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. 2026 Sep 6;22(3):e70251. doi: 10.1111/mcn.70251

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

Marília Valls 1, Tailane Scapin 1,2,✉, Marina Padovan 1, Mariana Viera dos Santos Kraemer 1, Ana Carolina Fernandes 1, Greyce L Bernardo 1, Paula Lazzarin Uggioni 1, Maria Cecília Cury Chaddad 3, Rossana P C Proença 1
PMCID: PMC13546739  PMID: 42702079

ABSTRACT

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.

Keywords: food policy, food supply, free sugars, fruit juice, monitoring, nutrition labelling

Summary

  • In Brazil, over 70% of packaged foods and beverages targeted at children and infants contained added sugars;

  • “Sugars” and “syrups” were the most common added sugar ingredients overall;

  • Brazil's current food labelling regulation (ANVISA) underestimated the presence of added sugars in packaged foods by 5% (73% vs. 78%) compared with a broader added sugars definition;

  • Findings support strengthening labelling regulation, restricting child‐targeted marketing, and promoting reformulation to protect children's health.

1. Introduction

In 2025, for the first time, child obesity has surpassed child underweight globally, affecting 1 in 10 children aged 5–19, which represents 188 million children worldwide (UNICEF 2025). According to data from the NCD Risk Factor Collaboration (NCD‐RisC), the prevalence of obesity among 5‐year‐old children in Brazil rose significantly from 6% in 1990 to 25% in 2022 (NCD‐RisC Factor Collaboration 2026; Phelps et al. 2024). The increase in childhood obesity is closely associated with shifts in dietary patterns, marked by the reduction in consumption of traditional and minimally processed foods and an increase in the consumption of processed and ultra‐processed foods containing high levels of saturated fats, sodium, and sugars (Jebeile et al. 2022; Martins et al. 2013). According to the 2019 Brazilian National Survey on Child Nutrition, 93% of children under 5 years old reported consuming ultra‐processed foods on the day prior to the survey, with 27% not consuming fruits and vegetables as part of their diets (UFRJ 2021).

One significant concern in children's diets is the excessive consumption of added sugars (Park et al. 2023). Growing evidence shows that excessive consumption of foods and beverages high in added sugars during childhood is associated with the risk of development of non‐communicable diseases, including obesity and tooth decay (Farhangi et al. 2022; Moores et al. 2022; Nikniaz et al. 2021). For this reason, the World Health Organization (WHO) recommends limiting sugar intake to no more than 10% of total daily energy intake for both children and adults (World Health Organization 2015). In Brazil, the dietary guidelines also advise limiting the consumption of ultra‐processed foods such as biscuits, soft drinks, and ready‐to‐eat meals (Brazil 2014; Monteiro et al. 2015), which usually contain high levels of sugars. In addition, the Brazilian Dietary Guidelines for children under 2 years of age do not recommend this population to consume sugars (Brazil 2019).

Added sugars are widely used in packaged foods. In countries such as Canada (Acton et al. 2017), Australia (Coyle et al. 2024), and Turkey (Bayram and Ozturkcan 2022), more than 60% of packaged food products available at supermarkets contain at least one added sugar ingredient. In Brazil, a 2013 study found that over 70% of packaged foods sold in supermarkets contain added sugars (Scapin et al. 2018). This is particularly concerning given packaged foods are also heavily promoted to children through several marketing tactics used by the food industry, including the widespread use of on‐pack marketing strategies such as cartoons, celebrities, and colourful packaging (Jones et al. 2023; Mulligan et al. 2020; Pérez‐Ferrer et al. 2019). Such strategies are highly effective in influencing children's food preferences and choices, thereby driving demand for these products (Boyland et al. 2022). Another study in Brazil identified over 600 on‐pack marketing strategies aimed at children within the range of packaged foods available for sale in a large supermarket (Rodrigues et al. 2016). Such products were mostly classified as ultra‐processed (Rodrigues et al. 2017), contained lower fibre (Machado et al. 2019), and higher sodium amounts (Borges et al. 2022) compared to similar products without such marketing tactics, with more recent data also demonstrating the frequent use of food additives among these types of products (Kraemer et al. 2024).

Despite previous studies on the use of added sugars in packaged foods and the prevalence of marketing strategies targeting children, there is a notable gap in comprehensive analysis combining both indicators and exploring these dimensions in the packaged food supply in Brazil. Regular monitoring of the nutritional quality of packaged foods is essential to inform policy and practice, particularly given the recent changes in the Brazilian food labelling regulatory scenario (Mais et al. 2022). Fully implemented in 2024, the revised Brazilian food labelling rules made added sugar labelling mandatory in most packaged foods in the country, while also establishing a definition for added sugars. However, the definition adopted appears to exclude certain ingredients that are internationally debated as added sugars (Scapin et al. 2018; Coyle et al. 2024) and that may contribute to adverse health outcomes, such as processed fruit ingredients. As a result, products containing these ingredients may not be captured under the Brazilian definition, potentially underestimating the true prevalence of added sugars in the food supply and reducing the comparability of surveillance data across countries. Therefore, the objectives of this study were to (1) analyse the declaration of added sugars on labels of packaged foods targeted at children sold in Brazil, and (2) compare the prevalence of added sugars in these products when using two different definitions of added sugars.

