Health and Development | Parenting | Child Health + Development | Nutrition | Food

Sweet Denial: What Sugar Is Really Doing to Us (and How to Fix It)

Learn what sugar does to our bodies, plus tips on how to eat healthier as a family, from starting small to getting the kids involved in cooking

On day seven of my family’s 10-day no-added-sugar challenge, I discovered that my teen liked soy milk, which at first seemed to me like a great way for my milk hater to get calcium. Then I had a second thought: Wait, why does my sweets-loving girl like it? I had forgotten to read the label: It turns out there are 5 grams of sugar in each serving!

I’ve always known my eldest daughter (who chose breast milk over all other foods until she was weaned) had a thing for sugar. “We are hardwired [from babyhood] for that sweet taste,” says Jennifer Adler, a Seattle-area nutritionist and author of Passionate Nutrition. “Sweetness is an indicator that food is safe, because it doesn’t have that bitter taste from alkaloids that signify poison in plants. If we look back through history, sweet meant we were safe.”

I’ve been scanning food labels for added sugar ever since I watched the documentary Fed Up and decided my family of four would participate in the 10-day no-added-sugar Fed Up Challenge. The film follows families struggling to lead healthier lives while indicting the food industry and the U.S. government for hiding sugar in 75 percent of packaged foods. In fact, we learn, researchers estimate that 15 percent of all calories consumed in our country comes from added sugars.

“Basically, the food industry has plied all of our foods with sugar so we buy more food. Because we then have a sugar addiction; we can’t stop even when we want to stop,” says Dr. Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco, where he is a professor of clinical pediatrics. “This wouldn’t be a big deal if it were just addiction like coffee is — and believe me, if you take my Starbucks away from me, I will kill you — but coffee, to my knowledge, doesn’t have a downfall like sugar does.”

Although Fed Up is stuffed full of statistics explaining why sugar is not good for our bodies, it’s the diabetes fact that haunts me most. In 1980, there were no documented cases of type 2 diabetes in U.S. adolescents (ages 8–19); 57,638 adolescents were diagnosed with type 2 diabetes in 2010.

To get a window into the cause, you need look no farther than the closest checkout aisle or vending machine. A can of Coca-Cola has 39 grams, or 7.8 teaspoons, of sugar. For comparison, the American Heart Association recommends limiting added sugar consumption to no more than half of your daily discretionary calories, which roughly translates to 4 teaspoons for ages 1–3; 3 teaspoons for ages 4–8; 5–8 teaspoons for tweens and teens; 6 teaspoons a day for most women; and 9 teaspoons a day for most men.

In a recent study published by Lustig and colleagues, dietary sugar intake was reduced from 28 percent to 10 percent for nine days in children (ages 9–18) who had one or more symptoms of metabolic syndrome, which can include hypertension, high blood sugar, abnormal cholesterol and excess body fat around the waist. “We didn’t give them good food; we substituted sugar for starch: chicken teriyaki [was] out, turkey hot dogs in; doughnuts out, but bagels in. The only added sugar they had was from fruit; we didn’t change their calories and their weight didn’t change,” Lustig says. “But every health aspect got better in 10 days.”

The participants’ LDL cholesterol (associated with heart disease) dropped an average of 10 points, while their triglycerides (which contribute to heart disease) fell 33 points. Notably, the children’s fasting blood sugar and insulin indicators significantly improved, which meant participants’ indicators of diabetes risk fell sharply.

When this study was published in the journal Obesity in October, a New York Times headline caught my eye: “Cutting Sugar Improves Children’s Health in Just 10 Days.” I wish it was harder for food companies to effectively hide sugar in the processed food that lines my grocery store shelves. But as Lustig says, “Until the federal government does just this, you are on your own. Parents have to be fastidious label readers or make their own food. And that’s the real answer: Eat real food.”

I feel lucky: A 2013 study by the Rudd Center for Food Policy and Obesity showed that only half of Americans cook every day, and 33 percent of children and 41 percent of teens eat fast food every single day. During our 10-day no-added-sugar challenge, I cooked and cooked and cooked. I attuned my ears to my children’s words as they spoke of sweet cravings while we tried to reduce our sugar intake.

In response to that information, I employ the tools doctors and nutritionists say are the most important for changing our household eating habits for the long term. My teen and tween already know that sugar mimics heroin as an addictive substance. What they need, though, is knowledge gathered from people in the business of helping families lead healthy lives. This is more important than pulling a bait and switch — simply substituting some foods for others and hoping they go along with it — and this is what I attempt to give them.

Slow down, start small

Do you grab a handful of granola bars on the way to soccer? Pass out breakfast in the car? Struggle to make it to work or pick up your kids on time? You’re not alone, and, it turns out, the pace of modern families is directly tied to diet.

“Many of our choices [around eating] are made because we are overscheduled and eating on the go, which can lead to snacking, fast-food stops, more pre-prepared/processed food and not paying attention while eating,” says Dr. Lenna Liu, a pediatrician at the Odessa Brown Children’s Clinic and the medical head of the obesity program at Seattle Children’s Hospital. “Take time to review all activities in your life and see if there are some that can be let go and where you can simplify.”

