Bethany Rittle-Johnson didn't grow up with fruit punch in the fridge or marshmallows in her cereal bowl. Her mom wouldn't buy that kind of stuff -- so she never developed a taste for it, says Rittle-Johnson. When she had her own kids, the Nashville mom wanted the same for her two daughters, now 7 and 11. Instead of poring over ingredients lists, she goes with her gut and categorically avoids the main offenders. No sweetened drinks, no cereals that resemble miniature cookies, and dessert only occasionally. But simply banning the overtly sweet stuff may not be enough anymore.
These days, the staples of kids' diets -- such as granola bars, flavored milk, and fruit snacks -- all contain sugar of one kind or another. When researchers from the University of Calgary analyzed foods like yogurt and cereal marketed specifically for toddlers, they found that more than half contained at least 20 percent of their calories from sugar.
And thanks to the craze for low-fat and fat-free foods that began in the 1990s, manufacturers started pulling out fat from products and replacing it with sugar. So you'll also see it in some pretty surprising places, including salad dressing, crackers, hamburger buns, pretzels, and chips.
Whether it's evaporated cane juice in organic cookies or high-fructose corn syrup in a squirt of ketchup, it's all adding up to very real health concerns. That's especially scary for a generation of children who are heavier than ever and increasingly burdened by grown-up problems such as type 2 diabetes and metabolic syndrome, which is a cluster of symptoms like high blood pressure and extra belly fat that raise the risk for heart disease. "Sugar is being consumed in massive amounts by children," says Parents advisor David Ludwig, M.D., Ph.D., director of the New Balance Foundation Obesity Prevention Center at Children's Hospital Boston. "It's delivering huge numbers of extra calories and placing young bodies under tremendous stress."
In fact, while many kids continue to fall short on nutrients necessary for growth -- like calcium, iron, vitamin D, and potassium -- their consumption of added sugars (the kind put into foods, not the natural sugar in fruit and milk) has reached alarming levels. It's fine for children to have some sugar. But health experts recommend no more than 5 teaspoons of added sugar every day, and the most recent government surveys show that toddlers and preschoolers get 16. The average 6- to 11-year-old gobbles up 24 teaspoons (nearly 20 percent of his daily calories). An analysis of the same data by the National Cancer Institute found that some 4- to 8-year-olds are getting as many as 36 teaspoons every day.
Eating a lot of high-sugar, high-calorie foods contributes to obesity (not to mention cavities), which can usher in serious health problems -- even during childhood. But according to the American Heart Association's last scientific statement about sugar, high-sugar diets themselves may also trigger elevated triglycerides and a kind of chronic, internal inflammation that can damage arteries and raise the risk for heart disease in adulthood.
The Sweet Truth
To grasp the risks of added sugar, you have to understand this first: "Sugar is sugar," says Barry Popkin, Ph.D., director of the Inter-Disciplinary Obesity Center at The University of North Carolina at Chapel Hill. Though manufacturers use more than a dozen different kinds of sweeteners in foods and drinks -- and some are being touted as more wholesome than others -- the body simply doesn't know the difference between them.
Eighty percent of foods in stores today are sweetened by either sucrose (table sugar) or high-fructose corn syrup (HFCS), a cheaper liquid sweetener alternative to sucrose introduced in the 1970s. Though HFCS has been cast as a nutritional villain -- and regular table sugar has been given a "health halo" for being more pure and less processed -- it actually doesn't matter metabolically. "Within a nanosecond of hitting the small intestine, high-fructose corn syrup and sucrose both break down into two molecules, glucose and fructose," says Robert Lustig, M.D., professor of clinical pediatrics at the University of California, San Francisco. "HFCS and sucrose are virtually equivalent."
The same goes for honey, fruit-juice concentrate, molasses, raw sugar, maple syrup, and agave nectar. They all become glucose and fructose molecules in the digestive system, and they all contribute extra calories to a kid's diet. And though many parents are seeking out less-processed foods, most sweeteners are processed to some degree. The raw materials for sucrose (sugar cane and sugar beets) undergo plenty of processing too. "It's a devious thing that some added sugars are being promoted as relatively healthy," says Dr. Popkin. "We should be cutting back on sugar in all its forms." That's big news coming from Dr. Popkin, whose own 2004 paper in The American Journal of Clinical Nutrition first proposed a link between HFCS and the obesity epidemic, and helped ignite a frenzy among scientists and consumers.