According to the American Heart Association’s dietary guidelines, men should consume less than 36 grams of sugar per day and women should consume less than 25 grams of sugar per day. Adherence to these guidelines increased from 8.0% in 2005-2008 to 9.1% in 2017−March 2020 among adults with CKD and increased from 5.7% in 2005−2008 to 8.2% in 2017−March 2020 among adults without CKD (crude estimates). Crude and age-standardized estimates are similar. Among adults with CKD, men, those aged 60–69 years, and those with hypertension or diabetes were generally more likely to adhere to the sugar consumption recommendations than their counterparts.
To view the trends in adherence to the recommended daily sugar intake by risk categories, select from the drop-down menu below. Risk categories include CKD, Age Category, Sex, Race/Ethnicity, Diabetes, and Hypertension.
Data includes CKD stages 1–5. Estimates were standardized to the 2010 U.S. Census population for adults.
NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center. Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.
Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.
Time trends in prevalence of adults with CKD within recommended daily sugar intake guidelines.
National Health and Nutrition Examination Survey (NHANES).
Noninstitutionalized U.S. adults aged ≥ 18 years, pregnant women excluded.
2005–March 2020.
U.S. adults aged ≥ 18 years with CKD who adhered to the recommended daily sugar consumption.
U.S. adults aged ≥ 18 years with CKD who have daily sugar intake measurements, overall or by each defined stratum.
CKD is defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Estimates are based on single estimates of eGFR and UACR.
Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.9938**age x (1.012 if female). κ = 0.7 if female and 0.9 if male α = -0.241 if female and -0.302 if male ** = raise to the power
UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.
Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).
Measured in random urine collection by fluorescent immunoassay.
Diabetes is defined by self-report of diabetes, treatment with insulin or oral anti-diabetes medications, or HbA1c ≥ 6.5%.
Hypertension is defined by self-reported hypertension, treatment with hypertension medications, or average systolic blood pressure greater than 140 mmHg (130 mmHg for CKD and diabetes) and diastolic blood pressure greater than 90 mmHg (80 mmHg for CKD and diabetes).
Self-reported total sugars (gm) were derived from the NHANES one day dietary questionnaire.
According to the American Heart Association, adherence to sugar intake recommendation is defined by consuming less than 36 grams per day of sugar for men and less than 25 grams per day of sugar for women.
Estimates were standardized to the 2010 U.S. Census population for adults: 18–39 years: 37.1%, 40–59 years: 38.1%, 60–69 years: 12.8%, and 70+ years: 12.0%.
Albuminuria and kidney function are assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence.
Appropriate NHANES survey weights are used for all analyses; if the relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.
Recommended Sugar Guidelines - AHA
