Background: Diets high in Added Sugar are associated with adverse health conditions. Immigrants may have different Added Sugar intake than nonimmigrants, which may contribute to differential health outcomes.
Objectives: We examined ) the cross-sectional association between Added Sugar intake and nativity and time in the United States and ) prospective association between Added Sugar intake and all-cause mortality by nativity.
Methods: Cross-sectional analyses were based on 17,489 adults (≥18 y) from the NHANES (2011 to March 2020) and prospective analyses were based on 31,291 adults (≥18 y) from NHANES 2003-2018. Multivariable linear regression models were used to assess the association between Added Sugar intake as a percent of energy, nativity (US-born compared with non-US-born), and time in the United States (<5 years, 5 to <15 y, 15-30 y, ≥30 y), after adjusting for important confounders. Multivariable Cox regression models were conducted to examine the association between Added Sugar intake and mortality.
Results: After adjusting for sociodemographic factors and BMI, individuals not born in the United States had 3.29% lower (95% CI: -3.69, -2.90, < 0.001) Added Sugar intake as a percent of energy compared with those born in the United States. These associations were consistent across all race/ethnicities. As time in the United States increased, Added Sugar intake increased significantly (-trend < 0.001) among non-US-born individuals. Added Sugar intake was not significantly associated with lower risk of all-cause mortality in non-US-born individuals or US-born individuals, after adjusting for confounders.
Conclusions: Added Sugar intake differed by nativity and time in the United States, underscoring the need to consider place of birth and length of time when characterizing dietary intake.
