28th January, 2012 - Posted by Drboo - 6 Comments
It is just after lunch and today X has eaten……
Cereal (a couple of spoonfuls)
Toast with jam
Pasta with peas and cheese
The scrapings of the bowl we made peanut cookies in (we bake almost every day)
So, a quick glance will tell you that X eats sugar. Quite a bit, apparently. I am a little embarrassed, actually. Should I be? Should I be worried?
Am I going to cause him to be hyperactive?
I destroying his teeth?
Am I destroying his brain?
Sugar triggers the brain to release serotonine – one of the biochemical messengers that has soothing anti-anxiety effects so in theory sugar should have a calming effect on the brain. So why the theory that it doesn’t? The idea (in print at least) seems to date back in the 1920s, Seham and Seham (1929) seemed to be the first to mention it, but I cannot find the actual reference anywhere. However, since then the idea has been perpetuated, and a quick google search throws up website after website about how sugar gives children a quick high, leaving them hyperactive, followed by a crashing low, which leaves them exhausted and difficult.
So, what does the research say?
A meta-analysis (Wolraich, 1995) of 16 studies (where they took the data of lots of studies and analysed them) study in 1995 conclusively disproved that sugar affects the behaviour or cognitive performance of children. The authors concluded that the strong belief of parents may be due to expectancy and common association. However, they also added, a small effect of sugar or effects on subsets of children cannot be ruled out.
This meta-analysis was not without its critics (Jacobson, 1996). The authors based their conclusion on the mean effect – they analysed the data by categorising it into children in whom sugar had no effect, a stimulatory effect, or a quieting effect. So if only a minority of children in the studies were truly sensitive to sugar, it could easily have been obscured by this averaging. So, as the authors did point out, a small subset of children may experience hyperactivity following exposure to sugar.
A study in 1987 (Benton et al) actually found that giving sugar (glucose) to children (versus a placebo) led those kids to tolerate frustration and concentrate better.
So, why do some kids seem to climb the walls after a dose of the sweet stuff? Well, while there may be a subgroup of children who do not tolerate sugar well (although this theory is not well evidenced) it does seem that parental expectancy has a lot to do with it. Hoover and Milich (1994) found that, when they told mothers that there sons were being given sugar (when they were actually given a placebo, those mothers (who had already stated that their children were sugar sensitive) did rate their sons as being significantly more hyperactive. They reacted differently to them as well, maintaining a closeness that wasn’t the before, and being more critical of their offspring. This study replicated findings of a previous one carried out in 1987 with 2-6 year olds (Kruesi, 1987) which concluded that that neither sugar or aspartame were to blame for children’s disruptive behaviour.
A weighty issue?
Ok. So I am not making him crazy hyperactive. But am I risking turning him into an obese child?
Well, no. Apparently not. A well carried out study (Gibson & Neate, 2007) looked at the role of calorie laden soft drinks and sugar on obesity in children and adolescents. They found that these elements of their diets did not play a significant role in the weight of the children. In fact, it was overeating generally (and specifically high fat and high protein intake) and lack of activity that was to blame for the rise in obesity in children and adolescents. This study replicated similar results found in other studies into the role of sugars in obesity, such as Naismith et al. (1995) who also found that higher sugar intake was not related to other nutritional deficits.
So teeth, then?
Sugar makes your teeth rot and fall out. Or sends you to the dentist for horrible drilling and fillings. This is a fact I picked up in my childhood. So is X’s diet going to cost us a fortune in dentist bills (once the NHS stops kindly paying for it)?
The idea is that refined sugar is an ideal restaurant for bacteria in your mouth, so plaque accumulates and you get cavities. But is it as simple as that?
Woodward and Walker (1994) found that the relationship between sugar and dental caries (rotting teeth, to you and me) is not that simple. They analysed the information from 90 countries, and when they separated the data from 29 industrialised nations, they found no evidence of a sugar-caries relationship. They conclude that there is considerable evidence that there is not a strong relationship between the amount of sugar consumed and caries occurrence in Western countries. They believe that (in addition to sugar) other factors, such as other aspects of diet, exposure to fluoride and genetic effects, must be considered when little Johnny has yet another tooth needing to be filled.
A similar, but not quite so conclusive finding was the result of a meta-analysis carried out in 2001 (Burt & Pai). The authors analysed 134 studies and concluded that only two papers found a strong relationship between sugar consumption and caries development, sixteen found a moderate relationship, and eighteen found weak-to-no relationship. They concluded that the relationship between sugar consumption and caries is “much weaker in the modern age of fluoride exposure than it used to be” but still advocate that controlling the consumption of sugar remains a justifiable part of caries prevention, however, even if it is not the most important aspect.