2. Methods

2.1. Study Design and Data Collection

This study used data from a comprehensive database containing information on the food and nutritional composition of 7828 packaged foods and beverages available for sale in 2020 at a major supermarket outlet in Florianopolis, capital of Santa Catarina state in southern Brazil. The selected supermarket belonged to one of the 15 largest supermarket chains in Brazil (Brazilian Association of Supermarkets 2019), and data collection was conducted at the largest outlet of this chain in Santa Catarina state. The packaged foods collected were from 1035 different brands, 94% of which were sold nationwide. In summary, all products available for sale at the time of data collection were photographed, and information such as product identification (name, brand, manufacturer, package size), nutrition facts panel, and list of ingredients were transcribed by trained Nutrition researchers into Microsoft Excel spreadsheets for analysis. Details regarding the methods for data collection and database creation have been published elsewhere (Kraemer et al. 2025). Ethical review was not required for this study as it did not involve human participants, human data, or animal subjects.

2.2. Identification of Packaged Foods Targeted at Children

Foods targeted at children were defined as products containing at least one child‐targeted marketing strategy displayed on the package (Mulligan et al. 2020). The following criteria were considered child‐targeted marketing on food packaging: (i) wording, colours, and lettering targeted at children, such as bright colour packages, cartoonish script, and child‐appealing font; (ii) brand characters; (iii) fictional animals or creatures; (iv) cartoon characters (licensed or unlicensed); (v) giveaways; and (vi) cross‐promotions (e.g., tie‐ins with movies or TV programs, ads from different media). Foods intended for feeding infants and young children (e.g., milk, infant formula, growing‐up milk, cereal‐based foods for infant feeding, fruit and vegetable purees for infant feeding) were also included in this study because their consumption is high from the first years of life onward (Theurich et al. 2020). The packages of all foods and beverages in the database were screened to identify those that were targeted at children or infants. Three researchers were responsible for the identification, and, in case of any disagreement, a fourth researcher was consulted to achieve consensus.

2.3. Identification of Packaged Foods Containing Added Sugars

Added sugar ingredients were defined according to both the definition used by the Brazilian Health Regulatory Agency (ANVISA) in the Brazilian food labelling regulation (Brazil 2020) and a broader definition considering further public health implications of processed fruit‐based ingredients (Scapin et al. 2018), hereafter referred to as the “broader added sugars definition”. The use of two definitions was necessary since the current ANVISA's definition (hereafter referred to as “ANVISA's added sugars definition”) does not include some added sugar ingredients (e.g., fruit juice). These ingredients are considered added sugars by other food label regulations and definitions and have the potential to be harmful to health and further discussion on this is available elsewhere (Scapin et al. 2018). The broader definition includes processed fruit and vegetable ingredients as added sugars. Table 1 below shows a comparison between both definitions.

Table 1.

Comparison between the two added sugars definitions used in this study.

Definition Source Definition Main differences
ANVISA's added sugars definition Brazilian Health Regulatory Agency (ANVISA), as per the Brazilian food labelling regulation (Brazil 2020) All monosaccharides and disaccharides added during food processing, including the fractions of monosaccharides and disaccharides derived from the addition of cane sugar, beet sugar, sugars from other sources, honey, molasses, treacle, rapadura, cane syrup, malt extract, sucrose, glucose, fructose, lactose, dextrose, invert sugar, syrups, maltodextrins, other hydrolysed carbohydrates, and ingredients containing any of the aforementioned ingredients, with the exception of polyols, added sugars consumed by fermentation or non‐enzymatic browning, and sugars naturally present in milk and dairy products, as well as sugars naturally present in vegetables, including whole, chopped, powdered, dehydrated, pulped, puréed, whole juices, reconstituted juices, and concentrated juices Excludes processed fruit and vegetable ingredients
Broader added sugars definition Scapin, Fernandes and Proença (2017) Added sugars are sugars and syrups added to foods and beverages during food processing, preparation, or meals. They include compounds such as white sugar, high‐fructose corn syrup, honey, and fruit juice and fruit juice concentrates, among others, and exclude sugars naturally present in foods, such as lactose in milk and sucrose and/or fructose in fruit. A sugar naturally occurring in a specific food, including fructose and sucrose, extracted and isolated from its source food and added to another food will be classified as an added sugar in the new food. Includes processed fruit and vegetable ingredients
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The presence of added sugar ingredients in packaged foods was identified manually through a systematic screening of the ingredient lists of each label. Two researchers independently identified and classified the added sugar ingredients according to both added sugar definitions, with a third researcher consulted in case of disagreement. Products in the database were then grouped into three categories: (i) foods without added sugars; (ii) foods listing at least one ingredient considered added sugars under the ANVISA's added sugars definition; and (iii) foods listing at least one ingredient considered added sugars under the broader added sugars definition. Finally, similar nomenclatures were grouped into categories to facilitate data analysis and presentation of results.

