The Truth About Sugar
Does it really make kids hyper? Or fat? How sweets affect your child, and the smartest ways to set limits
By Jessica Snyder Sachs
(originally published in Parenting)
DeeDee Brown of Richmond, Virginia, was looking for anything that might explain her daughter's meltdowns. "Normally, Chloe's calm and happy," says Brown. "But there were times when she'd fall apart -- screaming and yelling and so angry that nothing I said or did could console her." Just the terrible twos? Overtiredness? Playing with certain friends? Brown ruled out the possibilities one by one till she made the connection.
"Once a week, we'd go to the bank, where Chloe would get a lollipop. An hour later, she'd be a complete emotional mess." Brown noticed the same pattern after cookie binges and birthday parties. "I should have known," she says in hindsight. "I get cranky after eating sugar. I just didn't think about my child having the same issue."
Lick the Sugar Habit. The New Sugar Busters! Little Sugar Addicts. Good Carbs, Bad Carbs. A slew of new books would have us blame sugar for everything from behavioral problems to skyrocketing rates of childhood obesity and diabetes. Yet babies come into the world with a sweet tooth (nature's way of drawing them to breast milk). So you may rightly wonder, how could an occasional lollipop or cupcake be so detrimental?
Is sugar really poison -- or a harmless part of childhood?
For all the hype on both sides of the controversy, the truth may surprise you. Pediatricians and nutritionists agree: In modest amounts, sugar can have a healthful place in a child's diet (or an adult's). But many kids get too much, too often. Worse, sugar-rich foods tend to be full of empty calories and often displace the nutritious foods children need. A recent landmark study of more than 3,000 infants and toddlers found that close to half of 7- to 8-month-olds are already consuming sugar-sweetened snacks, sodas, and fruit drinks, a percentage that increases dramatically with age.
What's The Harm?
Findings like these concern health experts, especially because eating high-sugar foods early on makes kids crave them more later. Fortunately, "parents can do a lot to train their young child's taste buds so she doesn't end up wanting sweetness so much," says Gail Frank, a nutritional epidemiologist at California State University, in Long Beach.
Just as children differ in body type, activity level, and temperament, there's no set measuring spoon for the right amount of sugar in their diet. At the same time, how sugar plays into various health considerations can help guide you toward the right balance for your child:
Cavities Sugar alone doesn't cause them, but it does fuel the growth of bacteria that do. So while fluoridated water and regular toothbrushing help prevent cavities, a steady stream of sugar in the mouth increases their likelihood. That's why dentists advise against putting babies to sleep with a bottle of milk (it contains milk sugar) or fruit juice, or letting them sip the stuff throughout the day.
Behavioral problems Numerous studies have confirmed that sugar does not cause hyperactivity. In fact, a few drops of sugar water (a half teaspoon in an ounce of water) can soothe a fussing baby. When sugar enters the bloodstream and reaches the brain, it temporarily increases calming neurochemicals, such as serotonin.
That's not to say you're just imagining those post-birthday-cake meltdowns. The problem is what happens when blood-sugar levels rise too high. The body responds by producing a large amount of insulin, a hormone that sweeps sugar out of the blood and into body cells. Blood-sugar levels may then drop so quickly, your child may feel shaky or sluggish. Not surprisingly, low blood-sugar levels can trigger a craving for more sweets, which creates a vicious cycle of sugar highs and lows.
If your child tends to have postsugar meltdowns, you can prevent them by tempering the amount he gets at any one time -- controlling portion size, diluting fruit juices, choosing treats low in sugar -- and by making sure he eats something heartier along with sweets. Protein (cheese, soy, beans, meat, nuts) and fiber (fruits, veggies, whole grains) help slow the rise and fall of blood-sugar levels.
Obesity Sugar alone doesn't make kids overweight. Children gain too many pounds when they take in more calories than they burn. Unfortunately, sugary drinks and treats typically supply calories above and beyond what kids need to satisfy their hunger.
Sugar calories also tend to go down too fast and easy. A 12-ounce can of soda contains ten teaspoons of sugar (160 calories), and many sweetened fruit drinks have as much or more. Regularly drinking even one sugary drink (soda, fruit punch, or sweetened iced tea) a day increases the risk of obesity. That's one reason the American Academy of Pediatrics (AAP) issued a policy statement in January urging schools to stop offering sweetened drinks in cafeterias and vending machines.
Fruit juices, which contain concentrated amounts of fruit sugar, can also be overdone, says pediatrician Barbara Frankowski, M.D. The AAP advises age-by-age limits:
• No fruit juice for babies under 6 months
• No more than 6 ounces a day for babies 6 months to 1 year
• No more than 6 ounces a day for kids 1 to 6
• No more than 12 ounces a day for kids over 6.
