Tag: overweight

Sugar and Added Sugar

What do you think about when you think of sugar?

Candy and junk food?

It is important to remember that sugar is also naturally present in milk, including breastmilk and baby formula, and in fruits, and vegetables, etc.

That means that not all sugar is bad sugar.

Types of Sugar

Most of us have learned to limit or avoid certain types of sugar, like high fructose corn syrup, but you don’t have to avoid all sugar. In fact, if you eat fruits and vegetables, it would be awfully hard to avoid sugar.

You probably thought that sugar was sugar, right?


There are many different types of sugar, with the most common types including:

  • glucose – found in many fruits and in corn syrup
  • fructose – fruit sugar
  • sucrose – sugar cane, sugar beets (a combination of glucose + fructose)
  • maltose – barley or malt sugar (a combination of two glucose molecules)
  • lactose – milk sugar (a combination of galactose + glucose)

Honey, a sweetener like sugar, is also made up of glucose and fructose, but they are not combined together. In general, honey contains much more fructose than glucose, which is why it is so sweet.

What about table sugar? That’s sucrose.

Still, like most other types of sugar, table sugar is broken down by enzymes in our body to glucose, with each gram of glucose providing four calories of energy. If you don’t need that energy at the time, that glucose gets converted into fat and is stored away.

Good Sugar vs Bad Sugar

While it’s become popular to worry about how bad sugar is for us, that’s not really what you should focus on. Instead,  learn more about the the differences between naturally occurring sugar and added sugars.

A large strawberry contains about 1 gram of natural sugar. They are low in sugar, unless you dip them in sugar before giving them to your kids.
A large strawberry contains about 1 gram of natural sugar. They are low in sugar, unless you dip them in sugar before giving them to your kids. Photo by Ken Hammond

If there is a bad sugar, it is the added sugars in foods that help us get too much sugar in our diets.

Also, when you eat or drink something with naturally occurring sugar, even though you are getting some sugar, you are also getting many other vitamins and minerals in your diet. For example, when you drink milk or eat an orange,  you get other nutritional benefits, unlike drinking a soda or eating a piece of candy.

So while you do get sugar from all of them, that’s all you get from the soda and candy.

That’s why it is often said that junk food is filled with empty calories.

Has someone got you shocked about the sugar content of your child’s lunch consisting of a PB&J sandwich, applesauce, and fruit punch? Then swap the applesauce for an apple and the fruit punch for low-fat milk or water.

Identifying Added Sugars

A new food label with added sugars is coming - by January 2020...
A new food label with added sugars is coming – by January 2020…

How do you know if the foods you are eating are high in sugar?

Just check the Nutrition Facts label and look at the amount of Sugars listed under Total Carbohydrates.

That can be misleading though, as it doesn’t differentiate between natural sugars and added sugars. At least not yet.

For that, we have to check the ingredients list and look for clues that the food item contains added sugars, including that it contains things like:

Hidden Sugar on Ingredients List
agave nectar invert sugar
anhydrous dextrose lactose
beet sugar malt syrup
brown sugar maltose
confectioner’s powdered sugar maple syrup
corn syrup molasses
corn syrup solids nectars (e.g., peach nectar, pear nectar)
dextrose pancake syrup
fructose raw sugar
fruit juice concentrate sucrose
high-fructose corn syrup (HFCS) sugar
honey white granulated sugar

New rules from the FDA will hopefully soon make it easier to recognize added sugars on food labels, as they add information about the amounts of added sugars in foods.

Limiting Sugar in Your Diet

Although some people are concerned that sugar is an actual poison – it isn’t – the most common reason to avoid added sugar is to simply avoid extra calories.

Sugar itself doesn’t cause diabetes or ADHD or any number of other things it gets blamed for, except maybe getting cavities.

If you get too much sugar in your diet and you become overweight, then you could develop type II diabetes. Getting too much fat in your diet is also an easy way to become overweight though, especially if you don’t exercise everyday.

How much sugar is too much?

“Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates”

WHO on Sugars intake for adults and children

In general, you don’t usually want to get more than 10% of your daily calories from free sugars. Unfortunately, most people get too many calories in their diet, and too many of those calories are from free sugars.

Other recommendations are a little more restrictive.

“The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children <2 years of age.”

AHA on Added Sugars and Cardiovascular Disease Risk in Children

But remember, this is the sugar that you get from candy, cakes, fruit drinks, donuts, and soft drinks, etc.

A teaspoonful of sugar is equal to 4g of sugar or 16 calories.
A teaspoonful of sugar is equal to 4g of sugar or 16 calories. Photo by Samantha Celera (CC BY-ND 2.0)

In general, it is not the sugar that they get from whole fruits, plain yogurt, or milk.