That said, there is some evidence that you should have a sugar-free hour long zone before bed. Levine (2001) found that (in a study of 200 children aged 2 to 16) there was a strong relationship between dental caries and the consumption of both sugary food and drinks before bed. This study was a little skewed, however, with the children being predominantly from a lower socio-economic status, so other factors may have been involved, such as overall quality of nutrition.
Burn baby, burn
The glycemic index (GI) of foods is the measure of how quickly we burn the sugars in the food. The effect of a sugar-laden breakfast vs a low energy release one found that children with the breakfast sugar rush ate more for lunch than the slow release eaters (Warren et al. 2003).
And it’s not just the risk of overeating lunch that is the issue. A least two studies have found that kids that eat a low glycaemic index breakfast cereal were able to concentrate and remember better throughout the morning (Mahoney et al. 2005., Ingwersena, 2007). It seems that your oatmeal can be dusted in sugar, but as long as it has an overall low GI, your brain is more productive for longer. Good news for porridge, bad news for Cocoa Puffs.
Sweet news! Sugar with no constraints?
Well, personally, I am still reluctant to give X more sugar than he currently has. I tend to avoid buying snacks and cereals with a high sugar content (although I do bake with it – using unrefined sugars when we can (date syrup, maple syrup, agave etc – they have more nutrients than refined white caster sugar type stuff) and trying to ensure there is a low GI component in there) but does this research indicate that I am being over concerned?
I still think that filling up on sugary foods means that X is unlikely to eat a healthier option – a biscuit won’t give him the nutrients an apple will (unless it is one of my amazing healthy ones – I must create a recipe page on this website!) so obviously I would prefer him to eat the fruit than a chocolate bar. That said, the research mentioned above did find that higher sugar intake was not related to other nutritional deficits – which is in keeping with the theory that children will eat what they nutritionally need to grow (mentioned in my blog here http://www.babymanualnotincluded.com/blog/?p=180 ).
So, it seems from the research that maybe we should lighten up on the sugar issue, and focus more on getting our kids to run around and brush their teeth if we are worried about their health. By all means, steer them towards healthy nutrient-filled, or low GI, snacks. But let’s not sweat about the white stuff so much.
Benton, D., Brett, V., Brain, PF. 1982. Glucose improves attention and reaction to frustration in children. Biological Psychology. Volume 24, Issue 2, 95–100
Burt, B., & Pai, S., 2001. Sugar consumption and caries risk: a systematic review. Journal of Dental Education vol. 65 no. 10 1017-1023
Gibson, S. & Neate, D. 2007. Sugar intake, soft drink consumption and body weight among British children: Further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity. International Journal of Food Sciences and Nutrition. Vol. 58: 445-460
Ingwersena, J., Defeytera, MA., Kennedy, DO., Wesnesc, KA., Scholey, AB. 2007. A low glycaemic index breakfast cereal preferentially prevents children’s cognitive performance from declining throughout the morning. Appetite. Volume 49, Issue 1:240–244
Jacobson, MF. 1996. The effect of sugar on behaviour in children. JAMA. 275(10):756-757
Kruesi, M J., Rapoport, J L., Cummings, E. M., Berg, C J., et al. 1987. Effects of sugar and aspartame on aggression and activity in children. The American Journal of Psychiatry, Vol 144(11), 1487-1490.
Levine, RS., 2001. Caries experience and bedtime consumption of sugar-sweetened food and drinks–a survey of 600 children. Community Dent Health. Dec;18(4):228-31.
Mahoneya, CR., Taylora, HA., Kanareka, RB., Samuelb, P. 2005. Effect of breakfast composition on cognitive processes in elementary school children. Physiology & Behavior
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Naismith, D.J., Nelson, N., Burley, V., Gatenby, S. 1995 Does a high-sugar diet promote overweight in children and lead to nutrient deficiencies?Journal of Human Nutrition and Dietetics Volume 8, Issue 4, pages 249–254,
Warren, JD., Henry, CJK., Simonite, V. 2003. Low Glycemic Index Breakfasts and Reduced Food Intake in Preadolescent Children. PEDIATRICS Vol. 112 No. 5
Wolraich, ML; Wilson, DB; White, JW. 1995. The Effect of Sugar on Behavior or Cognition in Children: A Meta-analysis. JAMA. 274:1617-1621
Woodward, W. & Walker, A.R. 1994. Sugar consumption and dental caries: evidence from 90 countries. British Dental Journal 176, 297 – 302