Diabetes Sugar by itself isn't to blame. But a high-sugar diet can increase a child's risk of developing Type 2 diabetes or the prediabetic condition known as insulin resistance syndrome. Both can result when the body becomes less sensitive to insulin, and both are associated with a variety of serious health problems in later life, including heart disease and even infertility.
According to endocrinologists, a high-sugar diet may raise the risk of diabetes and insulin resistance syndrome indirectly, by contributing to obesity (a strong risk factor), and directly, by overworking the pancreas, the organ that produces insulin.
A Place At The Table?
While some moms discover that even a small piece of cake can trigger a meltdown in their child, many kids can indulge in occasional sweets without a problem. "Desserts and candy can be once-in-a-while treats," says pediatric endocrinologist David Geller, M.D., of Cedars-Sinai Medical Center, in Los Angeles. "Once a week is a good goal. The body only cares what you do to it most of the time."
What's more, in small amounts, sugar can even encourage nutritious eating. "When I was little, I learned to love grapefruit if it had a little sugar on it," says registered dietitian Valerie Duffy, Ph.D., of the University of Connecticut.
Similarly, a recent study found that adding about a teaspoon of sugar to a serving of whole-grain breakfast cereal -- such as oatmeal, wheat bran, or muesli -- made a tremendous difference in whether kids liked it, but it had no significant effect on their blood-sugar levels.
"There's some truth to the saying 'A spoonful of sugar helps the medicine go down,'" says Duffy. So relax: Go ahead and let your kids enjoy sugar in moderation. You may even find ways to let that natural sweet tooth lead them down the road to a lifetime of healthful eating.
A Shopping Guide
Everyone recognizes the white stuff in the sugar bowl, but what about the corn syrup in sweetened fruit drinks or the natural sugars in fruit juices, honey, maple syrup, and raw sugar? Are they any better, or worse, for our kids? And what's the scoop on artificial sweeteners? "For the most part, there are no good versus bad sweeteners, just all those choices," says University of Connecticut nutritionist Valerie Duffy. Some produce a faster rise in blood-sugar levels, however, which can then trigger rebound low-blood-sugar levels -- and thus emotional ups and downs -- in some kids and grown-ups. A guide to the leading sweeteners available, and how to ferret out a few that are hidden in foods and drinks:
White, powdered, brown, or raw, it's all sucrose. On product ingredient lists, it's usually just called "sugar." Also look for its close relatives dextrose, glucose, and maltose. In large amounts (more than a couple teaspoons, or about 5 grams), all produce an immediate rise in blood-sugar levels.
Calories: 16 per teaspoon, 4 per gram.
Also called fruit sugar, it occurs naturally in fruits and fruit juices. It produces a slightly slower increase in blood-sugar levels than sucrose, so it may be helpful for people who experience "sugar rebound." But fructose may be easy for the body to convert into fat. And we're consuming very large amounts of it as high-fructose corn syrup, especially in sodas.
Calories: 16 per teaspoon, 4 per gram.
Often found in sugar-free gum and no-sugar-added pastries, sorbitol, mannitol, maltitol, and xylitol are also in fruits. Why they're a good choice: They don't produce a significant rise in blood sugar, they're lower in calories than more quickly absorbed sugars, and they don't cause cavities.
Calories: 9 to 12 per teaspoon, 1.5 to 3 per gram.
The Food and Drug Administration has deemed five artificial sweeteners safe for everyday consumption by kids as well as adults: aspartame (Equal), acesulfame potassium (Sunett, Sweet One), sucralose (Splenda), neotame, and saccharin. (Saccharin's safety has been called into question, but long-term studies show no cancer risk to humans.) Their advantages: They're calorie-free, they don't produce a rise in blood sugar, and they don't cause cavities. Their disadvantages: Recent research (in adults) suggests that artificial sweeteners--like true sugars--may elevate the risk of cardiovascular disease, perhaps because the body responds to sweet tastes by producing insulin and/or storing fat. In addition, saccharin, aspartame, and acesulfame potassium don't taste exactly like sugar. Aspartame can't be used in baking or cooking.
Honey and maple syrup
These contain sucrose, fructose, and water and produce a quick rise in blood-sugar levels. Honey isn't safe for babies under 1.
Calories: about 22 per teaspoon.
This herbal extract hasn't been tested in humans, but animal studies suggest a link to reproductive problems and cancer. Nutritionists caution that stevia shouldn't be given to anyone until more is known about its safety.
Jessica Snyder Sachs is the author of GOOD GERMS, BAD GERMS: Health & Survival in a Bacterial World (Hill & Wang/FSG October 2007).