For example, don’t be mislead by scary claims, like yogurt might have more sugar than a Twinkie. Unless it is a kid’s brand, with a lot of added flavorings, the sugar in yogurt is mostly from naturally occurring milk sugar and sugar from added whole fruit, while a Twinkie is almost all added sugars.

Once you start being more mindful of how much sugar your kids are getting and you limit sugary drinks and candy every day, it becomes easy to get under about 25g of added sugar each day.

Avoiding Added Sugars

To help your kids avoid added sugar, it can help to:

  • drink water
  • limit or avoid soda, fruit drinks, and other sugar-sweetened drinks, including sports drinks
  • drink low-fat white milk without extra flavorings
  • avoid sugary cereals
  • choose canned fruits with water over syrup when not eating fresh whole fruit
  • limit candy, cakes, cookies, ice cream, and other junk foods
  • choose plain yogurt without added sugars instead of a flavored yogurt and then add fresh fruit to it

Even 100% fruit juice should be limited, and avoided all together if your infant is under 12 months old.

And don’t make the mistake of limiting added sugar, but then turning to high fat foods!

Healthier alternatives can include more nutrient dense foods, including beans and peas, eggs, fat-free and low-fat milk and cheese, fruits, lean meats and poultry, seafood, unsalted nuts and seeds, vegetables, and whole grain foods.

Most importantly, learn to read food labels to look for added sugar in the foods your kids eat and then avoid those food and watch their portion sizes. When you do allow your kids to have a treat, don’t go overboard with a 24 ounce soda or letting them eat a pint of ice cream.

Learn to eat healthy.

Remember that it’s not all about sugar, fat, carbs, or any other one thing. A registered dietician can be helpful if you need more help planning what your family eats.

What to Know About Sugar and Added Sugar

Learn to avoid added sugar in your child’s diet as part of an overall healthy eating plan.

More About Sugar and Added Sugar

Treating Hard to Control Obesity

Children aren’t just little adults, even big or overweight children.

So, it shouldn’t be surprising that obesity treatments might be different for children.

Childhood Obesity Treatments

The Let's Go! 5-2-1-0 message can help keep your kids at a healthy weight.
The Let’s Go! 5-2-1-0 message can help keep your kids at a healthy weight.

Most people know, even if they can’t get motivated to follow, basic treatments for obesity. They include eating and drinking fewer calories and being more active.

How are these treatments different for kids?

Kids are still growing, so calories shouldn’t usually be overly restricted. So we more often talk about healthy diets instead of dieting.

Remember that the goal for overweight and obese children and teens is to reduce the rate of weight gain while allowing normal growth and development.

CDC Tips for Parents – Ideas to Help Children Maintain a Healthy Weight

Treating Hard to Control Obesity

What do you do if your child continues to gain too much weight or just can’t seem to lose any weight despite trying?

Ask yourself these questions and bring the answers to your pediatrician:

  • Are other family members overweight?
  • Is your child physically active for at least one hour a day?
  • Does your child drink non-diet soda, fruit juice, or sweet tea each day?
  • How much milk and water does your child drink each day?
  • Do you eat out with your child one or more times each week?
  • Does your child get more than one to two hours of screen time each day?
  • Does your child have a TV and/or computer in their room?
  • Does your child frequently eat meals and snacks while watching TV?
  • How many fruits and vegetables does your child eat each day?
  • Do your child’s portion sizes at meal times resemble an adult portion size?
  • Does your child frequently get seconds at meal times?
  • What does your child eat at snack times?
  • How many snacks does your child eat each day?
  • How often does your family eat dinner together?
  • Are you waiting for your child to “grow into” his weight?
  • If physically active, what activities does your child do?
  • Do you know about how many calories your child should be getting each day?
  • Are you expecting a quick fix and for your child to lose weight quickly?

And perhaps most importantly, do you know why your child is overweight? If you don’t, or if you don’t really believe that he or she is overweight, then you will have a hard time helping get to a healthier weight.

A registered dietician can help teach you and your child more about healthy eating.

What To Know About Treating Hard to Control Obesity

Getting to a healthy weight is rarely easy, but there is help for kids who are overweight and with hard to control obesity.

For More Information About Treating Hard to Control Obesity

The Best Milk for Kids – Does It Still Come from a Cow?

The new joke seems to be that you can turn anything into milk.
The new joke seems to be that you can turn anything into “milk,” even peas.

You wouldn’t think that the idea that kids should drink milk would be controversial…

Of course, it is.

