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Background: Formulas often contain high amounts of added sugars, though little research has studied their connection to obesity.

Objectives: This study assessed contributions of added sugars from formulas during complementary feeding on total added sugar intakes, and association between these sugars and upward weight-for-age percentile [WFA %ile] crossing (participants crossing a higher threshold percentile had an upward crossing).

Methods: Data from three 24-h dietary recalls for infants (n = 97, 9 – 12 mo) and toddlers (n = 44, 13 – 15 mo) were obtained in this cross-sectional analysis. Foods and beverages with added sugars were divided into 17 categories. Pearson’s correlations were used to test relations between added sugar intake and upward WFA %ile crossing, followed by multivariable regressions when significant. Analysis of variance compared intakes of all, milk-based and table foods between primarily formula-fed vs. breastfed participants. Multivariate regressions were used to test effects of added sugars and protein from all foods vs. added sugars and protein from milk-based sources on upward WFA %ile crossing.

Results: Added sugars from formulas comprised 66% and 7% of added sugars consumed daily by infants and toddlers, respectively. A significant association was observed between upward WFA %ile crossing and added sugars from milk-based sources after controlling for gestational age, sex, age, introduction to solid foods, mean energy intakes, and maternal pre-pregnancy body mass index and education ( β = 0.003, 95% CI: 0.000, 0.007, p = 0.046 ). Primarily formula-fed participants consumed nearly twice the energy from added sugars ( p = 0.003 ) and gained weight faster (upward WFA %ile crossing = 1.1 ± 1.2 vs. 0.3 ± 0.6 , p < 0.001 ) than breastfed counterparts.

Conclusions: Added sugars in formulas predict rapid weight gain in infants and toddlers. Educating mothers on lower-sugar options may enhance childhood obesity prevention.

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Association Between Added Sugars From Infant Formulas And Rapid Weight Gain In The U.S. Infants And Toddlers