When Mary Poppins sang, “A spoon full of sugar helps the medicine go down,” should the children’s parents have objected? If she had suggested “a spoonful of honey,” would that have been healthier? And if she had recommended “a spoonful of high-fructose corn syrup,” should she have been fired on the spot?
Sugar, which most parents know should not be a major part of any child’s diet, is now a political issue as well as nutritional challenge. For a simple carbohydrate, sugar is a surprisingly complex subject. Sugar, in itself, isn’t the culprit; the body needs carbohydrates like sugar for energy. The danger lies in the amount of added sugar that is creeping into our children’s diets through processed foods, supersized portions and the intense marketing of super-sweet foods directly at kids. Those super-sweet foods, regardless of the type of sugar or even whether it’s a sugar substitute that’s used, are redefining our children’s taste preferences.
Where’s the sweet?
No conscientious parent would include a can of orange soda, with 13 teaspoons of sugar, in their child's packed lunchbox; yet a 12-oz. carton of orange juice — although certainly a healthier choice — still has 8 teaspoons of sugar. And a carton of fruit-at-the bottom yogurt might seem like a great choice for a healthy snack, except that it packs 11 teaspoons of added sugar. Compare this to a carton of plain yogurt, which has 2.5 teaspoons of naturally occurring sugars from lactose in the milk.
Surprisingly, it doesn’t necessarily matter if the sugar is from honey — which actually doesn’t have any minerals or vitamins — or high-fructose corn syrup (HFCS), a processed form of sugar that some nutritionists refer to as “the Devil’s candy.”
Heather Paves, a clinical dietitian at Children’s Hospital and Regional Medical Center, explains, “A child’s body doesn’t know if it’s receiving table sugar, honey, maple syrup or high-fructose corn syrup,” she says. The bottom line is that excessive sugar — regardless of the source — causes tooth decay and creates a preference for highly sweetened foods. This results in a loss of appetite for more nutritious food and adds empty calories with no nutritional value.
“Sweets do not satisfy hunger, especially if used as a snack,” says Paves, who works with overweight children and adolescents. She reports that we’re beginning to see a culture that is overweight but malnourished, and studies show that children who eat a lot of added sugar do not get enough calcium, vitamins or protein.
Sugar know-how
Developing good eating habits early on is important, according to Paves. She says 6- and 7-year-old kids can learn about nutrition and choose healthy snacks if you offer them two or three items from a food group. For instance, Paves suggests asking your child if she would like her “grain snack” to be crackers or pita bread. A “protein snack” can be a choice between peanut butter or hummus, and a “dairy snack” might be milk or cheese sticks. This approach subtly teaches children about the different food groups and gives them important information they can take with them as they get older.
Paves cautions parents about demonizing sugar and says it is more effective to allow sugar in moderation. “Kids will sneak outlawed foods when they’re with friends or at school. And teens will see it as nagging and resist, consuming more sugar and sodas,” she says. Even though it may not seem that teens are paying attention, she encourages parents to be “silent role models,” because kids do observe their parents’ food choices. In her work at Children’s Hospital, she counsels families to avoid processed foods, such as sugared cereals, flavored fruit drinks and gummy-textured snacks sweetened with high-fructose corn syrup.
It’s not always easy for parents to ignore sugary foods when TV commercials have the kids clamoring for Cap’n Crunch or make Fruit Rollups look like health food instead of just candy. According to a study released in March 2007 by the Kaiser Family Foundation, children between 8 and 12 years old watch more than 7,600 food ads a year; equally disturbing, 34 percent of all food ads targeting children or teens are for candy and snacks. While some parents ban television for this reason, others use it as an opportunity to discuss advertising and how information in commercials may not be true. You can ask, “How do you think this ad might be trying to trick you?” or “What do you think might not be true?”
The diabetes link
Although there is no scientific evidence that HFCS causes health problems or is directly responsible for obesity, health experts say this highly processed, synthetic form of sugar is definitely part of the problem. Food manufacturers describe this form of processed sugar as “natural” because it contains no synthetic material, color or flavor additives; critics, however, maintain it is “artificial” because it is not actually found in nature.
