Should you be concerned about your child eating sugar?

Should you be concerned about
your child eating sugar?
Making sure that fruits, vegetables, whole grains
criteria needed to measure the reliability of a study
and other fiber-rich foods, and calcium-rich dairy
or how to evaluate that information in the larger
products are the centerpieces of your child’s diet is
context of the total scientific evidence.
important dietary advice. Sugar makes many of
these healthy foods palatable. A bowl of nutrient
Sugar has been an important ingredient in people’s
and fiber-rich homemade oatmeal tastes great with
diets for centuries and the subject of countless stud-
a heaping teaspoon of brown sugar.
ies. When the full body of science is evaluated dur-
ing a major review of scientific literature, experts
Foods and beverages that contribute calories but
continue to conclude that sugars intake is not a
few vitamins and minerals should be considered
causative factor in any disease, including obesity.
treat foods. But, just because a food contains sugar
does not make it a food that should be avoided.
Starting with its 1986 review of 1000 scientific
papers, the Food and Drug Administration’s (FDA)
What Is Sugar?
Sugars Task Force in their report on “Evaluation of
All green plants produce sugar (sucrose) through
Health Aspects of Sugars contained in
photosynthesis, the process by which plants trans-
Carbohydrate Sweeteners” reported that “with the
form sunlight into the food they need to grow.
exception of dental caries, the scientific evidence
clears sugars of links with other diseases including
Once photosynthesis creates sugar, plants have the
diabetes, hypertension, behavior and obesity.”
unique ability to change sugar to starch and starch
to various sugars for storage. This diversity pro-
The 1989 National Academy of Sciences Report on
vides us with a wide variety of tasty fruits and veg-
Diet and Health stated, “Sugar consumption (by
etables, from the starchy potato to the sweet carrot.
those with an adequate diet) has not been estab-
lished as a risk factor for any chronic disease other
Sugar/sucrose is a carbohydrate that occurs natu-
than dental caries in humans.”
rally in almost every fruit and vegetable. For exam-
ple, there are four grams of naturally occurring
In 1997, a joint Food and Agriculture
sucrose in a peach. The sucrose in that peach is
Organization/World Health Organization expert
identical to the sugar you buy at the store to put on
consultation concurred that “there is no evidence of
your cereal.
direct involvement of sucrose, other sugars and
starch in the etiology of lifestyle diseases.” This
Sucrose occurs most abundantly in sugarcane and
conclusion was published in the Food and
sugar beets. The refining process simply separates
Agriculture Organization’s “Carbohydrates in
the sucrose from the sugarcane or sugar beet plant
human nutrition” report.
matter. Since sugar is not chemically manipulated
it is completely natural and has just 15 calories per
A 3-year National Academy of Sciences comprehen-
teaspoon.
sive review of the scientific literature was complet-
ed in 2003. Based on the 279 scientific references
What Does the Science Say About Sugar
cited in Chapter 6 (Dietary Carbohydrates: Sugars
Intake?
and Starches), the Academy panel concluded that,
It seems like every week a new study comes out
that grabs the headlines. A single study on any sub-
“Based on the data available on dental caries,
ject is not conclusive and needs further investiga-
behavior, cancer, risk of obesity, and risk of
tion therefore is not a strong basis to change behav-
hyperlipidemia [excess blood fat like triglyc-
ior. The average person does not understand the
erides or cholesterol], there is insufficient evi-
Make an informed choice.
Choose pure natural sugar – 15 calories per teaspoon.
The Sugar Association, Inc. 1101 15th Street NW, Suite 600, Washington, DC 20005 202/785-1122 www.sugar.org

