Most of us know that sugar can wreak havoc on adult bodies, but few realize how uniquely harmful it is to the growing livers, hearts, and brains of children. And the damage can begin early in life. In his research on the effects of sugar on kids' present and future health, USC Professor of Pediatrics and Program Director for Diabetes and Obesity at Children's Hospital Los Angeles Michael Goran has found that too much sugar doesn't just cause childhood obesity, it can cause health issues in kids who are not overweight too, including fatty liver disease, prediabetes, and elevated risk for eventual heart disease. And, it is a likely culprit in the behavioral, emotional, and learning problems that many children struggle with every day.
In a groundbreaking study, Goran's team conducted a detailed analysis of the sugary products that kids love and found that these yogurts, cereals, sodas, and juices often had more sugar than advertised and also contained different types of sugar than were being disclosed. Today's children are not just consuming more sugar than ever, but they are consuming sugars that are particularly harmful to themand their parents don't even know it.
The news is dire, but there is also plenty of hope. We can prevent, address, and even in many cases reverse the effects of too much sugar. In this guide to "Sugarproof" kids, Dr. Goran and co-author Dr. Emily Ventura, an expert in nutrition education and recipe development, bust myths about the various types of sugars and sweeteners, help families identify sneaky sources of sugar in their diets, and suggest realistic, family-based solutions to reduce sugar consumption and therefore protect kids. Their unique "Sugarproof" approach teaches parents to raise informed and empowered kids who can set their own healthy limits without feeling restricted. With a 7- and 28-day challenge to help families right-size sugar in their diets, along with more than 35 recipes all without added sugars, everyone can give their children a healthy new start to life.
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|Publisher:||Penguin Publishing Group|
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About the Author
Read an Excerpt
Growing Up Sweet
Can Turn Sour:
All Our Kids Are at Risk
From the outside, Melissa looked healthy. She was a slender, athletic thirteen-year-old who loved playing basketball and soccer. Yet something was clearly wrong. Despite her long afternoons of sports practice, Melissa had trouble falling asleep. During the night, she woke up multiple times, and because of this, she'd become moody and dark circles emerged under her eyes. On top of everything else, Melissa felt constantly bloated and had frequent stomach cramps.
Under her normal-kid exterior, Melissa's body was silently developing the signs of chronic disease. And behind this disturbing transformation stood one clear factor: the sugar in her diet. Melissa's sugar habits over the course of the day had gradually worked up to a breaking point. She had juice most mornings at breakfast, a cereal bar on school days for a snack, tea sweetened with sugar most evenings, ice cream every other day for dessert at home, and the occasional candy bar from the convenience store down the street from her house when out with friends. Also, Melissa was chewing "sugar-free" Trident gum every day, which is sweetened with a variety of sugar alcohols and other sweeteners.
Melissa doesn't fit what we think of as the profile of a kid on the verge of serious health problems. Melissa wasn't overweight; she wasn't drinking soda; she was physically active; her parents tried to emphasize healthy eating habits. But sugar is now so pervasive, and food marketing so insidious, that during the course of her busy days, Melissa ended up consuming unsafe quantities of not just sugar but also other sweeteners without her parents' full awareness. Because Melissa's parents eventually realized how much sugar Melissa was consuming, they were able to help their daughter reshape her eating habits, and Melissa started to feel energetic and happy again.
Melissa could easily be any child growing up in the United States today. She could be a child in one of our families, or a child in yours. That's exactly the point. No matter whether they are slender or overweight, whether they are active or sedentary, whether they live in a food desert or in a farming community, whether they live in suburbs or cities, all our kids are at risk because they are living their lives immersed in sugar. They're at risk for the familiar downsides of sugar-the energy rushes and the crashes. But with our combined fifty years of experience, we know both from our research and from our professional interactions with families that children are at risk for other dangers, too. As a parent, you might attribute symptoms like mood swings, poor sleep, fatigue, difficulty concentrating, or other health issues to stress, hormones, a growth spurt, or an underlying disease. The reality is that all of these problems, whether they seem minor or major, can be connected to too much sugar. Sugar could be causing much more damage to your child's body than you imagined. Compelling new research has shown us that sugar is more dangerous than anyone ever knew, affecting nearly every part of a child's developing body.
The Perfect Sugar Storm
Marco is another kid who seemed pretty healthy from the outside. At age seventeen, he was a big guy. He was overweight, but he was also strong and athletic-looking. And in fact, Marco spent several hours each day playing ball after school and didn't have any other complaints about his health. But underneath his sporty exterior, our evaluation led to a disturbing diagnosis-Marco was very sick.