According to Dr. Leanne Liu, a pediatrician who specializes in diabetes at Children’s Hospital, HFCS is contributing to the obesity epidemic. “It is in almost anything that is processed; if you look at any processed food, corn syrup or high-fructose corn syrup is often the first ingredient,” says Liu, who treats low-income children with diabetes at the Odessa Brown Clinic. She believes the prevalence of HFCS in processed food is not only a public health issue but has political ramifications, because the U.S. government subsidizes corn production.
Liu emphasizes that eating too much sugar does not directly cause diabetes. “It is a myth that sugar causes diabetes … the real link to diabetes is obesity.” While Type 1 diabetes is genetic, Type 2 diabetes is preventable and related to obesity. She says Type 2 diabetes used to be called “adult onset diabetes,” but is now becoming a common disease among children. “If children are overweight when they’re 3 or 4, Type 2 diabetes can appear in their teens,” she explains.
Liu, who has 8- and 11-year-old children, believes nutritional messages need to be balanced and focused on moderation. “Banning a specific category of food only encourages a child to sneak the food,” she says. And she reminds parents, “What you bring into your home determines what your kids eat.”
Encouraging good food choices
Mercer Island resident Kari Fisher, who is a public health nutritionist for the Public Health Department in Seattle and King County, agrees that having healthy foods at home creates a good nutritional foundation. As the mother of two teenage boys, she knows her kids are free agents when they’re not at home. Her solution is to have healthy yet interesting choices at home, such as popcorn, hummus, fruits and vegetables.
“Once kids acquire a taste for things that are sweet, there’s no going back,” Fisher says. She says humans have an innate preference for food that is sweet because, from an evolutionary standpoint, at one time it helped people avoid bitter-tasting poisons.
What about sugar substitutes? Although studies show that sugar substitutes are safe and can reduce cavities, Fisher says they help children develop a preference for things that are intensely sweet, which encourages them to eat food that has no nutritional value and isn’t satisfying. As a nutritionist, Fisher says she would rather a child eat sweetened yogurt than cookies or chips. But her first choice is plain yogurt sweetened with fresh fruit.
As a member of the Mercer Island School District’s Wellness Committee, Fisher has been involved in developing a food policy for school cafeterias that is interesting to kids and also healthy. She believes there needs to be a cultural shift at high schools. Many kids do have the choice to go off campus for lunch, but Fisher says, “School should not be in the business of profiting from serving unhealthy food.”
Amy Holmes, a former high school science teacher who taught at Vashon, Ballard and University Prep, remembers how discouraging it was to see what her students ate. “Mid-morning, kids would come to class after guzzling a 20-ounce PowerAde,” she says. “They would be crawling on the ceiling, but were asleep by the end of class."
Now the mother of a 3-year-old son and 18-month-old daughter, Holmes is making a major effort to totally eliminate processed foods from her family’s diet. When her son, Gus, was 7 months old, he developed food intolerance. Amy went back to breastfeeding, adding in one food at a time. “If he had sugar, Gus became a different kid,” she said. Although she tried to be casual, Holmes decided it was easier to make anything sweet from scratch, so she could control the amount of sugar. Because of her interest in science and nutrition, Holmes has created a blog (feedingbaby.blogspot.com) to share information with other parents.
A call for sugar moderation
Amanda Kelly has developed one important rule for her five children: Eat something good before something that’s junky. The Seattle mother of 12-year-old triplets (two boys and one girl) and 8- and 6-year-old boys, she notices that some kids just have more of a sweet tooth than others.
Kelly describes her 8-year-old son as a “sugar hound” and recalls the time she found him hiding under a table at a birthday party eating candy. She says it’s actually getting easier now that he’s older. “We can point to his behavior and ask how he felt in a certain situation. Teaching him that his behavior and how he feels is related to sugar helps him make better choices.”
If Kelly’s kids are thirsty, she always offers water instead of juice and keeps a case of water in the trunk of her car for emergencies. Kelly has never made sugar a forbidden food, allowing her kids an occasional soda or a Shirley Temple when they’re dining out. She says that children whose parents are overly strict about sugar are obsessed about it when they’re at her house. Her goal is to present a balanced approach to nutrition but also maintain what she calls a “sense of fun.”
