A new study suggests children in the US begin consuming added sugar at a very young age and that many toddlers' sugar intake exceeds the maximum amount recommended for adults.
The study found 99 percent of a representative sample of US toddlers age 19-23 months consumed an average of just over seven teaspoons of added sugar on a given day—more than the amount in a Snicker's® bar. Sixty percent of children were found to consume added sugar before age one.
Added sugar consumption has been linked with obesity, dental caries, asthma, and risk factors for heart disease, such as high cholesterol and high blood pressure. Eating foods with added sugar also can influence a child's food preferences, potentially leading to less healthy food choices later in life, researchers say.
"This is the first time we have looked at added sugar consumption among children less than two-years-old," said lead study author Kirsten Herrick, a nutritional epidemiologist at the Centers for Disease Control and Prevention (CDC). "Our results show that added sugar consumption begins early in life and exceeds current recommendations. These data may be relevant to the upcoming 2020-2025 Dietary Guidelines for Americans."
Herrick will present the research at the American Society for Nutrition annual meeting during Nutrition 2018, held June 9-12, 2018 in Boston.
There is no chemical difference between sugars that are found naturally in fruits, vegetables, and milk and sugars that are added to food products during processing or preparation. The body metabolizes natural and added sugars in the same way. However, added sugars are considered more damaging to health because they displace nutritional components of foods and contribute significantly to caloric intake. Foods containing added sugars are often not accompanied by the other nutritional benefits one derives from eating foods that naturally contain sugar, such as the fiber and vitamins contained in an apple.
"The easiest way to reduce added sugars in your own diet and your kids' diet is to choose foods that you know don't have them, like fresh fruits and vegetables," said Herrick.
Herrick analyzed data from more than 800 infants and toddlers between six- and 23-months-old who participated in the 2011-2014 National Health and Nutrition Examination Survey (NHANES), a research study that is representative of the American population.
Parents were asked to record every item their child consumed during a 24-hour period. To assess added sugar, researchers counted any calorie-containing sugars that were added to a food item, including cane sugar, high-fructose corn syrup, honey, and other forms of sugar. The study did not include artificial zero-calorie sweeteners or the sugars that occur naturally in fruits, vegetables, and milk.
The results indicate that 85 percent of infants and toddlers consumed added sugar on a given day. Added sugar consumption rose with age. At age six to 11 months, just over 60 percent of babies consumed added sugar on a given day, averaging just under one teaspoon. Among those age 12-18 months, 98 percent consumed added sugar, averaging 5.5 teaspoons. By 19-23 months, 99 percent of children consumed an average of just over seven teaspoons of added sugar on a given day.
The US government's 2015-2020 Dietary Guidelines for Americans (DGA) does not include guidelines specific for children under age two although the 2020-2025 edition, soon to be in development, will include dietary recommendations for infants and toddlers. The 2015 DGA Advisory Committee did propose that all Americans cut their intake of solid fats and added sugars as an effective strategy to pare calories and focus more on foods that contribute to a nutrient-rich diet.
Daily recommended limits for added sugar are six teaspoons or less per day for children age two to 19 and for adult women and nine teaspoons or less per day for adult men. Previous research suggests most Americans exceed those limits.
"Once kids start eating table food, they're often eating the same types of foods that mom and dad have in their diet, and other research has demonstrated that adults exceed recommendations for added sugar too," said Herrick.
The current study does not indicate which types of food contributed to children's added sugar intake, though the research team plans to examine sources of added sugar in the future. Other studies have identified ready-to-eat cereals, bakery items and other desserts, sugar-sweetened beverages, yogurt, and candy to be significant sources of added sugar in children's diets.
Among children aged 12-23 months, Herrick said added sugar consumption was highest among non-Hispanic black children and lowest among non-Hispanic white children. There were no differences in added sugar consumption by race among infants six to 11 months.
The team plans to further investigate the data, including examining trends over time. Other studies have suggested added sugar consumption among American children has declined over the years.