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Week of 29 January 1999

Vol. II, No. 21

Health Matters

Sweet stuff: sugar and children

With Valentine's Day rapidly approaching, I am wondering about the claims that sugar and children don't mix well. Is there any truth to the old adage that sugar leads to hyperactive children?

Ah, sugar. There are a lot of myths about this sweet substance. Most of what the public believes about sugar, however, is not true. Sugar does not cause hyperactivity. It is not addictive. It is not the only cause of cavities. It does not make people fat. And it does not cause diabetes.

While it is a hotly debated topic among pediatricians, educators, and parents, there is no scientific evidence that sugar has any impact on children. In fact, says Alan Meyers, M.D., a pediatrician at Boston Medical Center and an associate professor of pediatrics at Boston University School of Medicine, sugar intake that exceeds recommended daily dietary levels has no effect on a child's behavior or cognition. Some children may have an idiosyncratic reaction to sugar, but this is not the norm. "It's safe to say, based on scientific studies over the past 10 years, that there is no convincing evidence that sugar intake has a negative effect on children's behavior," he says.

In a 1994 Vanderbilt University study, researchers cleared the refrigerators and kitchen cabinets in the homes of nearly 50 children. The families then received foods sweetened with sugar, saccharin, or aspartame (NutraSweet), without being told which sweetener they were eating. Every three weeks, their diet was switched. The children were given a battery of tests, measuring everything from attention span to hyperactivity to memory. The study's conclusion: none of the sweeteners had any impact on behavior.

Supporting this conclusion, the 1998 edition of the American Academy of Pediatrics' Pediatric Nutrition Handbook says that there is no evidence that sugar causes increased hyperactivity or decreased cognitive ability in children. "Parents have been primed by the media hype of the 'Halloween effect,'" says Meyers. "That is, the more sugar children eat, the worse their behavior gets. For most children other factors play a role in their behavioral problems."

Among these, Meyers says, may be a preexisting condition that is aggravated by sugar intake. A child's misbehavior may also be environmental in nature. It is generally during holidays or special occasions that larger-than-usual amounts of sugar are available to children. These are times when children are already overstimulated and may act out -- giving sugar a bad rap. "There are reasons to limit a child's sugar intake," says Meyers, "but adverse behavior is not one of them." Among the reasons to limit intake are the risk of dental caries (cavities), and the empty calories and poor nutritional value of sugar-filled foods.

Another widely held misconception about sugar is that it is addictive. The Nutrition Committee of the American Academy of Pediatrics says the notion that some children (and adults) get hooked on sugar is a false one. People who are addicted to a substance, such as alcohol or drugs, show signs of withdrawal, including the shakes, excessive sweating, and nausea, when they don't get enough of it. No one suffers from these physical symptoms if they don't get a sugar fix.

Another myth is that sugar causes people to be overweight. In fact, no studies have shown that overweight people eat more sugar than other people; some studies even suggest they eat less of it. The misconception may stem from the fact that sugary foods are full of fat -- a concentrated source of calories, which adds weight. People who think that eating a lot of sugar leads to diabetes are also wrong. Diabetes is a chronic condition in which the pancreas can no longer produce insulin, a hormone that breaks down sugars for energy. "A lot has been said and written about sugar and how it affects kids," says Meyers. "Rather than blaming sugar, parents should examine the other factors that may truly be the cause of their children's problems."

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on the impact of sugar on children or other health issues, call 638-6767.