Abstract

Background and Objectives: Optimizing sugar intake during early childhood is critical for preventing noncommunicable diseases. Although international guidelines recommend limiting free sugar intake, Japan is yet to consolidate data on free sugar intake among children under 2 years of age. This study examined free sugar intake, dietary sources, and associated factors among Japanese children aged 18–23 months. Methods and Study Design: A cross-sectional study was conducted among children attending infant health checkups in Kama City, Japan. Caregivers recorded two non-weighed dietary records (one weekday and one Sunday). Free sugar intake, dietary sources, and related factors were analyzed. Results: Among 84 participants, the mean free sugar intake was 13.3 g/day, corresponding to 5.7% of estimated energy requirements. Overall, 44.0% of children exceeded the World Health Organization recommended level of <5% of energy from free sugar, and 16.7% exceeded the <10% threshold. Major sources included confectioneries (43.2%), fruits including 100% fruit juice (27.3%), dairy products (23.3%), and sweetened beverages (4.6%). Free sugar intake was 37% higher on Sundays than on weekdays. Multivariable analyses showed no significant associations between excessive free sugar intake and demographic or lifestyle characteristics. Conclusions: A substantial proportion of Japanese infants aged 18–23 months consumed free sugar in excess of World Health Organization recommendations. These findings highlight the need to improve caregiver awareness of major free sugar sources, particularly 100% fruit juice, and support the development of age-specific dietary guidance and pediatric nutrition counseling in Japan.

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