Luke Voytas is a pediatrician and author in Portland, Oregon. His posts combine research and common sense to help parents be calm and confident in raising their kids.

Sugar, Sugar, Everywhere

Sugar, Sugar, Everywhere

*The following is an excerpt from my book, Beyond the Checkup.

Sugar is on the short list of things I get pretty worked up about. Some is essential for life - evolution shaped us to seek out and crave those sweet high-energy fruits that used to be hard to come by. But sugar is not hard to come by now, and if you don't keep your guard up, your child will absolutely get too much of it. When it comes to sugar, be skeptical. It may be true that the history of soda is all tied up in Norman Rockwell nostalgia, being young and having fun, and polar bears. And maybe grandfatherly farmers in Florida do indeed tenderly pick their own oranges in the morning sun with the goal of bringing homestyle goodness to your child. Or maybe there are a bunch of wealthy folks in suits worried about the bad rap sugar is getting. Maybe they fund lots of research to show that sugar's not so bad. And maybe they've paid large sums of money to get their products into the schools your child will attend. 

What's so bad about sugar, anyway?

-Sugar makes children more likely to be overweight. A 2013 study found that kids who drink more sugar-sweetened beverages between ages two and five are 40 percent more likely to be obese by ages four and five. (1)

-Sugar makes it harder for your body to know when it's full. Leptin is an important hormone that tells your brain when you're sated. But consuming too much sugar can cause your body to become resistant to leptin and miss out on that signal. Then you eat too much, which further increases leptin resistance in a vicious cycle. 

-Sugar overworks your pancreas. Your pancreas makes insulin, which is crucial for taking all that sugar from your blood and bringing it into your cells where it's used for energy. But your pancreas is more likely to conk out if it's producing insulin at maximum capacity for years. And that's the first step towards type 2 diabetes.

-Sugar can affect your liver in a similar way to alcohol. (2) There is also evidence that it seems to age your brain cells a bit faster and contribute to problems with memory.

-Sugar may affect your child's behavior. I try to back up most claims with scientific evidence, so I have to be honest that there really is no consistent high-quality research showing that increased sugar makes a child more irritable, aggressive, inattentive, or emotional. But I do have two eyes and two kids, and I'm telling you it affects their behavior. Perhaps it's the adrenaline caused by the excitement over the sugar. This is a great chance for your to do some research on your own child! Yay, science!

The American Heart Association recommends that children over age two get no more than 6 teaspoons of "added sugars" (sugars used as ingredients in processed foods) per day. But in a 2012 data brief, the National Center for Health Statistics estimated that children overall get over 20 teaspoons per day, (3) and that children aged two to five get over 13 per day! That's a lot and means kids get about 16 percent of their calories from added sugar. About half of this comes from beverages, with soda being the biggest single source. Kids who eat more meals away from home have higher sugar intake. It's probably not surprising to you that sugar and fast food have a lot of sugar, but it hides in foods you wouldn't expect as well.

When you're reading labels, realize that four grams of sugar = 1 teaspoon = 1 sugar packet. So realizing that you're giving your child seven packets of sugar in a regular strawberry yogurt can really put things in perspective. Also, our society has been more concerned with fat in foods rather than sugar for a long time. So beware of products that say "low fat" or "reduced fat" - companies often try to maintain flavor in these items by adding more sugar, which is not a good trade-off for anyone, but especially your kid. Getting familiar with food labels is a great way to watch your child's sugar intake.

P.S. - In full disclosure, I really am a terrible hypocrite. When I was a kid my favorite candy was Fun Dip (candy cigarettes being a close second). Do you remember Fun Dip? It consisted of three packets of pure fruit-flavored sugar. But that's not the best part. Instead of forcing you to use your finger, they actually gave you two "Lik-A-Stix" made out of sugar to eat your sugar! Oh, the memories.

1. Sugar-sweetened beverages and weight gain in 2- to 5-year-old children. DeBoer M. et al. Pediatrics. 132(3), 2013;413-420.

2. Public health: the toxic truth about sugar. Lustig RH et al. Nature. 482(7383), 2012;27-29.

3. Consumption of added sugar among U.S. children and adolescents, 2005-2008. Centers for Disease Control and Prevention, NCHS Data Brief. No. 87, 2012;

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