Ballard mom Megan Aukema’s two daughters — 6-year-old Talia and 4-year-old Iris — have yet to visit a McDonald’s or taste a soda. She realizes this won’t last long, but says, “I’m trying to delay it and give them some other options while they’re young and I’m in control.” For snacks, she’ll offer strawberries, raisins or a hunk of cheese over packaged kid snacks such as fruit roll-ups or yogurt snacks that she knows are sweetened with high-fructose corn syrup.
But Aukema doesn’t make a big deal about sugar. “They eat plenty of cake and ice cream at parties, candy at parades and at Halloween . . . but it’s not an everyday occurrence,” she says. She and her husband made the decision not to have dessert after every meal. “It’s one way we keep from getting into bad habits. Sometimes we have dessert but only if we’re having guests for dinner or it’s a special occasion.” She says her girls never ask, “What’s for dessert?”
Aukema, who is the principal of a marketing communications firm, finds herself using a motto with a positive spin: “If you eat too many junky sweets, you won’t have room for all the good stuff.”
Deborah Ashin is the mother of 16-year-old twins. She recently co-authored, with Dr. Pamela Carlton of Stanford University, Take Charge of Your Child’s Eating Disorder: A Physician’s Step-by-Step Guide to Defeating Anorexia and Bulimia.
Can you spot the hidden sugars in your child’s diet?
The Center for Science in the Public Interest, a nutrition advocacy group, offers some surprising information about food that you might consider healthy:
1. One Quaker Oatmeal To Go bar has almost 5 teaspoons of sugar. (This is more than a bowl of Fruity Pebbles, which has almost 3 teaspoons of sugar per serving.)
2. One tablespoon of ketchup contains one teaspoon of sugar.
3. One-quarter cup of maple syrup has 10 teaspoons of sugar.
4. Fruit “drinks,” “beverages,” “-ades,” and “cocktails” are essentially non-carbonated soda pop. Sunny Delight, Fruitopia, and others are only 5 percent to 10 percent juice.
5. Fat-free cakes, cookies, and ice cream may have as much added sugar as their fatty counterparts.
6. Granola bars that don't have fiber are just candy bars.
Pay attention to labels
Reading the ingredient label on processed foods can help to identify added sugars. According to the U.S. Department of Agriculture, added sugars on food labels include:
Brown sugar (white sugar with added molasses)
Corn sweetener
Corn syrup
Dextrose
Fructose
Fruit juice concentrates
Glucose
High-fructose corn syrup
Honey invert sugar
Lactose (sugar in milk)
Maltose
Malt syrup
Molasses (a by-product of beet and sugar cane refining)
Raw sugar
Sucrose
Sugar
Make sure that any of these added sugars are not listen as one of the first few ingredients on the “Nutritional Facts” label.
Amy Holmes’ low-sugar zucchini spice bread
Amy Holmes, who bakes all of her family's desserts, adapted this recipe from Mollie Katzen's The Enchanted Broccoli Forest. She adds flax meal for a nutty sweetness to balance all the spices, and uses only one-third cup of sugar.
Zucchini Spice Bread
2 cups (packed) grated zucchini
6 Tbs melted butter
1/3 cup sugar
2 eggs
2 tsp vanilla extract
1 cup unbleached white flour
1 cup whole-wheat flour
1/4 cup ground flax meal
1 tsp salt
3 tsp baking powder
1/2 tsp freshly grated nutmeg
1/2 tsp allspice
1 1/2 tsp cinnamon
2/3 cup currants
1 cup walnuts, coarsely chopped (optional)
• Preheat oven to 350 degrees. Lightly grease bottom of a standard-size loaf pan.
• Squeeze out excess moisture from zucchini and set aside.
• Beat together melted butter and sugar until well incorporated and sugar begins to dissolve.
• Add eggs one at a time, beating well after each addition, and then beating again until mixture is very smooth and light yellow in color.
• Stir in vanilla and flax meal.
• In a separate bowl, sift together the dry ingredients.
• Add the sifted dry ingredients, alternately with the zucchini, to the butter-and-egg mixture, beginning and ending with the dry.
• Stir in nuts (if using) and currants.
• Spread the batter into the prepared pan. Bake 50 to 60 minutes, or until knife inserted all the way into the center comes out clean, and top is nicely browned. Remove bread from pan after about 10 minutes of cooling, and then continue to cool on a rack for another 30 minutes . . . if you can!
