Journal of Dental School

Vol. 44 No. 1 (2026)

A Narrative Review of the Free Sugar Intake Among Canadians: Metabolic Health and Oral Health Implications for Public Policy

Journal of Dental School, Vol. 44 No. 1 (2026), 29 December 2025 , Page e26
https://doi.org/10.22037/jds.v44i1.45986

Abstract

Objective(s): This study aimed to review levels and patterns of free sugar intake among Canadians, examine the dual implications for metabolic health (e.g., obesity, diabetes) and oral health (primarily dental caries), and identify evidence-based public health and policy interventions to reduce free sugar consumption. Methods: To synthesize current evidence, a narrative synthesis was executed by evaluating peer-reviewed articles and national reports (from PubMed, Scopus, and Google Scholar) published from 2010 to 2024 on free sugar consumption and its health impacts in Canada. Results: Synthesized evidence showed consistently high free sugar intake among Canadians, often exceeding the WHO recommendation of <10% of total energy. Children and adolescents were particularly high consumers. Major sources were sugary beverages, desserts, snacks, and ultra-processed foods. While men consumed higher absolute amounts, intake relative to energy was similar across genders. Key evidence showed that high consumption is linked to increased risks for dental caries, type two diabetes, and obesity. Studies indicated that targeted reductions in sugar content, especially in prepackaged foods and beverages, could yield significant public health and economic benefits. Conclusion: Canadians’ free sugar intake remains high, primarily from sugary beverages and ultra-processed foods, with significant implications for metabolic and oral health. To address this, public health strategies must be multifaceted, focusing on product reformulation, clear front-of-package labelling, and interventions targeting key dietary sources. Policy action is essential to reduce consumption effectively and mitigate the associated chronic disease burden across the population.

Keywords:
  • Dietary Sucrose
  • Sugar-Sweetened Beverages
  • Public Health
  • Health Policy
  • Dental Caries

How to Cite

Fatemi, S., & Ghasemi, H. (2026). A Narrative Review of the Free Sugar Intake Among Canadians: Metabolic Health and Oral Health Implications for Public Policy. Journal of Dental School, 44(1), e26. https://doi.org/10.22037/jds.v44i1.45986

References

1. Bernstein JT, Christoforou AK, Ng A (Praneet), Weippert M, Mulligan C, Flexner N, et al. Canadian free sugar intake and modelling of a reformulation scenario. Foods. 2023; 12(9):1771. doi:10.3390/foods12091771

2. Scientific Advisory Committee on Nutrition. Carbohydrates and health [Internet]. London: TSO; 2015. Available from: https://assets.publishing.service.gov.uk/media/5a7f7cc3ed915d74e622ac2a/SACN_Carbohydrates_and_Health.pdf

3. Gillespie KM, Kemps E, White MJ, Bartlett SE. The impact of free sugar on human health—a narrative review. Nutrients. 2023; 15(4):889. doi:10.3390/nu15040889

4. Rana H, Mallet M-C, Gonzalez A, Verreault M-F, St-Pierre S. Free sugars consumption in Canada. Nutrients. 2021; 13(5):1471. doi:10.3390/nu13051471

5. Wang YF, Chiavaroli L, Roke K, DiAngelo C, Marsden S, Sievenpiper J. Canadian adults with moderate intakes of total sugars have greater intakes of fibre and key micronutrients: Results from the Canadian Community Health Survey 2015 public use microdata file. Nutrients. 2020; 12(4):1124. doi:10.3390/nu12041124

6. Chiavaroli L, Wang Y (Flora), Ahmed M, Ng A (Praneet), DiAngelo C, Marsden S, et al. Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: Cross-sectional analyses of the Canadian Community Health Survey 2015 public use microdata file. Appl Physiol Nutr Metab. 2022; 47(4):415–28. doi:10.1139/apnm-2021-0517

7. Zaltz DA, Ahmed M, Vergeer L, Schermel A, L’Abbé MR. Free sugars in the Canadian diet: A research summary and future directions for food policy. Applied Physiology, Nutrition, and Metabolism. 2025; 50:1–6. doi:10.1139/apnm-2023-0632

8. Liu S, Munasinghe LL, Maximova K, Taylor JP, Ohinmaa A, Veugelers PJ. The economic burden of excessive sugar consumption in Canada: Should the scope of preventive action be broadened? Can J Public Health. 2022; 113(3):331–40. doi:10.17269/s41997-022-00615-x

9. Dasgupta K, Mussa J, Brazeau A-S, Dahhou M, Sanmartin C, Ross NA, et al. Associations of free sugars from solid and liquid sources with cardiovascular disease: A retrospective cohort analysis. BMC Public Health. 2023; 23(1). doi:10.1186/s12889-023-15600-3

10. Bergeron A, Labonté M-È, Brassard D, Bédard A, Laramée C, Robitaille J, et al. Intakes of total, free, and naturally occurring sugars in the French-speaking adult population of the province of Québec, Canada: The predise study. Nutrients. 2019; 11(10):2317. doi:10.3390/nu11102317

11. Flexner N, Bernstein JT, Weippert MV, Labonté M-È, Christoforou AK, Ng A (Praneet), et al. How many diet-related non-communicable disease deaths could be averted or delayed if Canadians reduced their consumption of calories derived from free sugars intake? A macrosimulation modeling study. Nutrients. 2023; 15(8):1835. doi:10.3390/nu15081835

12. Bernstein J, Schermel A, Mills C, L’Abbé M. Total and free sugar content of Canadian prepackaged foods and beverages. Nutrients. 2016; 8(9):582. doi:10.3390/nu8090582

13. Hamel V, Nardocci M, Flexner N, Bernstein J, L’Abbé MR, Moubarac J-C. Consumption of ultra-processed foods is associated with free sugars intake in the Canadian population. Nutrients. 2022; 14(3):708. doi:10.3390/nu14030708

14. Liu S, Munasinghe LL, Ohinmaa A, Veugelers PJ. Added, free and total sugar content and consumption of foods and beverages in Canada. Health Rep. 2020;31(10):14-24. doi: 10.25318/82-003-x202001000002-eng.