2.4. Data Analysis

For the analysis and reporting, packaged foods targeted at children and infants were classified into 18 major food categories based on their characteristics and nutritional composition. Descriptive analyses were conducted to assess the percentage of products in each food group that contained the presence of added sugars according to the two added sugar definitions. The median, minimum and maximum number of added sugar ingredients per product within each food group was also calculated. McNemar's chi‐square test was used to assess for significant differences in the percentage of products with added sugars according to each added sugar definition, with a significance level set at p < 0.05. The frequency of use of different types of added sugar ingredients was reported for all products. The analyses were conducted using Microsoft Excel and Stata software version 18.0 (Stata Corp. 2023, College Station, TX, USA).

3. Results

Of the 1118 packaged foods targeted at children and infants included in our analysis, 73% contained at least one added sugar ingredient based on ANVISA's definition. This proportion increased significantly to 78% when applying the broader definition of added sugars (Table 2). Among the 18 food categories analysed, “Bakery products,” “Sweet biscuits and snacks,” and “Confectionery” had the highest percentages of products containing added sugars, regardless of the definition used.

Table 2.

Descriptive results of added sugars presence in packaged foods marketed at infants and children in Brazil, stratified by food group and type of added sugars definition.

Food groups N ANVISA's added sugars definition Broader added sugars definition % difference*
% (n) of products containing added sugars Median Min‐Max % (n) of products containing added sugars Median Min‐Max
Bakery products 36 100.0% (36) 3 1–7 100.0% (36) 3 1–7 0
Cereal and grain products 43 79.1% (34) 2 1–6 81.4% (35) 2 1–6 −2.3
Dairy products 196 61.7% (121) 3 1–8 63.3% (124) 2 1–8 −1.6
Plant‐based dairy alternatives 50 34.0% (17) 1 1–3 44.0% (22) 1 1–3 −10.0
Ice cream and popsicles 47 89.4% (42) 4 1–9 93.6% (44) 4 1–9 −4.3
Processed meat 19 73.7% (14) 1 1–3 73.7% (14) 1 1–3 0
Confectionery 229 96.5% (221) 2 1–10 96.9% (222) 2 1–10 −0.4
Processed fruits and vegetables 14 21.4% (3) 1 1–2 21.4% (3) 1 1–2 0
Fruit juices and other fruit‐based beverages 59 37.3% (22) 3 1–5 67.8% (40) 3 1–5 −30.5
Soft drinks 37 75.7% (28) 2 1–4 75.7% (28) 2 1–4 0
Sweet biscuits and snacks 106 98.1% (104) 2 1–10 100.0% (106) 2 1–10 −1.9
Savoury snacks 103 63.1% (65) 2 1–5 63.1% (65) 2 1–5 0
Sugars, honey and related products 44 93.2% (41) 2 1–4 93.2% (41) 2 1–4 0
Convenience food 21 66.7% (14) 2 1–2 71.4% (15) 2 1–2 −4.8
Edible oils and margarine 12 16.7% (2) 1 1–1 16.7% (2) 1 1–1 0
Fruit and vegetable purees, pulps and soups for infants 31 0% (0) 3 1–5 54.8% (17) 3 1–5 −54.8
Infant formulas 56 91.1% (51) 1 1–3 94.6% (53) 1 1–3 −3.6
Food supplements 15 20.0% (3) 1 1–2 33.3% (5) 1 1–2 −13.3
Total 1118 73.2% (818) 2 1–10 78.0% (872) 2 1–10 −4.8
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*Bold denotes statistical significance at p < 0.05. Difference in relative values.

The proportion of products identified as containing added sugars was significantly lower when using ANVISA's definition compared to the broader definition, both overall and within three specific food categories: “Fruit and vegetable purées, pulps, and soups for infants” (–54.8%), “Fruit juices and other fruit‐based beverages” (–30.5%)', and ‘Plant‐based dairy alternatives' (–10.0%) (Table 2).

Among products with added sugars, the median number of added sugar ingredients per product was 2 (range: 1–10), consistent across both definitions. Categories with the highest median number of added sugar ingredients were “Ice cream and popsicles” (median = 4), followed by “Bakery products,” “Fruit juices and other fruit‐based beverages,” and “Fruit and vegetable purées, pulps, and soups for infants” (each with a median = 3). The highest maximum number of added sugar ingredients in a single product (n = 10) was observed in the “Confectionery” and “Sweet biscuits and snacks categories” (Table 2).

The most common type of added sugars found in packaged foods targeted at children was “Sugars,” including cane sugar and its variations, present in 72.6% of products. “Syrups” were also frequently used, appearing in 22.7% of the products analysed. Under the broader definition of added sugars, fruit and vegetable‐based ingredients were also commonly used as added sugar ingredients, with “Concentrated, purée, powdered, pulped, or dehydrated” forms found in 13.1% of products, and “Fruit and vegetable juices” in 8.9%. In addition, 10% of products contained other sweet‐tasting ingredients like chocolate, which may include added sugars in their composition, even if not explicitly listed on the ingredients list (Table 3).

Table 3.

Types of added sugar ingredients in packaged foods marketed at infants and children in Brazil, categorized by sugar type.