Because he was overweight, Marco's pediatrician referred him to one of our clinical research studies. Our initial dietary intake uncovered some alarming news. Marco and his family thought he was making reasonable food choices for an active teenager, but in fact he was drinking juice, soda, and a couple of sports drinks every day, which comes to a whopping 100 grams of sugar. That's around 25 teaspoons daily-more than three times the maximum amount we recommend for boys Marco's age. Without realizing it, Marco was delivering a very dangerous sugar load to his liver, more than his body could handle. Part of our study was focused on studying the effects of sugars and excess body weight on liver health in children, so Marco had an MRI of his liver. Marco, his family, and his pediatrician were all stunned to hear the results: Marco was suffering from an extreme case of fatty liver disease, with measurable signs of damage to his liver. If Marco didn't make changes soon, he could eventually find himself in need of a liver transplant.
Fatty liver disease used to be a problem reserved for adult alcoholics. These days, we're no longer surprised when we discover that kids in our clinic are in advanced stages of liver trouble. Not to mention kids with type 2 diabetes or other metabolic disorders. Why? All of us, adults included, are susceptible to the harmful effects from too much sugar. But research shows that children in particular are at increased risk. This risk is caused by three critical conditions: kids' inborn preference for sweet flavors; today's high-sugar food environment; and the unique vulnerability of kids' developing bodies to the effects of too much sugar. These three conditions have come together to create a perfect sugar storm for our kids.
Born This Way
How long has it been since you had a package of Pixy Stix? Pop Rocks? Grape Bubble Yum? If you loved these sweets as a kid and have tried them as an adult, you probably wondered how you could ever have enjoyed dumping so much sugar straight into your mouth. But you probably did love it when you were a kid. Here's why: Kids have a stronger built-in preference for sweet flavors compared to adults. They are more attracted to both real sugar and low-calorie sweeteners. Given the choice, kids will typically select the sweeter option, and then want more of it. Even amateur scientists have documented the phenomenon. My (Michael's) daughter's elementary school science class performed a simple experiment, asking both kids and teachers to taste five different lemonades of varied sweetness. The younger kids preferred the sweetest version and the teenage kids and adults preferred the less sweet versions.
As your kids have probably informed you, their taste buds really are different from yours. Their inborn love of sweet tastes makes evolutionary sense. It ensures that infants will like breast milk, which is sweet. As they start to wean, their preference for sweets helps them avoid bitter-tasting foods that could harm them. A child's love of sweets is not a moral flaw. Kids who clamor for Pixy Stix and Pop Rocks are just being kids. But as you're about to see, this natural attraction to sweetness makes kids highly vulnerable within our modern food environment.
Our Kids Live in a Sugar-Saturated Environment
Alyssa lives in the heart of South Los Angeles and within a food desert-a neighborhood with few options for healthy, fresh food. Alyssa could easily walk to convenience stores and fast-food restaurants from her home and school, but if her family wants to shop at a grocery store that offers produce, they would have to drive twenty minutes or take a long bus ride. Because Alyssa was concerned about her family's history of diabetes, she agreed to participate in our sixteen-week research study, which was designed to help teens eat less sugar. Alyssa shared with us a view of her neighborhood and the impact it had on her food choices: "Right across the street I have the doughnut shop, I have the gas station, the liquor store, and then one block over you have the Burger King, Subway, and an other gas station. Another block over you have your Taco Bell/Pizza Hut, and McDonald's. So say . . . I was hungry, and I had about $5 in my pocket, I could either go this way and indulge, and go that way and indulge. Or even go right across the street and get chips and a soda. So either way, it's bad."
Alyssa's situation is extreme, but it's not all that unusual-about 20 percent of all US households are in food deserts. And in some ways, all of us have experiences like hers, whether we live in a true food desert or not. Think about the last time you were in a restaurant, at an airport, on the road, or at a party. You probably had some options for healthy eating, but it's likely that those options were far outnumbered by the junk. Sweets especially tend to dominate: the sweet coffee drinks, sauces, dressings, pastries, and desserts. And as you'll see in a moment, even savory foods often contain sugar as well. What has brought us to this point? Why can't Alyssa escape sugar even when she tries? Why can't you and your kids?
We have some answers to these questions. Five environmental elements contribute to the sugar-loaded food environment in which we now live. Think of them as nutritional weather conditions that children and families have to navigate every day, each contributing to a downpour of sugar (Figure 1):
Figure 1: The Five Environmental Elements Contributing to the Perfect Sugar Storm
One evening when my (Michael's) daughter was nine, I picked her up from ballet, and she made a special request for turkey dogs for dinner. We stopped at the grocery store, and I ended up doing a bit of research looking for the best choice of hot dog buns. While I checked the nutrition labels, my daughter was rolling her eyes. As the child of a nutrition scientist, she had long ago become used to these types of thorough examinations. As I looked for a decent percentage of whole grains and limited preservatives, I couldn't help but notice that every package on the shelf featured some kind of added sugar. Most of the time, it was listed as the second or third ingredient. The buns that were lowest in sugar had a minimum of 3 or 4 grams of sugar (that's 1 teaspoon) in each bun, so I bought a package of those.
