The bitter facts about sugar

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Many parents have no idea just how much sugar their children are eating.

Most would never pack two Krispy Kreme glazed donuts for their children’s lunch. Instead, they’d probably opt for more traditional items like a peanut butter and jelly sandwich on whole wheat bread, yogurt, an apple and a juice box.

Sugar Donut WWith protein, dairy, fruit and fiber, the more traditional lunch packs a nutritious punch. But it can also have almost double the amount of added sugar as the donuts.

Today’s children are consuming too much sugar — and their health is suffering as a result.

A recent American Heart Association analysis found U.S. children ages 2 to 19 are consuming an average of 19 teaspoons (about 80 grams) of added sugar daily. That’s more than three times the AHA’s recommended amount to stay healthy.

“Excess sugar is linked to heart disease, high triglyceride levels, obesity and diabetes,” says Dr. Deon Edgerson-George, a pediatrician with Eastern Shore Primary Care in Chester.

At least one study has also found that sugar hinders learning and memory by slowing down the brain.

Added sugar is everywhere, not just in candy, soda and sweet cereals. It’s hiding in most packaged foods, and it comes with a range of confusing names, from dextrose to maltose.

Pediatricians, schools and lawmakers are making moves to help parents reduce the sugar in their families’ diets. Efforts include more nutrition education during doctors’ appointments, increasing the number of fresh fruits and vegetables available in schools, and reducing the amount of sugary snacks in vending machines.

The key, they say, is moderation and awareness.

“Sugar is not all bad,” Edgerson-George says. “Your body uses it as a form of energy to keep going. But too much of it can be bad.”

No sugar coating the heath impact

Sugar is a carbohydrate found in plants, especially in sugar beets and sugar cane. In food, it comes in two forms: naturally occurring sugars (found in fruits and milk) and added sugars (found in candy, cookies, soft drinks, fruit drinks and more), according to the AHA. Added sugars also show up in unexpected places such as certain brands of crackers, tomato-based pasta sauces, condiments like ketchup, fat-free salad dressings and even bread.

Sugar messy face WIn small quantities, neither form of sugar is bad, says Michele Hanks, a registered dietitian at University of Maryland Baltimore Washington Medical Center. The problem arises when children eat too many foods loaded with added sugar and, as a result, eat fewer healthy foods like fruit and vegetables, she says. Their diets become energy dense but nutrient poor.

“These are called empty calories,” Edgerson-George says. “You’re getting the sugar without the vitamins and minerals.”

The AHA recommends youth ages 2 to 18 consume less than 6 teaspoons (about 25 grams) of added sugar a day to stay healthy. It also recommends children and teens limit intake of sugar-sweetened drinks to no more than 8 ounces weekly. A 12-ounce can of Coca-Cola has 39 grams of sugar, so according to the guidelines, kids should drink no more than 2/3 of a can per week.

Experts say, however, that many children exceed these recommendations in just one meal.

The problem is, excess sugar goes straight to the liver and eventually turns into fat, says Dr. Edisa Padder, a pediatrician who practices in Columbia and Laurel. As a result, some overweight and obese children are developing non-alcoholic fatty liver disease (NAFLD), or fatty liver, a condition where fat builds up around the liver. This condition was once only seen in adults, Padder says.

High levels of sugar in the blood can also cause higher cholesterol levels and inflammation, she says. Combined, these can lead to a hardening and narrowing of the arteries, a disease called atherosclerosis.

“We have learned that excess sugar, and not just excess fat, are damaging to our blood levels and leads to poorly functioning blood vessels and heart disease,” Padder says.

In recent years, she’s seen more children with insulin resistance (which can lead to Type 2 diabetes) and obesity than ever before in her 10-year career.

Cutting back on sweets

Throughout the past few years, Maryland schools have taken steps to reduce the amount of sugary foods and snacks available at school and increase the amount of fresh fruits and vegetables offered. Federal (USDA) guidelines require public schools to offer food items where no more than 35 percent of the total content per portion is composed of sugar (milk and whole fruit are excluded from the totals).

In Howard County Public Schools, all juices sold are made from 100 percent fruit or 100 percent vegetables and do not have added sugars, says Brian Ralph, director of food and nutrition services. The school system has also reduced the amount of sugary cereals offered.

Anne Arundel County Public Schools have a monthly “Tasting of the Rainbow” program where students can sample new or different local fruits or vegetables like kuri squash, yellow watermelon and purple sweet potato. The goal is to get them eating healthier, less-sugary foods now so they continue to make healthy choices as adults, says Jodi Risse, the school system’s supervisor for food and nutrition.

If children are eating the correct amount of nutritious foods and calories for a healthy body weight, there isn’t much room for excess sugar, experts say.

Sugar Healthy kidsMaking healthier choices

While most children will always have a taste for sugar, experts and parents say there are simple ways to encourage healthier choices and minimize sugar intake.