Our entire food and family culture has changed in the past 60 years. Dr. Wendy Sue Swanson, a general pediatrician and executive director of digital health at Seattle Children’s Hospital, reflects back to when her mom grew up in the 1940s. “Food was prepared for her by her mom. She ate every meal while sitting at a table because she came home for lunch. They never went out to eat and they weren’t eating in the car, in front of the TV or on the side of the sports field,” Swanson says. “Not only has the food industry changed the caloric density, the sugar density and the portion size, we’ve changed where we consume it.”

We know prepackaged food, fast food and restaurant meals all include more sugar, salt and fat, so one important shift is cooking more whole foods at home, Liu says. She recommends starting small: Cook one big meal on the weekend together and plan to enjoy leftovers later.

Of course, children are more interested in eating the food they help cook, but getting them to the cutting board can be tricky. “Children appreciate when their opinions are respected, so let them have input,” says Cynthia Lair, assistant professor for Bastyr University’s School of Nutrition and Exercise Science, founder of Bastyr’s bachelor of science degree program in and the author of Feeding the Whole Family. “Offer a choice of tasks appropriate for their age, such as setting the table for a 4-year-old or preparing salad for an older child. They may grumble, but you are offering the child an opportunity to contribute, which makes them feel more part of the family.”

“One of the ways I helped my young daughter enjoy cooking came out of my own insecurity. During recipe testing for my book, I’d have her give me feedback on the taste. I’d ask, ‘Does it need salt or lemon?’ As an adult, this troubleshooting ability has made her a really good cook,” Lair says.

Make home wholesome

The name Ellyn Satter is repeated by doctors and nutritionists far and wide. Satter, an authority on eating and feeding, is famous for the phrase “division of responsibility.”

“[Satter says] our job as parents is to be the earnest provider of good food, and that children eat when they are hungry and stop when they are full,” Swanson says. “That calorie-dense and full-of-sugar food? Our job is not bringing that stuff into our homes and to think judiciously while we shop. The best way to spend our money is on fresh foods and vegetables. It’s about cooking foods that grow in the ground.”

Respected feeding approaches for parents suggest that, just as it’s up to the child to decide which foods they choose to eat and how much, it’s up to the parent to help children develop skills to navigate outside food environments, especially as those children grow into teenagers. “Because every time they leave the house, they are presented with food choices; why wouldn’t they choose what tastes good?” says Rebecca Finkel, MA, MS, RD, nutritionist at Odessa Brown Children’s Clinic.

As a mom of an almost 14-year-old, I know I have less control over what my teenager eats. During our challenge, I offered an after-school snack of peanut butter and apples to my teen. She snapped at me, saying, “I didn’t ask for that.”

She didn’t ask for that and yet she ate it before she reached for chips. What I learned from this is that kids — just like adults — don’t always know what they need to change. But we can guide them.

Contents of a kitchen

Look inside your refrigerator, search your pantry and snap pictures of your cupboards’ contents. This, experts say, is your starting point for creating change.

Replace packaged food that contains added sugar with real food. Cut up some fruit and veggies and put those at eye level, because what’s readily available and seen is more likely to be eaten, Lair says.

Here are some more tips from Nick Rose, MS, nutrition educator at PCC Natural Markets:

  • Don’t get confused by label claims such as “no refined sugar” or “no artificial sweeteners.” Instead, read the ingredients list and avoid anything with more than 24 grams of added sugar; 24 grams of added sugar equals 6 teaspoons of added sugar, which equals your daily sugar max.
  • Replace sweet snacks with savory ones: Instead of reaching for a sweet treat for a snack, reach for string cheese, mixed nuts, crackers, baby carrots or seaweed snacks.
  • Switch to plain yogurt instead of flavored yogurt. Flavored yogurts can have as much as 6 teaspoons of added sugar per serving. You can sweeten it yourself by adding 1–2 teaspoons of sugar or honey and then work your way down to using even less.
  • Don’t stress about the natural sugars in fruits, vegetables and dairy products. That sugar comes with fiber, water and other essential nutrients.
  • Rely on the list of ingredients, and avoid any and all added sugars (if there’s an “ose” at the end of the word, that’s sugar!), including agave, coconut sugar and brown rice syrup. These sweeteners may sound healthier, but they are still added sugars and should be consumed in moderation.
  • Remember that you can eat some sugar. The recommendation is to eat less sugar, not completely avoid sugar! It is ideal to limit your sugar intake to 5 percent of your total calories; you can enjoy some sugar each day and still be healthy.
  • Also, Rose says, to reduce your sugar intake, always look at your beverage consumption. “Half of all sugar consumed in the U.S. comes from sugar-sweetened beverages, including soda, energy drinks, coffee drinks, iced teas, lemonade and some fruit drinks. Replace these with water, tea, carbonated water or diluted fruit juice,” he says.

