Kids and Sugar

Sugar is present in just about every food we eat, whether it be natural or added. There is nothing inherently wrong with sugar in fact we and our children have been consuming it in small amounts since day one in breast milk or formula. The problem is that when we buy ready-made packaged foods the sugar content can get much higher than we would like or even than we realize. The process of manufacturing these products and the ingredients can often mask one another making it difficult to tell by the taste how much sugar is really present. Sugar is used to enhance flavor and texture and that's why so much is added into our food without us even realizing.

In this article, I'll take a look at the science of sugars, the different types of sugars in our diet, which types of sugars are better and worse, and what the research says about sugars.

The Science

Table sugar is what we usually refer to when we talk about sugar and it is the product of refining beet sugar or cane sugar. Chemically speaking, it is a molecule made up of two monosacharides - glucose and fructose. This sugar is one type of molecule that falls under the category of carbohydrates which also includes starch and cellulose; one of the main components of dietary fiber.

Many people believe that we should avoid all carbohydrates since they break down into sugar in the same way. Though this statement is not entirely false, a distinction should be made between simple and complex carbohydrates. Simple carbs, don't contain much more besides the sugar itself and therefore our bodies don't need to expend any energy in metabolizing it and therefore increase our blood sugar quickly. Think of candy, ice popsicles and jams. Complex carbs are what bread, pasta and rice are made of and they have more chemical bonds in their structure and therefore our digestive system must work harder to break them down into the simple sugars that enter our blood stream. This important difference is why most nutritionists will agree that not all carbohydrates are created equal.

The difference between the different carbohydrates can be measured by their glycemic index (GI). This is an indicator of how quickly a food raises our blood glucose levels. Remember that glucose is one of our building blocks from which sugar is made. Sugar breakdown starts in the mouth during chewing and then is finally broken down in the small intestine by specific enzymes. A lollipop will have a much higher GI than a sweet potato for example. This is because a sweet potato is loaded with dietary fibers that help to increase the time it takes to fully digest it into its component sugars. An added bonus is that eating a sweet potato will keep you full much longer than a lollipop; hence the term "empty calories" for the lollipop.

Now that we know the difference between various types of carbohydrates, you may be wondering whether the different sugars we use to sweeten foods are also not created equal. The short answer to this is that they are indeed created equal. Let's take a look at the different types of common unrefined sugars.

Brown sugar - A sucrose sugar with molasses that is either left in during the refining process or added back in to color the refined table sugar. You can find out which one yours is by rinsing it in water. If the brown color washes off revealing white sugar, that is your answer.

Palm sugar - is a fancy way of saying it is the sugar that comes from the sap of a palm tree.

Coconut sugar - comes from the sap of a type of palm tree, the coconut tree. For comparison, maple syrup comes from the sap of the maple tree.

The Research

Too much sugar in the diet on a long term basis is known to be unhealthy as it causes various diseases, including diabetes, obesity, and tooth decay. According to the WHO (World Health Organization), worldwide obesity has tripled since 1975. Of course, these diseases cannot be attributed solely to consumption of sugars and that is why many people have started to question whether this guideline to reduce sugar intake is accurate. The source of the glucose and fructose is more important than simply being present or not.

Recent research in the field of metabolism, and nutrition has indicated that sugar and fructose are at least partly involved in the development of non-alcoholic fatty liver disease. The source of fructose in our diet is mainly from sucrose and high-fructose corn syrup found in soft drinks. Fructose is also present in honey and fruits but not in such a large amount that one could consume in a serving. The problem with fructose is not only that it is high in empty calories, but that the chemical fructose is actually involved in creation of fatty cells and blocks break down of fatty acids in the liver. Amazingly, fruit contains compounds in addition to fructose that help to block this process of fructose-induced metabolic syndrome. So although there is fructose, eating the entire fruit protects us against the potentially harmful effects (1,2).

Another article looked at the association of added sugar intake and cardiovascular disease (CVD) by looking at the data from the National Health and Nutrition Examination Survey (NHANES) from various years from 1988-2010. They found that sugar intake increased from 1988-2004 but decreased during the survey period of 2005-2010. Sugar intake of greater than or equal to 10% of total calories up to 25% of total calorie, had a 30% higher risk of developing CVD. The risk increased with increasing sugar intake and not necessarily from an increase in overall consumption or diet quality (3).

Sugar and Babies

Sugar on its own does not provide any of the nutrition required by babies and therefore it is recommended to stay away from added sugars for as long as possible. This is much easier said than done especially for a second child who will see their sibling eating sweets much sooner than a first child. The general rule you will here most nutritionists say is to wait until age 2 for sweetened foods. I personally started to give homemade baked desserts a little before age 2. A muffin sweetened with a little brown sugar provides nutrients in addition as part of the food and therefore would be ok. For very small babies 6mos - 2 years I would try to sweeten foods with fruit such as apples (grated apples are great in muffins), dates and frozen berries.

The many names for sugar

Unfortunately, it is not always easy to tell from the nutrition facts label whether there is sugar added to a product. There are over 100 different names for sugars. Don't be fooled by the names that seem more natural "date sugar" is still sugar.

Below is a list of sweeteners that are often added to packaged foods without even being labeled as 'sugar'.

• Sucrose

• Coconut sugar

• Barley malt

• Fructose

• Dextrose

• Glucose

• Date Sugar

• Rice syrup

• Agave

• Confectioner's sugar

• Turbinado sugar

• Fruit juice concentrates

Conclusion

Calorie for calorie, sugar is a carbohydrate and therefore has the same amount per gram as protein. So in theory, carbohydrates and therefore sugars will not lead to weight gain. However, as we saw in the case of fructose and non-alcoholic fatty liver disease, health status is much more than just calories in-calories out. The food we eat influences a wide range of chemical processes in our bodies altering their metabolism depending not only on how much we eat but what we eat them with. That is because unless we are taking a vitamin, or drinking soda; we are not eating just nutrients, we are eating the whole food. So while this is not your excuse to eat all cinnamon rolls and ice cream your heart desires, they can (and should be ;-)) included as part of a healthy diet. For babies and children watch out for the many names for sugar and try to avoid as much added sugars as possible until age 2 (and beyond).

Satisfying your sweet tooth by making deserts at home is a great way to control the amount of added sugar you consume. Here are some recipes you might like to try:

1. Raspberry Olive Oil Brownies

2. Ice Box Blueberry Cheesecake

3. Chocolate Snowball Cookies

Sources:

1. Fructose and sugar: A major mediator of non-alcoholic fatty liver disease, Johnson RJ et al

2. Perspective: A Historical and Scientific Perspective of Sugar and Its Relation with Obesity and Diabetes, Lanaspa M, Andrews P, Sanchez-Lozada L, Johnson R

3. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults, Gregg E, Zhang Z, Yang Q