Sugar type category Examples of ingredients found Number of products and (%) containing each added sugar category
ANVISA's added sugars definition Broader added sugars definition
Sugars Sugar, inverted sugar, liquid inverted sugar, liquid sugar, demerara sugar, organic sugar, coconut sugar, brown sugar, caramelized sugar, refined sugar, caramel syrup, molasses, cane sugar, organic demerara sugar, caramelized sugarcane, caramel, sucrose, crystal sugar 812 (72.6%) 812 (72.6%)
Syrups Glucose syrup, sugar syrup, glucose syrup, malt extract syrup, glucose‐fructose syrup, high fructose corn syrup, corn syrup solids, corn glucose syrup 254 (22.7%) 254 (22.7%)
Maltodextrin Maltodextrins 174 (15.6%) 174 (15.6%)
Glucose Dextrose, glucose, dextrin, powdered glucose, corn glucose, corn dextrin 115 (10.3%) 115 (10.3%)
Cereal‐based sugar extracts Malt extract, cereal extract (barley and malt), guarana extract, powdered barley malt extract 77 (6.9%) 77 (6.9%)
Lactose Lactose 42 (3.8%) 42 (3.8%)
Sweets Condensed milk, dulce de leche, salted caramel crunch, strawberry jam, powdered dulce de leche, guava paste 23 (2.1%) 23 (2.1%)
Fructose Fructose 16 (1.4%) 16 (1.4%)
Concentrated, purée, powder, pulp, or dehydrated Processed strawberry, mango pulp, coconut flakes, sweet potato puree concentrate, banana pulp, banana powder, apple purée, raisins — 147 (13.1%)
Fruit and vegetable juices (natural, reconstituted or concentrated) Apple juice, carrot juice, reconstituted apple juice, concentrated beet juice, concentrated orange juice — 100 (8.9%)
Other sweet‐tasting ingredients that may contain added sugars Chocolate, sweet biscuit, chocolate chips, strawberry‐flavoured sprinkles, vanilla‐ flavoured filling, cocoa syrup, churros‐ flavoured corn cereal, coconut crunch — 106 (9.5%)
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4. Discussion

This study provides evidence on the prevalence of packaged foods targeted at infants and children that contained added sugars, applying two definitions of added sugars, based on products sold by a large supermarket chain in southern Brazil. Seventy three percent of the 1118 products analysed contained at least one added sugar ingredient according to ANVISA's regulatory definition, significantly rising to 78% when using a broader definition. These findings demonstrate the high exposure of Brazilian children to products containing added sugars and highlight the limitations of relying solely on the narrower current regulatory definition for monitoring and policy purposes.

The percentage of products containing added sugars observed in this study is consistent with previous Brazilian data, including a 2013 supermarket study showing that 70% of packaged foods contained added sugars (Scapin et al. 2018). Similar trends have been reported internationally, where child‐targeted products are consistently high in sugars. In France, 90% of products with child‐directed marketing contained sugars (Richonnet et al. 2021), with a more recent study across France, Belgium, and Luxembourg founding that this prevalence was 78% for child‐targeted cereals (Robert et al. 2024). Similarly, in the United Kingdom, more than 80% of children's breakfast cereals were high in free sugars, which used a sugar definition closely aligned with our broad added sugars definition (Boyland et al. 2022). In Spain, a slightly lower prevalence was found with approximately 60% of food products marketed to infants and toddlers containing added sugars (Leszczyńska et al. 2025).

Regarding the types of sugars used, the most commonly added sugars term in our sample was cane sugar‐derived products, appearing on over 70% of the labels analysed. This aligns with findings from France (85%) (Richonnet et al. 2021) but contrasts sharply with Portugal (14%) (Santos et al. 2022) and the United States (31%) (Maalouf et al. 2017), where fruit juice concentrates were highly frequent in this type of products. This illustrates how differences in definitions, labelling regulations, sugar production, and ingredient terminology can complicate cross‐country comparisons.

Alarmingly, over 90% of infant formulas have at least one type of added sugar in their composition, regardless of the added sugars definition. Besides isolated dairy‐based added sugar sources such as lactose, most of these products also contained maltodextrin in their composition. Dietary guidelines for children under 2 years do not recommend sugar consumption in this population Brazil 2019).

The presence of added sugars in our study was not limited to traditionally sweet categories such as confectionery or sweet biscuits. High frequencies were also observed in categories typically perceived as savoury, such as processed meats and savoury snacks. Because these products do not have a sweet taste, the presence of added sugars may go unnoticed by consumers yet still contribute to total intake. This is particularly concerning for children under 2 years of age, for whom Brazilian dietary guidelines recommend avoiding any added sugars (Brazil 2014, 2019). Early exposure to sugars through such products may contribute to taste preference conditioning and excessive sugar consumption in later childhood (Drewnowski et al. 2012).