Of course, 1 teaspoon of sugar in a hot dog bun is not really such a big deal. But I was surprised that I couldn't find at least one option without added sugar. And the surprises didn't end there. When we sat down to dinner, none of us would have known the buns contained any sugar. They didn't taste sweet. In fact, they didn't taste very good at all. No one liked them, and we ended up eating the hot dogs without the buns. I couldn't help but wonder: What would the buns have tasted like without any sugar added? Of course, as a nutrition scientist, I know that food companies often add sweeteners to mask the taste of other chemicals and preservatives and to enhance palatability. The result can be more of a neutralizing effect than a sweet flavor.
You might fondly recall childhood cultural touchstones like a cone from the ice cream truck, a dripping Popsicle at the swimming pool, or a cookie after school. I grew up in Scotland in the 1960s and '70s, and I have happy memories of the "lemonade van," which came around on Saturday mornings to sell sodas. On occasion, my parents would buy a bottle for the family to share at dinner. For me, it's a happy memory built around ritual, family, and food. We enjoyed it and it is-to this day-a fond memory of childhood. When I recently asked my eighty-four-year-old mother about this, she indicated that there was never any concern about this affecting our health. Soda was a treat to be enjoyed together as a family.
Today, sugar is everywhere. It's no longer a treat or saved for a big or special occasion. It's our baseline, our environment, and has become an everyday staple. We've normalized the nearly constant consumption of sugar in childhood. It can seem that everywhere a kid turns, there stands a well-meaning adult offering something temptingly sweet: as an after-school snack, during sports practices, at playdates, or at a grandparent's house. Holidays, traditionally a time to enjoy sweets, have gone supersized. One parent lamented, "It's as if Halloween through Easter has become a six-month-long dessert buffet."
The historical view can provide perspective. During the American colonial period, the amount of sugar consumed by the average person in 1750 was just 4 pounds per year, which is just over 1 teaspoon per day. By 2000, sugar consumption peaked at 150 pounds per year-or a whopping 45 teaspoons per day for the average American. Imagine a 2-pound bag of sugar. In 1750, the average person was consuming two of those bags in a year. By 2000, this increased to one and half bags of sugar each week. The United States is now the world's largest per capita consumer of sugar. If you stacked all the sugar as cubes from one day of sugar consumption in the United States, it would tower halfway to the moon.
As my encounter with the hot-dog buns shows, it's not just that sugar is offered to kids more often (more about that soon) but that it's hiding. Even when you're looking for it, sugar can be hard to spot. Of course it's in cookies, cakes, and ice cream, but it's also in places parents think of as "safe": hot dog buns, bread, granola bars, yogurt, milk, salty snacks, sausages, frozen meals, pasta sauce, salad dressing, and more. Again, a staggering 70 percent of all packaged foods at the grocery store contain some kind of added sugar-for snack foods, the number rises to 80 percent. Sometimes it's easy to read an ingredient list and identify the sugar. When you get in the habit of reading labels, you'll notice how often sugar appears as a first, second, or third ingredient. But there are also whole categories of sugar that are disguised with healthy-sounding names, such as organic brown rice syrup or fruit juice concentrate. And that doesn't even take into account artificial sweeteners like the designer chemicals aspartame, sucralose, and AceK, or all-natural sweeteners like stevia and monk fruit. They may not have the calories, but they can still cause problems for your child's health. In the next chapter, we'll help you identify these hidden forms of sugar so that you can make informed choices for your family. For now, it's enough to recognize that your children are probably consuming vastly more sugar than you did as a kid.
Table of Contents
Part 1 This Is Your Child on Sugar
Chapter 1 Growing Up Sweet Can Turn Sour: All Our Kids Are at Risk 3
Chapter 2 Not All Sugars Are Created Equal: The Many Disguises of Sugar 27
Chapter 3 Hyperactive, Moody, Angry, Sleepy, and Stilt Hungry: Children on Sugar 71
Chapter 4 Smarter without Sugar: Sugar's Effects on Learning, Memory, and the Growing Brain 93
Chapter 5 From Teeth to Toes and Everything in Between: How Sugars and Sweeteners Can Damage the Vital Parts of Growing Bodies 109
Part 2 Sugarproof Your Child… and Your Family
Chapter 6 Sweet Talk: Motivate Your Family for Success 139
Chapter 7 Cutting Sugar: Seven Sugarproof Strategies That Work 167
Chapter 8 The 7-Day No-Added-Sugar Challenge: Sugarproof in One Week 199
Chapter 9 The 28-Day Challenge: A Gradual Plan for Rightsizing Sugar 229
Chapter 10 Keep This (Not-So-) Sweet Thing Going: How to Grow the Sugarproof Movement 257
Part 3 The Sugarproof Kitchen: Recipes and Tips 269