  • Choose fruit. “Don’t discount the fact that kids like fruit,” Hanks says. “During the holidays, always include a fruit platter on the buffet trays. A chocolate-covered strawberry is a better choice than a cookie.” Or, offer fruit for breakfast instead of that sugary donut, Edgerson-George says.
  • When buying treats, avoid artificial sweeteners. Shannon Crosley, an Annapolis mother of two and a health coach, says her children eat a small bowl of ice cream every night. But she only buys the brands with natural ingredients like milk and sugar. The fewer the ingredients the better, she says.
  • Toss or donate candy. On days like Halloween and at birthday parties when her children receive excess candy, Crosley asks them to pick out a few favorites. Then, she throws the rest away or donates it.
  • Eat more fiber-rich foods. To improve her health two years ago, Saffa Naeem, 17, drastically reduced the amount of refined sugars in her diet. The Lanham resident cut out most sweets, including brownies, chocolate and candy, and added fiber-rich foods like apples and quinoa. Fiber is filling and slows the body’s absorption of sugar (which helps with blood sugar control). As a result of the change, she says she is more motivated and has more energy.
  • Limit snacking. Children today eat a lot of snacks — after soccer games, as class rewards, even as incentives for good behavior. “I tell my patients, ‘Listen to your body,’” Padder says. “Eat when you are hungry as opposed to snacking at scheduled times.”
  • If you need snacks, prepare them at home. By preparing healthy snacks at home instead of buying pre-packaged, convenient snacks at the store, parents can control the nutritional content and the portion size, Padder says.

“It’s all about progress not perfection,” Crosley says. “The most I can do is educate my kids without completely depriving them.”

Hanks agrees and reminds parents that when it comes to sugar, moderation is key.

“You don’t want to have parents that restrict everything because then they go and raid other peoples’ pantries,” she says. “It’s not sugar that’s bad. It’s the foods you are choosing.”

Click next below to learn about hidden sugar and sugar substitutes


Sugar hiding in some favorite foods

Six teaspoons of added sugar equals about 100 calories or 25 grams. To put this in perspective, here is the sugar content in some kid-favorite foods:

  • 1 tablespoon of Heinz ketchup – 4 grams
  • 2 tablespoons of Kraft honey mustard dressing – 7 grams
  • Yoplait strawberry banana Go-Gurt – 8 grams
  • 1 Krispy Kreme glazed donut – 10 grams
  • 3 Kellogg’s buttermilk Eggo Pancakes – 12 grams
  • 1 tablespoon of Smucker’s strawberry jam – 12 grams
  • 12-ounce bottle of orange Gatorade – 21 grams
  • McDonalds vanilla soft serve in a cone – 25 grams

Sugar WWhat about the fake stuff?

Parents may be tempted to allow their children to have artificial sweeteners, but there is little known about the effect of these sweeteners on kids. Early research is far from promising.

“Some researchers call it a massive, uncontrolled public health experiment,” Padder says. “There is evidence in animal studies that artificial sweeteners may alter our gut microbe and lead to glucose intolerance.”

Glucose intolerance puts children at risk for diabetes.

There is also evidence that diet drinks containing artificial sweeteners are often consumed in the absence of other foods, Padder says. This can interfere with systems that regulate hunger and feeling full, and can lead to weight gain.

“Until we learn more what these ‘foreign’ sugars do to our bodies, it probably is safer to stay away from them,” Padder says.

Legislative actions to reduce sugar, increase healthy choices

Lawmakers are considering or have passed several measures to increase access to healthier choices, including:

  • The Maryland Healthy Vending Act would make healthy food and drink options more available in vending machines on state properties like parks, recreation centers and office buildings. The bill, backed by Sugar Free Kids Maryland, is expected to go before the General Assembly in early 2017, says Shawn McIntosh, executive director of Sugar Free Kids Maryland, a statewide coalition to combat Type 2 diabetes, heart disease and tooth decay in children. The act failed in 2016 after the Senate Finance Committee voted to kill the measure.
  • The Prince George’s County Council introduced a similar bill in September that would limit sales of any snack with more than 200 calories or a high fat, calorie or sugar content in vending machines on county, municipal and park properties. Vending machines would also be required to include bottled water and show nutritional information for every product.
  • A 2015 Howard County law requires 75 percent of vending machine options in county-owned properties to meet caloric, fat and sugar guidelines.

Sugar by any other name

According to SugarScience, a website developed by health scientists from the University of California, San Francisco, there are more than 60 different names for sugar, making it hard to find on ingredient labels. That will soon change. In May, the White House and the U.S. Food and Drug Administration announced companies will be required to show “added sugar” on food labels by 2018. In the meantime, if you’re monitoring your family’s sugar intake, watch for these names:

anhydrous dextrose
brown sugar
confectioner's powdered sugar
corn syrup
corn syrup solids
dextrose
fructose
high-fructose corn syrup (HFCS)
honey
invert sugar
malt syrup
maltose
maple syrup
molasses
nectars (e.g., peach nectar, pear nectar)
sucrose
Source: U.S. Department of Agriculture

By Allison Eatough

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