In our study, the choice of added sugars definition had a marked impact on measured prevalence of products containing these ingredients. Under the broader definition, the proportion of “Fruit juices and other fruit‐based beverages” with added sugars was almost twice that found using ANVISA's definition (68% vs. 37%), while no products containing added sugars were identified for “Fruit and vegetable purees, pulps and soups for infants” using ANVISA's definition, against 55% using the broader definition. This difference reflects that current Brazilian regulations exclude certain processed fruit and vegetable ingredients, such as juices, concentrates, and powders, that are classified as added/free sugars under WHO‐aligned definitions (Scapin et al. 2018; World Health Organization 2015). Although we have analysed the presence of added sugar ingredients and not their content levels, this regulatory gap may underestimate children's actual exposure to sugars and create a loophole that allows the food industry to reformulate their products replacing commonly known added sugar ingredients with ingredients like fruit juice concentrates. Such substitutions enable manufacturers to, for example, circumvent front‐of‐labelling requirements, including warnings for “high‐in‐sugar” products. Moreover, this leaves a gap for marketing strategies such as the use of fruit and vegetable imagery on labels, which can lead parents to perceive these products as healthier than they are (Schmidtke et al. 2025).

From a public health perspective, although processed fruit and vegetable ingredients may retain some vitamins and minerals, processing alters their physical structure by breaking down the cellular matrix, which both reduces fibre content and releases sugars from their natural matrix, converting them into free sugars within the product (Zhang et al. 2024). These readily available sugars are more rapidly absorbed by the body, resulting in a higher glycaemic response compared with whole fruits (Louie and Tan 2026). Previous research has extensively discussed the distinction between whole fruits and fruit juices, including calls for dietary guidelines to emphasise the benefits of whole fruit over fruit juice, with the latter contributing to excessive free sugar intake (Mavadiya et al. 2025). In addition, processed fruit products such as fruit juices typically contain higher levels of sugar than whole fruits and, along with the lack of fibre, have led to concerns that fruit juices may have effects similar to sugar‐sweetened beverages (Guasch‐Ferré and Hu 2019). Several studies have demonstrated the potential adverse health impacts of excessive free sugar intake in children, including weight gain (Farhangi et al. 2022; Moores et al. 2022; Nikniaz et al. 2021), early dental caries (Boustedt et al. 2022), and emerging evidence suggesting possible psychological effects associated with high free sugar consumption (Voltas et al. 2024).

Our findings highlight the urgent need for stronger regulatory action to reduce children's exposure to added sugars in packaged foods. Revising Brazil's regulatory definition of added sugars to include processed fruit and vegetable ingredients that contribute to free sugar intake would improve monitoring accuracy and policy relevance. In light of these concerns, and to align with food trade policies within the Mercado Común del Sur (Mercosur), ANVISA has recently (October 2025) committed to reviewing the current definition of added sugars to potentially include fruit‐ and vegetable‐based ingredients such as juices, pulps, and purées (MERCOSUL 2025).

Strengthening restrictions on child‐directed marketing on packaging should also be prioritised, as it could reduce the appeal and visibility of high‐sugar products to children, as seen in Mexico, where warning labels and packaging restrictions have been implemented together (Taillie et al. 2019). Reformulation targets for child‐targeted products should also be considered, with safeguards to prevent replacing sugars with non‐nutritive sweeteners, which are not recommended for children (World Health Organization 2023). Given the persistently high prevalence of added sugars across packaged foods sold in Brazil since 2013, these measures should be mandatory rather than voluntary, as industry self‐regulation has proven insufficient to protect children's health.

Strengths of this study include the data collection within a large supermarket chain, a systematically collected dataset, and the application of two added sugar definitions, allowing direct comparison of their impact on prevalence estimates. Data collection in 2020, just before Brazil's updated labelling legislation took effect, provides a valuable baseline for future monitoring (Brazil 2020). Limitations include the analysis of products from a single supermarket chain, which may not represent the entire national market, and reliance on ingredient lists, which may not fully disclose all sugar sources within compound ingredients. Future research should consider collecting data from smaller retailers, which may offer different food products than large supermarket chains and are often frequented by lower‐income households. Our assessment focused on identifying the presence of added sugar ingredients rather than quantifying their amounts. Accurately estimating added sugar content from packaged food labels is methodologically challenging, as manufacturers were not required to disclose the quantity of added sugars on food labels in Brazil at the time of our data collection. With the implementation of updated Brazilian food labelling regulations in 2024, future assessments of the actual amount of added sugars in foods targeted at children and infants are recommended. Additional research should also consider longitudinal studies to monitor changes in sugar presence and marketing strategies following Brazil's updated labelling regulations, including research into the effects of the forthcoming Mercosur regulatory update, contingent on its approval and subsequent implementation.

5. Conclusion

Over 70% of packaged foods targeted at infants and children in Brazil contain added sugars, with prevalence underestimated when using ANVISA's narrower added sugars definition. Broader definitions reveal hidden sugar sources, particularly from fruit and vegetable‐based ingredients, underscoring the need for improved labelling regulation, stricter marketing restrictions for packaged strategies targeted at children on unhealthier foods, and reformulation policies to protect children's health and align with WHO sugar intake recommendations.

Author Contributions

M.V. and T.S. performed the analysis and wrote the paper. M.V., T.S., and R.P.C.P. designed the research study. M.P., M.V.S.K., A.C.F., G.L.B., P.L.U., and M.C.C.C. provided critical feedback on the manuscript.

Conflicts of Interest

The authors declare no conflicts of interest.

