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Global Health Econ Sustain Total sugar consumption Philippines

4. Discussion

Results from the 2008 Philippine National Nutrition
Survey revealed that the median intake of total sugar
among children aged 7 months to 18 years old ranged from
19.1 to 29.9 g/day, but varied by age group, sex, wealth
quintile, and population distribution, with certain groups
displaying higher sugar intake levels. Children in the
highest wealth quintiles and urban areas had the highest
sugar intakes. The total sugar intake across all age groups
approximated to a range of 5.3 – 30.9% of energy intake.
The adverse effect of high total sugar intake in young
people was investigated in the diabetes autoimmunity
Figure 1. The total sugar intake in the Philippines in 2008 (presented
as a percentage of energy consumption) according to the respective study in the young, a prospective cohort study since 1993
demographic groups. involving children with an increased genetic risk for
type 1 diabetes. Islet autoimmunity (IA) is a preclinical
3.4.1. Processed foods manifestation before the development of diseases (Lamb
et al., 2015). The study found that among children with
Consumption of table sugar, milk formula, baked IA, progression to type 1 diabetes was significantly
products, non-alcoholic beverages, sweetened rice cakes associated with intake of total sugars (hazard ratio: 1.75,
and snacks, processed soup, sauces, flavor enhancers, 95% confidence interval: 1.07, 2.85). The following
and vegetable and fruit products increased significantly biological mechanisms were suggested to explain the
during this period (from 2008 to 2013). Likewise, the association: (i) consistent hyperglycemia from high sugar
intake of certain beverage products, that is, coffee, tea, intake increases cytokine toxicity and oxidative stress,
sweetened juice drinks, and other sweet drinks, increased which increases beta cell apoptosis (Zhang et al., 2014);
significantly from 2008 to 2013. Consumption of baked (ii) increased sugar intake increases the demand for
products (i.e., biscuits, crackers, cookies, cakes, pies, and insulin, further overloading the beta cells and increasing
pastries) increased significantly among children aged autoimmune attacks (Aaen et al., 1990); and (iii) exposure
1 – 18 years old. In children aged 7 – 11 months old, table to high levels of sugar may be toxic to the beta cell, directly
sugar and confectionery intakes decreased by 0.5 g/day, inducing beta cell apoptosis and reducing normal beta cell
but there were increased consumptions of milk formula
and milk products by 7.1 g/day, rice, cereal, and starch proliferation (Zhang et al., 2014).
products by 6.7 g/day (notably from breakfast cereal and The formation of advanced glycation end products
sweetened rice cakes and snacks), non-alcoholic beverages (AGEs) is another adverse effect of high sugar intake
by 3.3 g/day (notably from sweetened fruit juice and other (Aragno & Mastrocola, 2017; Peppa et al., 2003).
sweet drinks), and baked products by 1.8 g/day increase An example of AGE is hemoglobin A1c or glycated
(notably from biscuits, crackers, and cookies). hemoglobin, which indicates the blood sugar level over
the past 2 – 3 months and is used to detect diabetes.
3.4.2. Minimally processed foods AGEs are toxic compounds resulting from non-enzymatic

Regular milk consumption increased significantly among glycoxidation of reducing sugars with free amino groups
children aged 1 – 18 years old. In contrast, there was a of proteins, lipids, and nucleic acids through the Maillard
significant decrease in fruit and vegetable intake among reaction. The initial product of the reaction is a Schiff base,
children aged 3 – 18 years old. In addition, there were which undergoes dehydration and rearranges to produce
significantly decreased consumptions of rice, cereals, and ketoamine or Amadori products (e.g., hemoglobin A 1c,
starches (for children aged 7 – 11 months old, 1 – 2 years a diabetes indicator). High glucose concentrations, if
old, and 9 – 18 years old), as well as fish, meat, and poultry persistent, lead to further reactions of ketoamines with
(for children aged 9 – 18 years old). In children aged dicarbonyl compounds to form irreversible AGEs. AGEs
7 – 11 months old, whole milk consumption increased by form covalent crosslinks with proteins, altering their
2.6 g/day, and vegetable and fruit consumption increased structure and reducing their protein function. It is known
by 2.1 g/day. In contrast, the consumption of less-processed that hyperglycemia induces high rates of protein glycation,
rice, cereals, and starches decreased by 32.6 g/day, and leading to the development of age-related diseases (Aragno
the consumption of fish, meat, and poultry decreased by & Mastrocola, 2017). In diabetes and insulin resistance,
0.6 g/day. the accumulation of AGEs is elevated, leading to the early

Volume 2 Issue 1 (2024) 6 https://doi.org/10.36922/ghes.2060