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dence to set a UL (upper level) for total or
Does Sugar Cause a “Sugar High”?
added sugars.”
We often hear that when we eat something sweet
we get a burst of energy (high) that releases insulin
The Academy report states unequivocally,
followed by a profound loss of energy (low).
“There is no clear and consistent association
The glycemic index (GI) is a measure of how fast
between increased intakes of added sugars and
the body breaks down starches and sugars into
BMI [body mass index]”
blood glucose after a food or beverage is consumed.
Does Sugar Cause Diabetes?
The common belief that sugar causes a rapid rise in
There is no reason to be concerned that if your child
blood glucose (glycemic response) which then trig-
eats sugar it will lead to diabetes.
gers an abnormal production of insulin followed by
an atypical drop in blood glucose is not a physiologi-
Normally, carbohydrates in the foods we eat are
cal or scientific reality. Sugar is not a high glycemic
digested and changed into glucose, the sugar that
food and does not uniquely raise blood glucose lev-
circulates in the blood and is one of the body’s
els. With a GI of 58 sugar has a low-to moderate
major sources of energy. Before the body can use
glycemic response.
glucose as energy, insulin (a hormone produced by
the pancreas) must be present to allow body tissue
Comparison of glycemic index (GI) and
to convert glucose to energy.
glycemic load (GL) of certain foods
A person with diabetes either does not produce
Food
GI
GL
enough insulin or cannot properly use the insulin
Apple
40
6
the pancreas does produce.
Baked potato
85
26
Brown rice
50
16
According to the American Diabetes Association,
Carrots
92
5
sugar does not causes diabetes. You can access
Corn flakes
92
24
information on popular myths about diabetes on the
Orange juice
50
13
internet at: http://www.diabetes.org/diabetes-
Plain bagel
72
25
myths.jsp
Potato chips
54
11
Wheat bread
53
11
Myth:
Table sugar (sucrose)
58
6
Eating too much sugar causes diabetes.
Ranges for GI and GL
No. Diabetes is caused by a combination of
GI
GL
genetic and lifestyle factors. However, being
overweight does increase your risk for devel-
High
70 or more
20 or more
oping type 2 diabetes. If you have a history of
Medium
56 to 69
11 to 19
diabetes in your family, eating a healthy meal
Low
55 or less
10 or less
plan and regular exercise are recommended
K F Powell et al, International table of glycemic index and glycemic load
to manage your weight.
values: 2002, Am J Clin Nutr 2002; 76:5-56.
You may have also heard that eating a low GI diet
Not only does sugar not cause diabetes but individ-
is healthful. Both the U.S. Institute of Medicine
uals with diabetes do not have to strictly avoid eat-
and the panel of scientists who developed the 2005
ing sugar according to the American Diabetes
Dietary Guidelines for Americans rejected the con-
Association:
cept of GI as a useful measure of diet quality or a
helpful weight loss tool. The 2005 Dietary
“The available evidence from clinical studies
Guidelines Advisory Committee concluded,
demonstrates that dietary sucrose does not increase
“Current evidence suggests that the glycemic index
glycemia more than isocaloric amounts of starch.
and/or glycemic load are of little utility for provid-
Thus, intake of sucrose and sucrose containing
ing dietary guidance for Americans.”
foods by people with diabetes does not need to be
restricted because of concern about aggravating
Does Sugar Cause Hyperactivity?
hyperglycemia. Sucrose should be substituted for
Hyperactivity is a specific diagnosable syndrome
other carbohydrate sources in the food/meal plan or,
recognized by professionals as Attention Deficit
if added to the food/meal plan, adequately covered
Hyperactivity Disorder or ADHD. It is a behavioral
with insulin or other glucose-lowering medication.”
disorder characterized by chronic problems with

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attention, impulsiveness and/or hyperactivity that
actual physical dependence. Food does not generate
is inappropriate for a child’s age. Under normal
withdrawal, the medically distinct symptoms char-
conditions a very energetic or “highly active” child
acteristic of authentic addiction.
has the ability to control his behavior, whereas the
truly hyperactive child may be able to modify, but
Should I Purchase Sugar Free or Less
not fully control, his behavior.
Sugar Products For My Child?
Recently the Associated Press asked five nutrition
Folklore linking certain foods, such as sucrose or
scientists to evaluate newly introduced “reduced
table sugar, with very active behavior in children
sugar” kids cereals. The scientists found that the
began in the early 1970s, when Dr. Benjamin
reduced sugar versions of popular kid’s cereals pro-
Feingold proposed the theory that diet may
vided no reduction in calories or improved nutri-
adversely affect children’s behavior. Since that
tional content over the regular sugared versions.
time, considerable research has been devoted to the
The replacement ingredients providing the neces-
subject. In over 20 studies, including those support-
sary bulk and texture to the reduced sugar cereals
ed by the Food and Drug Administration, science
had no nutritional or caloric advantage over sugar.
has been unable to support claims that sugar
affects children’s behavior.
Since then, some academic institutions, nutrition
experts and media professionals have begun to
In carefully controlled studies, meals were provided
warn consumers that less sugar does not necessari-
for two weeks to children whose parents believed
ly mean fewer calories or improve nutrition.
their children were affected by sugar. Parents and
teachers monitored their behavior after the meals,
Misplaced emphasis on sugar-containing foods is an
unaware of whether the children had consumed
oversimplification of the current problem and will
sugar or artificial sweeteners. No adverse effects
have the same outcome as the failed low-fat mes-
were found from either.
sages of the 1990s.
A 1995 meta-analysis [a systematic review of the
Are Artificial Sweeteners the Answer?
scientific literature] published in the Journal of the
Sugar and sugar-sweetened foods are one of life’s
American Medical Association confirmed clearly
pleasures, and it is unrealistic to think that people
that sugar does not cause hyperactivity or behavior
will completely forego this simple form of enjoy-
problems. This conclusion remains settled science.
ment. The question remains, “Is ingredient substi-
tution the best solution for solving today’s compli-
Children do, indeed, tend to become excited at spe-
cated problems or will it simply create a new set of
cial occasions, such as birthdays and Halloween.
problems?”
However, continued scientific review, most recently
by the Institute of Medicine, confirm that there is
Is there any evidence that the use of artificial
no evidence that sweeteners cause hyperactivity.
sweeteners will help control weight? According to
the American Dietetic Association (ADA) 2004 posi-
Is Sugar Addictive?
tion paper on the use of nutritive and nonnutritive
Addiction is compulsive behavior with medically
sweeteners, “Nonnutritive sweeteners added to the
identifiable physiological symptoms. Eating sugar
diet have been shown to promote a modest loss of
or any other carbohydrate (or proteins or fats) does
weight.” Yet ADA also stated the undeniable, “The
not produce these symptoms.
prevalence of obesity has increased substantially at
the same time as the consumption of nonnutritive
The premise put forth by some (not the consensus
sweeteners has increased.”
of the scientific community) is the pleasure one
experiences from eating food causes changes in
Times sweeter Acceptable Daily
brain chemistry that lead to addiction. It is well
Sweetener
than sugar
Intake
known that all pleasurable experiences (one good
example is exercise) generate chemical responses in
Sucralose
600
5mg/kg/bw/day
the brain, but all changes in neurochemistry do not
equate to addiction. The science on food addiction is
Aspartame
60-220
50mg/kg/bw/day
limited and most of that science has been conducted
Acesulfame-K
200
15mg/kg/bw/day
with rats.
The reality is people like tasty foods. But there are
With more and more foods containing high intensi-
distinct differences between a psychological depend-
ty sweeteners, there is no doubt that consumption
ency that is often an emotional response to food and
of artificial sweeteners by children will increase. It