Acknowledgements

The authors acknowledge the use of Microsoft Copilot (accessed November 2025) to translate parts of the Methods section from Portuguese to English. Copilot was also used to check grammar and improve sentence structure for the Introduction and Discussion sections. All AI‐revised content was subsequently reviewed and edited by the authors to ensure accuracy and clarity of meaning. Open access publishing facilitated by Deakin University, as part of the Wiley ‐ Deakin University agreement via the Council of Australasian University Librarians.

Valls, M. , Scapin T., Padovan M., et al. 2026. “The Extension of Added Sugar Use in Packaged Foods Targeted at Children in Brazil.” Maternal & Child Nutrition 22: e70251. 10.1111/mcn.70251.

Marília Valls and Tailane Scapin contributed equally to this study.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Acton, R. B. , Vanderlee L., Hobin E. P., and Hammond D.. 2017. “Added Sugar in the Packaged Foods and Beverages Available at a Major Canadian Retailer in 2015: A Descriptive Analysis.” CMAJ Open 5, no. 1: E1–E6. 10.9778/cmajo.20160076. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bayram, H. M. , and Ozturkcan A.. 2022. “Added Sugars and Non‐Nutritive Sweeteners in the Food Supply: Are They a Threat for Consumers?” Clinical Nutrition ESPEN 49: 442–448. 10.1016/j.clnesp.2022.03.006. [DOI] [PubMed] [Google Scholar]
  3. Borges, C. A. , Khandpur N., Neri D., and Duran A. C.. 2022. “Comparing Latin American Nutrient Profile Models Using Data From Packaged Foods With Child‐Directed Marketing Within the Brazilian Food Supply.” Frontiers in Nutrition 9: 920710. 10.3389/fnut.2022.920710. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Boustedt, K. , Roswall J., and Twetman S.. 2022. “Free Sugars and Early Childhood Caries Development: A Prospective Cohort Study.” European Archives of Paediatric Dentistry 23, no. 5: 829–833. 10.1007/s40368-022-00745-3. [DOI] [PubMed] [Google Scholar]
  5. Boyland, E. , McGale L., Maden M., et al. 2022. “Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and Health: A Systematic Review and Meta‐Analysis.” JAMA Pediatrics 176, no. 7: 221037. 10.1001/jamapediatrics.2022.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brazil . 2014. Dietary Guidelines for the Brazilian Population 2014. Ministry of Health. https://www.fao.org/nutrition/education/food-dietary-guidelines/regions/brazil/en/.
  7. Brazil . 2019. Dietary Guideline for Brazilian Children Under 2 Years. Brasília: Ministry of Health. https://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_chhildren_under.pdf.
  8. Brazil . 2020. Brazilian Health Regulatory Agency. Resolution n° 429 of 2020. Establishes Requirements For The Nutritional Labeling of Packaged Food. Brasília: Ministry of Health. https://www.gov.br/anvisa/en/rules-and-regulations/arquivos/rdc-429_2020.pdf.
  9. Brazilian Association of Supermarkets . Ranking 2018. 2019. https://www.abras.com.br/edicoes-anteriores/Main.php?MagNo=244#page/33.
  10. Coyle, D. H. , Davies T., Taylor F., Howes K., Pettigrew S., and Jones A.. 2024. “Assessing the Policy Implications of Different Definitions for Added Sugars: An Analysis Across the Australian Packaged Food and Beverage Supply.” Current Developments in Nutrition 8, no. 2: 102058. 10.1016/j.cdnut.2023.102058. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Drewnowski, A. , Mennella J. A., Johnson S. L., and Bellisle F.. 2012. “Sweetness and Food Preference.” Journal of Nutrition 142, no. 6: 1142S–1148S. 10.3945/jn.111.149575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Farhangi, M. A. , Tofigh A. M., Jahangiri L., Nikniaz Z., and Nikniaz L.. 2022. “Sugar‐Sweetened Beverages Intake and the Risk of Obesity in Children: An Updated Systematic Review and Dose‐Response Meta‐Analysis.” Pediatric Obesity 17, no. 8: e12914. 10.1111/ijpo.12914. [DOI] [PubMed] [Google Scholar]
  13. Guasch‐Ferré, M. , and Hu F. B.. 2019. “Are Fruit Juices Just as Unhealthy as Sugar‐Sweetened Beverages?” JAMA Network Open 2, no. 5: e193109. 10.1001/jamanetworkopen.2019.3109. [DOI] [PubMed] [Google Scholar]
  14. Jebeile, H. , Kelly A. S., O'malley G., and Baur L. A.. 2022. “Obesity in Children and Adolescents: Epidemiology, Causes, Assessment, and Management.” Lancet Diabetes & Endocrinology 10, no. 5: 351–365. 10.1016/S2213-8587(22)00047-X. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Jones, A. , Shahid M., Morelli G., et al. 2023. “Chocolate Unicorns and Smiling Teddy Biscuits: Analysis of the Use of Child‐Directed Marketing on the Packages of Australian Foods.” Public Health Nutrition 26, no. 12: 3291–3302. 10.1017/S136898002300215X. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Kraemer, M. V. S. , Fernandes A. C., Ares G., et al. 2024. “Infant and Children's Exposure to Food Additives: An Assessment of a Comprehensive Packaged Food Database.” Journal of Food Composition and Analysis 134: 106473. 10.1016/j.jfca.2024.106473. [DOI] [Google Scholar]
