabolic Considerations
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1 Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
2 Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G 2W1, Canada
3 Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
*Correspondence: (David W.L. Ma)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(9), 259;
Submitted: 17 December 2022 | Revised: 1 June 2023 | Accepted: 9 June 2023 | Published: 18 September 2023
(This article belongs to the Special Issue Vehicle for Cardiovascular Translational Research: Nutrition)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Excess dietary sugar intake increases the risk of unhealthy weight gain, an important cardiometabolic risk factor in children. To further our understanding of this relationship, we performed a narrative review using two approaches. First, research examining dietary sugar intake, its associations with cardiometabolic health, impact of genetics on sweet taste perception and intake, and how genetics moderates the association of dietary sugar intake and cardiometabolic risk factors in preschool-aged children 1.5–5 years old is reviewed. Second, methodological considerations for collecting and analyzing dietary intake of sugar, genetic information, and markers of cardiometabolic health among young children are provided. Our key recommendations include the following for researchers: (1) Further longitudinal research on sugar intake and cardiometabolic risk factors is warranted to inform policy decisions and guidelines for healthy eating in preschool-aged children. (2) Consistency in sugar definitions is needed across research studies to aid with comparisons of results. (3) Select dietary collection tools specific to each study’s aim and sugar definition(s). (4) Limit subjectivity of dietary assessment tools as this impacts interpretation of study results. (5) Choose non-invasive biomarkers of cardiometabolic disease until the strengths and limitations of available biomarkers in preschool-aged children are clarified. (6) Select approaches that account for the polygenic nature of cardiometabolic disease such as genome risk scores and genome wide association studies to assess how genetics moderates the relationship between dietary sugar intake and cardiometabolic risk. This review highlights potential recommendations that will support a research environment to help inform policy decisions and healthy eating policies to reduce cardiometabolic risk in young children.

dietary assessment
G-18-0022070/Heart and Stroke Foundation of Canada
376067/Canadian Institutes of Health Research
Fig. 1.
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