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is important to note that the FDA sets Acceptable
intake should be consumed in moderation. Parents
Daily Intakes for artificial sweeteners base on kilo-
can help their children by allowing these foods as
grams of body weight per day. (See chart on previ-
occasional treats. Simply eliminating sugar from
ous page)
the diet will not increase health and control weight.
The American public, especially children, need to
Parents who monitor their children’s consumption
understand that the problem of overweight and obe-
of artificial sweeteners should look at the ingredi-
sity are caused by eating too much food, no matter
ent statement of all foods they purchase for their
the source.
children. Some products, even products that do not
make claims to have reduced sugar content, contain
Maybe our grandmothers had it right
multiple artificial sweeteners or sugar alcohols.
when they told us to eat a little of every-
thing on our plates and then go out and
play.
Sugar Alcohols/ Polyols Approved in the US
• Sorbitol
References
• Mannitol
Glinsmann, W.H., et. al. “Evaluation of health aspects of
• Xylitol
sugars contained in carbohydrate sweeteners.” J. Nutr
• Erythritol
ll6(llS):Sl-S216, l986.
• D-Tagatose
• Isomalt (Palatinat)
National Research Council. “Diet and Health:
• Lactitol
Implications of Reducing Chronic Disease.” National
• Maltitol
Academy Press, 1989.
• Polydextrose
• Hydrogenated Starch Hydrolysis
World Health Organization and Food and Agriculture
Organization of the United Nations. “Carbohydrates in
Artificial Sweeteners Approved in the US
human nutrition.” Report of a Joint FAO/WHO consulta-
• Saccharin
tion. FAO Food and Nutrition Paper 66, Rome, 1998.
• Aspartame
• Acesulfame-K
National Academy of Sciences, Institute of Medicine,
• Sucralose
Food and Nutrition Board. Dietary Reference Intakes for
• Neotame
Energy, Carbohydrate, Fiber, Fat, Fatty Acids,
Cholesterol, Protein, and Amino Acids. National
Parents should also consider the consequences of
Academy Press, 2002. pg. 6-42.
changes to accustomed tastes. American consumers
are forgetting the taste of real, natural foods as
American Diabetes Association. “Evidence-Based
their palates become accustomed to the more
Nutrition Principles and Recommendations for the
intense sweetness of artificial products used to
Treatment and Prevention of Diabetes and Related
replace sugar.
Complications.” Diabetes Care 25(Supplement 1): S50-
S60, 2002.
Why You Should Not Be Concerned About
Your Child Eating Sugar
K F Powell et al, “International table of glycemic index
and glycemic load values”: 2002, Am J Clin Nutr 2002;
The Facts
76:5-56.
Sugar intake has never been linked to any
negative health impact, including obesity.
'Position of the American Dietetic Association: Use of
Nutritive and Nonnutritive Sweeteners'. J Am Diet Assoc
Sugar is natural and has only 15 calories
Vol 104 2 p.255-275 Feb 2004.
per teaspoon.
Wolraich, Mark L. et al “The Effect of Sugar on Behavior
Sugar has added flavor and provided many
or Cognition in Children.” JAMA, Nov 22/29 1995.
essential functional properties to our food sup-
ply for centuries.
Sugar makes many nutrient-rich foods taste
better so children will eat them.
Foods or beverages with high levels of sugars
and/or fats that don’t contribute to key nutrient

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