  17. Kraemer, M. V. S. , Fernandes A. C., Chaddad M. C. C., et al. 2025. “Assessing Nutritional Composition and Ingredients of Packaged Foods in Brazil: An In‐Store Census Method for Creating a Comprehensive Food Label Database.” Frontiers in Nutrition 12: 1568089. 10.3389/fnut.2025.1568089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Leszczyńska, P. M. , de Las Heras‐Delgado S., Shyam S., et al. 2025. “Nutritional Content and Promotional Practices of Foods for Infants and Young Children on the Spanish Market: A Cross‐Sectional Product Evaluation.” European Journal of Pediatrics 184, no. 6: 333. 10.1007/s00431-025-06156-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Louie, J. C. Y. , and Tan S. Y.. 2026. “Free Sugars Consumption and Type 2 Diabetes: What Are the Concerns and How Strong Is the Evidence?” Current Nutrition Reports 15, no. 1: 11. 10.1007/s13668-026-00740-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Maalouf, J. , Cogswell M. E., Bates M., et al. 2017. “Sodium, Sugar, and Fat Content of Complementary Infant and Toddler Foods Sold in the United States, 2015.” American Journal of Clinical Nutrition 105, no. 6: 1443–1452. 10.3945/ajcn.116.142653. [DOI] [PubMed] [Google Scholar]
  21. Machado, M. L. , Rodrigues V. M., Nascimento A. B., Dean M., and Fiates G. M. R.. 2019. “Nutritional Composition of Brazilian Food Products Marketed to Children.” Nutrients 11, no. 6: 1214. 10.3390/nu11061214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Mais, L. A. , Borges C. A., Khandpur N., Duran A. C., and Martins A. P. B.. 2022. “Brazil's Nutrition Labeling Regulation: Challenges Ahead on the Path to Guaranteeing Consumer's Right to Adequate Information.” Frontiers in Nutrition 9: 2022. 10.3389/fnut.2022.921519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Martins, A. P. B. , Levy R. B., Claro R. M., Moubarac J. C., and Monteiro C. A.. 2013. “Participacao Crescente De Produtos Ultraprocessados Na Dieta Brasileira (1987–2009).” Revista de saúde pública 47, no. 4: 656–665. 10.1590/s0034-8910.2013047004968. [DOI] [PubMed] [Google Scholar]
  24. Mavadiya, H. B. , Roh D., Ly A., and Lu Y.. 2025. “Whole Fruits Versus 100% Fruit Juice: Revisiting the Evidence and Its Implications for US Healthy Dietary Recommendations.” Nutrition Bulletin 50, no. 3: 411–420. 10.1111/nbu.70009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. MERCOSUL . 2025. MERCOSUL/XCIII SGT n.3/P. Res. n.05/25. Regulamento técnico MERCOSUL sobre rotulagem nutricional e alimentos embalados. https://www.gov.br/anvisa/pt-br/assuntos/noticias-anvisa/2025/PRes0525RTMRotulagemNutricional_PT.pdf.
  26. Monteiro, C. A. , Cannon G., Moubarac J.‐C., et al. 2015. “Dietary Guidelines to Nourish Humanity and the Planet in the Twenty‐First Century: A Blueprint From Brazil.” Public Health Nutrition 18, no. 13: 2311–2322. 10.1017/s1368980015002165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Moores, C. J. , Kelly S. A. M., and Moynihan P. J.. 2022. “Systematic Review of the Effect on Caries of Sugars Intake: Ten‐Year Update.” Journal of Dental Research 101, no. 9: 1034–1045. 10.1177/00220345221082918. [DOI] [PubMed] [Google Scholar]
  28. Mulligan, C. , Potvin Kent M., Christoforou A. K., and L'Abbé M. R.. 2020. “Inventory of Marketing Techniques Used in Child‐Appealing Food and Beverage Research: A Rapid Review.” International Journal of Public Health 65, no. 7: 1045–1055. 10.1007/s00038-020-01444-w. [DOI] [PubMed] [Google Scholar]
  29. NCD‐Risc Risk Factor Collaboration . 2026. Child and Adolescent Body Max Index. https://www.ncdrisc.org/data-visualisations-adiposity-ado.html.
  30. Nikniaz, L. , Abbasalizad‐Farhangi M., Vajdi M., and Nikniaz Z.. 2021. “The Association Between Sugars Sweetened Beverages (SSBs) and Lipid Profile Among Children and Youth: A Systematic Review and Dose‐Response Meta‐Analysis of Cross‐Sectional Studies.” Pediatric Obesity 16, no. 7: e12782. 10.1111/ijpo.12782. [DOI] [PubMed] [Google Scholar]