15. Jones AC, Kirkpatrick SI, Hammond D. Beverage consumption and energy intake among Canadians: Analyses of 2004 and 2015 National Dietary Intake Data. Nutrition Journal. 2019;18(1). doi:10.1186/s12937-019-0488-5

16. Langlois K, Garriguet D. Sugar consumption among Canadians of all ages. Health Rep [Internet]. 2011; 22(3):1-5. Available from: https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2011003/article/11540-eng.pdf?st=Fqn4OhAK

17. Ahmadi N, Black JL, Velazquez CE, Chapman GE, Veenstra G. Associations between socio-economic status and school-day dietary intake in a sample of grade 5–8 students in Vancouver, Canada. Public Health Nutr. 2014; 18(5):764–73. doi:10.1017/s1368980014001499

18. Lieffers JR, Ekwaru JP, Ohinmaa A, Veugelers PJ. The economic burden of Not Meeting Food Recommendations in Canada: The cost of doing nothing. PLOS ONE. 2018;13(4). doi:10.1371/journal.pone.0196333

19. Loewen OK, Ekwaru JP, Ohinmmaa A, Veugelers PJ. Economic burden of not complying with Canadian Food Recommendations in 2018. Nutrients. 2019; 11(10):2529. doi:10.3390/nu11102529

20. Czoli CD, Jones AC, Hammond D. Trends in sugary drinks in Canada, 2004 to 2015: A comparison of market sales and dietary intake data. Public Health Nutr. 2019; 22(15):2723–8. doi:10.1017/s1368980019001654

21. Bernstein JT, Christoforou AK, Weippert M, L’Abbé MR. Reformulation of sugar contents in Canadian prepackaged foods and beverages between 2013 and 2017 and resultant changes in nutritional composition of products with sugar reductions. Public Health Nutr. 2020; 23(16):2870–8. doi:10.1017/s1368980020001159

22. A Patenaude S, Papagerakis P, RLLieffers J. Development of a nutrition questionnaire for dental caries risk factors. Int J Environ Res Public Health. 2020; 17(5):1793. doi:10.3390/ijerph17051793

23. Kirkpatrick SI, Raffoul A, Lee KM, Jones AC. Top dietary sources of energy, sodium, sugars, and saturated fats among Canadians: Insights from the 2015 Canadian Community Health survey. Appl Physiol Nutr Metab. 2019; 44(6):650–8. doi:10.1139/apnm-2018-0532

24. Langlois K, Garriguet D, Gonzalez A, Sinclair S, Colapinto CK. Change in total sugars consumption among Canadian children and adults. Health Rep. 2019; 30(1):10-19. Available from: https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2019001/article/00002-eng.pdf?st=JMj6VXKp

25. Lee JJ, Ahmed M, Ng A (Praneet), Mulligan C, Flexner N, L’Abbé MR. Nutrient intakes and top food categories contributing to intakes of energy and nutrients-of-concern consumed by Canadian adults that would require a ‘high-in’ front-of-pack symbol according to Canadian Labelling Regulations. PLOS ONE. 2023; 18(5). doi:10.1371/journal.pone.0285095

26. Mahajan A, Yu J, Hogan JL, Jewell K, Carriero A, Annis A, et al. Dietary sugar intake among preschool-aged children: A cross-sectional study. CMAJ Open. 2021; 9(3): E855-63. doi:10.9778/cmajo.20200178

27. Warren C, Hobin E, Manuel DG, Anderson LN, Hammond D, Jessri M, et al. Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians: A cross-sectional analysis of the 2015 Canadian Community Health Survey–Nutrition. Can J Public Health. 2022; 113(3):341–62. doi:10.17269/s41997-021-00602-8

28. Yu J, Mahajan A, Darlington G, Buchholz AC, Duncan AM, Haines J, et al. Free sugar intake from snacks and beverages in Canadian preschool- and toddler-aged children: A cross-sectional study. BMC Nutr. 2023; 9(1). doi:10.1186/s40795-023-00702-3

29. Emmett P. Effects of free sugars intake on human health and disease. Nutrients. 2023; 16(1):31. doi:10.3390/nu16010031

30. Daley AJ. Time to get our teeth into reducing obesity: Should dentists screen and deliver interventions to reduce obesity in the population? Br Dent J. 2022; 232(2):78–9. doi:10.1038/s41415-022-3872-z

31. Murphy MM, Barraj LM, Brisbois TD, Duncan AM. Frequency of fruit juice consumption and association with nutrient intakes among Canadians. Nutr Health. 2020; 26(4):277–83. doi:10.1177/0260106020944299

  • Abstract Viewed: 17 times
  • PDF Downloaded: 11 times

Download Statastics

Developed By

Open Journal Systems

Information

Make a Submission

Make a Submission