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.