  31. Park, S. , Zhao L., Lee S. H., et al. 2023. “Children and Adolescents in the United States With Usual High Added Sugars Intake: Characteristics, Eating Occasions, and Top Sources, 2015‐2018.” Nutrients 15, no. 2: 274. 10.3390/nu15020274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Pérez‐Ferrer, C. , Auchincloss A. H., de Menezes M. C., Kroker‐Lobos M. F., Cardoso L. O., and Barrientos‐Gutierrez T.. 2019. “The Food Environment in Latin America: A Systematic Review With a Focus on Environments Relevant to Obesity and Related Chronic Diseases.” Public Health Nutrition 22, no. 18: 3447–3464. 10.1017/s1368980019002891. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Phelps, N. H. , Singleton R. K., Zhou B., et al. 2024. “Worldwide Trends in Underweight and Obesity From 1990 to 2022: A Pooled Analysis of 3663 Population‐Representative Studies With 222 Million Children, Adolescents, and Adults.” Lancet 403, no. 10431: 1027–1050. 10.1016/S0140-6736(23)02750-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Richonnet, C. , Mosser F., Favre E., Robert M., Martin F., and Thiebaut I.. 2021. “Nutritional Quality and Degree of Processing of Children's Foods Assessment on the French Market.” Nutrients 14, no. 1: 171. 10.3390/nu14010171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Robert, M. , Martin F., Xhonneux A., Mosser F., Favre E., and Richonnet C.. 2024. “Nutritional Quality of Breakfast Cereals on the French, Belgian and Luxembourg Markets: Which Cereals for Children?” Nutrients 16, no. 16: 2701. 10.3390/nu16162701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Rodrigues, V. M. , Rayner M., Fernandes A. C., Oliveira R. C. d, Proença R. P. dC., and Fiates G. M. R.. 2016. “Comparison of the Nutritional Content of Products, With and Without Nutrient Claims, Targeted at Children in Brazil.” British Journal of Nutrition 115, no. 11: 2047–2056. 10.1017/S0007114516001021. [DOI] [PubMed] [Google Scholar]
  37. Rodrigues, V. M. , Rayner M., Fernandes A. C., de Oliveira R. C., Proença R. P. C., and Fiates G. M. R.. 2017. “Nutritional Quality of Packaged Foods Targeted at Children in Brazil: Which Ones Should Be Eligible to Bear Nutrient Claims?” International Journal of Obesity 41, no. 1: 71–75. 10.1038/ijo.2016.167. [DOI] [PubMed] [Google Scholar]
  38. Santos, M. , Matias F., Loureiro I., et al. 2022. “Commercial Baby Foods Aimed at Children Up to 36 Months: Are They a Matter of Concern?” Foods 11, no. 10: 1424. 10.3390/foods11101424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Scapin, T. , Fernandes A. C., Dos Anjos A., and Proença R. P. C.. 2018. “Use of Added Sugars in Packaged Foods Sold in Brazil.” Public Health Nutrition 21, no. 18: 3328–3334. 10.1017/s1368980018002148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Scapin, T. , Fernandes A. C., and Proença R. P.. 2017. “Added sugars: Definitions, classifications, metabolism and health implications.” Revista de Nutrição 30, no. 05: 663–677. 10.1590/1678-98652017000500011. [DOI] [Google Scholar]
  41. Schmidtke, A. , Hickey K., and Martin J.. 2025. “Beyond the Label: Seeing Past Marketing on Baby and Toddler Foods in Australia.” Food for Health Alliance. https://www.foodforhealthalliance.org.au/downloads/campaigns/FHA_BeyongTheLabel_A4-12pp_HW%20WEBSITE.pdf. [Google Scholar]
  42. Taillie, L. S. , Busey E., Stoltze F. M., and Dillman Carpentier F. R.. 2019. “Governmental Policies to Reduce Unhealthy Food Marketing to Children.” Nutrition Reviews 77, no. 11: 787–816. 10.1093/nutrit/nuz021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Theurich, M. A. , Zaragoza‐Jordana M., Luque V., et al. 2020. “Commercial Complementary Food Use Amongst European Infants and Children: Results From the EU Childhood Obesity Project.” European Journal of Nutrition 59, no. 4: 1679–1692. 10.1007/s00394-019-02023-3. [DOI] [PubMed] [Google Scholar]
  44. UFRJ . 2021. Brazilian National Survey on Child Nutrition (ENANI‐2019). Universidade Federal do Rio de Janeiro. https://enani.nutricao.ufrj.br/enani-2019/.
  45. UNICEF . 2025. Feeding Profit. How Food Environments Are Failing Children. Child Nutrition Report 2025. UNICEF. https://www.unicef.org/reports/feeding-profit.
  46. Voltas, N. , Jardí C., Hernández‐Martínez C., Arija V., and Canals J.. 2024. “Association Between Free Sugars Intake and Early Psychopathological Problems.” Journal of Child Health Care 28, no. 4: 760–773. 10.1177/13674935221135106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. World Health Organization . 2015. Guideline: Sugars Intake for Adults and Children. World Health Organization. https://www.who.int/publications/i/item/9789241549028. [PubMed] [Google Scholar]
  48. World Health Organization . 2023. Use of Non‐Sugar Sweeteners: WHO guideline. https://www.who.int/publications/i/item/9789240073616. [PubMed]
  49. Zhang, X. , Liao X., Wang Y., Rao L., and Zhao L.. 2024. “Health Effects of Fruit Juices and Beverages With Varying Degrees of Processing.” Food Science and Human Wellness 13, no. 5: 2456–2479. 10.26599/FSHW.2022.9250202. [DOI] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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