Supplementary Material for: Understanding the risk factors for early-life sugar consumption: a scoping review

Background: The risk factors for early-life sugar consumption in different countries have not been thoroughly mapped, making it difficult to plan interventions.
Summary: This scoping review aims to map evidence on the risk factors for introduction of sugar in the first two years of life and to characterize the methodological features of the studies included. Population, Concept, and Context strategy (PCC) was adopted to identify relevant studies published up to February 2025 using PubMed, Scopus, Dentistry and Oral Sciences Source, and Web of Science databases. Any interventional or observational study investigating associated or risk factors for the early introduction of sugar in the first two years of age was eligible. The study had no funding, and the protocol was not registered. In total, 348 articles were suitable for initial screening of title and Abstracts; 118 were submitted to full-text analysis, identifying 19 papers involving 43,622 children from Europe (n=6), North America (n=5), South America (n=3), Asia (n=3), and Oceania (n=2). Considerable methodological variation was found between studies, particularly in study design, data collection instruments, and types of sugar investigated. The introduction of sugar was earlier among children from regions with greater socioeconomic inequalities and from mothers with lower level of education, younger age, single mothers, and higher number of siblings. Additionally, behavioral risk factors identified included higher parental sugar consumption, maternal smoking, and shorter breastfeeding duration.
Key messages: The risk factors identified in this scoping review can inform the planning of future strategies to prevent sugar consumption in the first two years of life. Furthermore, substantial methodological variations identified across studies may guide researchers in developing future research in this field.

背景：当前尚未对全球各国婴幼儿生命早期食糖摄入的风险因素开展全面系统的梳理，这给相关干预措施的规划带来了困难。
研究概述：本范围综述（scoping review）旨在梳理生命最初两年内食糖引入相关风险因素的研究证据，并刻画纳入研究的方法学特征。本研究采用人群、概念、情境（Population, Concept, and Context, PCC）研究策略，依托PubMed、Scopus、牙科学与口腔科学来源（Dentistry and Oral Sciences Source）及Web of Science数据库，检索截至2025年2月发表的相关研究。凡针对生命最初两年内食糖早期引入的相关影响因素或风险因素开展的干预性或观察性研究，均符合纳入标准。本研究无资助来源，且未提前注册研究方案。总计348篇文献通过标题与摘要初筛；其中118篇进入全文细读分析，最终纳入19篇文献，涉及来自欧洲（n=6）、北美（n=5）、南美（n=3）、亚洲（n=3）及大洋洲（n=2）的43622名儿童。研究间存在显著的方法学差异，尤其体现在研究设计、数据收集工具及所调研的食糖类型方面。社会经济不平等程度更高地区的婴幼儿，以及母亲受教育水平较低、年龄较轻、为单身母亲且家中兄弟姐妹数量较多的儿童，其食糖引入时间更早。此外，本次研究识别出的行为类风险因素还包括家长更高的食糖摄入水平、母亲吸烟及较短的母乳喂养时长。
核心结论：本范围综述所识别的风险因素，可为未来制定预防婴幼儿生命最初两年食糖摄入的策略提供科学参考。此外，不同研究间存在的显著方法学差异，可为该领域后续研究的开展提供重要指导。