Watching the film Fed Up, I was shocked to learn that 80 percent of public schools in America have contracts with soda companies, and that the typical can of soda contains 10 teaspoons of sugar.

Keeping soda out of our homes makes a big difference, but if you declare any food taboo, it only becomes more alluring. Maybe home is soda-free, but having a soda at restaurants or parties occasionally is OK, Liu says.

Start talking

Months before we started our Fed Up Challenge, I told my kids we would be giving up added sugar for 10 days. Even though they rolled their eyes at me, their buy-in was amazing. I think that’s because I kept the conversation casual while also making it a family affair. Yes, they had to participate, but their suggestions counted. For instance, my teen reminded me that she liked kale chips and suggested making homemade pretzels as an after-school snack.

Finkel recommends using media and advertising messages as opportunities for critical thinking. “Ask them why professional athletes might need Gatorade. Why do we maybe not need Gatorade, or when would a sports drink be appropriate?”

Lair suggests allowing older children to discover how their diet makes them look and feel. “Question them in an exploratory way. Have you been eating something different that might have changed your skin or your energy levels? Get them to figure it out, instead of you telling them what they should or shouldn’t do,” she says.

Make dessert

Finally, we reach the sweet spot otherwise known as dessert. Lair suggests that parents consider a “homemade only” rule for desserts. “When you make sweets at home, other whole foods like eggs, butter and nuts and fewer artificial ingredients are included,” she says.

The day after our sugar challenge ended, my girls and I baked profiteroles from scratch. My teen was worried that the sugarless whipped cream wouldn’t be sweet enough, and I suggested that the chocolate sauce might balance the savory. The proof was in the tasting, and there was much joy as my family of four ate dessert that evening. I’m happy to report the maple-syrup-sweetened chocolate sauce balanced the unsweetened whip cream and baked eggy puffs.

“Be conscious and aware about the impact of sugar, but don’t get so dogmatic as to lose the sweetness in your life and the joyful connections that sugary food can bring to celebration,” Adler says. “I tell clients I’d rather see them eating a Big Mac with joy than be stressed out while eating a kale salad in their car.”

For my family, the 10-day no-added-sugar challenge brought a new lightness to our dinner table. My anxiety about what my children choose to eat lessened the more I listened to their thoughtful (and often humorous) input. Now we’re talking more about our food choices instead of mindlessly eating (or intentionally hiding) that Halloween candy stash. 

Inspire healthy eating through reading

With sugar all around us — enhancing packaged food, gleaming in yummy treats and intensifying restaurant entrée flavors — we need inspiration to choose the less-sugared path. Here are some books (and a few blogs) for all ages of readers, starting with adults and working backward to the youngest pre-readers. Some suggestions come from publisher Philip Lee’s Readers to Eaters Food Literacy Reading List.

Adult and teen reads

  • The whole family will enjoy ChopChop magazine’s Cooking Club.
  • My Year of Meats by Ruth L. Ozeki is fictional and perfect for adults and older teens interested in food politics.

Older elementary tweens

  • While the recipes here aren’t necessarily low-sugar, my children cook with this book (great photographs with step-by-step instructions). DK Children’s Complete Children's Cookbook have gotten my kids cooking and eating whole foods. Or pick-up Grow It, Cook It by DK Publishing, with has instructions on growing, harvesting fruits and vegetables, along with recipes.
  • Chew On This by Eric Schlosser and Charles Wilson illuminates the fast food industry for readers in grades 4 and up.
  • Relish: My Life in the Kitchen: this graphic novel by a chef’s daughter Lucy Kinsey offers readers lessons on food, cooking, and family, including recipes (grade 6 and up).

Younger kids

Add the global perspective with Hungry Planet: What the World Eats by Peter Menzel and Faith D’Aluisio, a comparative photo-chronicle of their authors to 30 families in 24 countries for 600 meals in all.

Alice Waters and the Trip to Delicious by Jacqueline Briggs Martin, Illustrated by Hayelin Choi is a picture book biography about the Berkeley chef who created Chez Panisse restaurant and The Edible Schoolyard Project.

How Did That Get in My Lunchbox? by Chris Butterworth looks at how typical lunchbox foods are made, and includes health tips.

What to get your child to eat a tomato? Read them I Will Never Not Ever Eat a Tomato by Lauren Child.

Introduce healthy eating with the very classic Berenstain Bears while reading out loud to the very young: The Berenstain Bears and Too Much Junk Food.

The original version of Stone Soup (by Marcia Brown) starts with three hungry French soldiers are returning from a war. There are many version of this story about creating soup out of a stone by sharing. Here’s a modern retelling not linked to a particular time and place by Heather Forest and Susan Gaber.

The Vegetables We Eat by Gail Gibbons introduces preschoolers to how vegetables are grown and why they are good to eat.

Lois Ehlert’s Eating the Alphabet board book is a picturesque way to begin the food conversation. 

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