The Extension of Added Sugar Use in Packaged Foods Targeted at Children in Brazil.

Excessive added sugars intake in early childhood has been associated with an increased risk of obesity and other non-communicable diseases. In Brazil, packaged foods form a substantial part of children's diets, yet no studies have examined the presence of added sugars in products specifically marketed to this population. This study assessed the prevalence and types of added sugars in packaged foods targeted at infants and children in Brazil, comparing two definitions: the current Brazilian food labelling regulation (ANVISA's definition) and a broader definition aligned with the World Health Organization's free sugars concept. A total of 1118 packaged foods and beverages from a 2020 Brazilian supermarket database featuring child-targeted marketing strategies were analysed. Ingredient lists were screened to identify the presence of added sugar ingredients, and products were classified into 18 food categories. Comparison analyses of the prevalence of presence, number, and types of added sugar ingredients across definitions were conducted. Overall, 73.2% of products contained at least one added sugar ingredient according to ANVISA's definition, increasing to 78.0% under the broader definition. The largest differences between definitions were observed for "Fruit and vegetable purées, pulps, and soups for infants" (0% vs. 54.8%) and "Fruit juices and other fruit-based beverages" (37.3% vs. 67.8%). "Sugars," including cane sugar and its derivatives, were the most common type of added sugar used, followed by "syrups," and "maltodextrin." These findings reveal the widespread presence of added sugars in Brazilian packaged foods targeted at children. Broader definitions can uncover hidden sources, particularly in processed fruit-based and infant products, underscoring the need for a comprehensive definition that includes all sugars with potential harm to health, to strengthen monitoring efforts and protect children's health.