The controversy is more over the type of milk now and not so much over the amounts though. Few people disagree with the American Academy of Pediatrics 2014 clinical report on Optimizing Bone Health in Children and Adolescents, in which they recommended that “Children 4 through 8 years of age require 2 to 3 servings of  dairy products or equivalent per day. Adolescents require 4 servings per day.”

Which Kind of Milk You Got?

While you used to have to go to Whole Foods to get soy milk, nearly every grocery store now has every type of “milk” you can think of, and some you haven’t.

So in addition to raw and pasteurized cow’s milk, it is possible to buy:

  • almond milk
  • cashew milk
  • coconut milk
  • flax milk (flax seeds)
  • goat milk
  • hazelnut milk
  • hemp milk
  • lactose free milk (cow’s milk without lactose)
  • oat milk
  • potato milk (as powdered milk)
  • quinoa milk
  • rice milk
  • ripple milk (peas)
  • 7 grain milk (Oats, Brown Rice, Wheat, Barley, Triticale, Spelt and Millet)
  • soy milk
  • sprouted rice milk

Complicating matters even more, once you decide on the type of milk to give your kids, you will have a lot of other options to choose from – organic, hormone free, sweetened vs unsweeted, enriched vs original, and a long list of flavors, etc.

The question is no longer simply Got Milk?

Best Milk for Kids

So which milk is best for your kids?

While each type of milk has its fans, in general, unless your child has food allergies or intolerances, the best milk is going to be the one you can afford, with the nutrients your child needs, and which he is going to drink.

What about the idea or argument that cow’s milk is made for baby cows?

Following that logic, if you weren’t going to give your kids cow’s milk, then you probably wouldn’t give them most plant based milks, as they are commonly made from seeds. Almonds, peas, and soybeans, etc., aren’t “made” to make milk. They are produced to make more plants. But just like we pasteurize and fortify cow’s milk so that we can consume it, we have learned to use these other foods.

Best Milk for Kids with Food Allergies

While the wide availability of so many different types of milk is confusing for many parents, it has been great for pediatricians and parents of kids with food allergies and intolerances. Having more of a variety has also been helpful for vegan families.

In general, you should breastfeed or give your infant an iron fortified formula until they are at least 12 months old, avoiding milk or other allergy foods as indicated if you are breastfeeding and your child develops an allergy, or switching to a hypoallergenic or elemental formula if your child develops a formula allergy.

And then, after your toddler is old enough to wean from breastmilk or formula, you:

  • should avoid cow’s milk, lactose-free cow’s milk, and goat milk if your child has a milk protein allergy
  • should avoid almond, cashew, coconut, and hazelnut milk if your child has a nut allergy (yes, even though almonds and coconuts are really stone fruits and not true nuts, they have been rarely known to cross react and trigger allergic reactions)
  • should avoid soy milk if your child has a soy allergy
  • should make sure your child’s milk is fortified with calcium and vitamin D

Most importantly, talk to your pediatrician and/or a pediatric allergist before switching to a plant based milk if your child has food allergies and before trying to switch back to cow’s milk after you think they have outgrown their allergy.

Other Things to Know About Kids Drinking Milk

Kids don’t necessarily need to drink any kind of milk. They do need the nutrients that you commonly get from milk, including fat, protein, calcium, and vitamin D, etc. You should also know that:

  • the American Academy of Pediatrics recommends that most toddlers drink whole milk until they are two years old, when they should switch to reduced fat milk.
  • switching to reduced fat milk can be appropriate for some toddlers who are already overweight or if their pediatrician is concerned about their becoming overweight or about their cholesterol, etc.
  • most cow’s milk that you buy in your grocery store doesn’t have any added growth hormone (labeled rBST-free), even if it isn’t organic
  • the AAP, in a report on Organic Foods: Health and Environmental Advantages and Disadvantages, states that “there is no evidence of clinically relevant differences in organic and conventional milk”
  • if a company makes more than one type of non-dairy milk, such as rice, almond, and soy, then cross-contamination could be a problem for your child with food allergies
  • most kids with a lactose intolerance can tolerate some lactose in their diet, so may be able to drink some cow’s milk and eat cheese, yogurt, and ice cream, even if they can’t tolerate a lot of regular cow’s milk
  • while plant based milks are lactose free and some are unsweetened, others might have added sugar, including cane sugar or cane syrup
  • unlike cow’s milk, most plant based milks are very low in protein
  • although they aren’t labeled as 1% or 2%, plant based milks typically have less fat than whole milk
  • phytoestrogens in soy milk are a concern for some people
  • most milk, even oat milk, is gluten-free, with the exception of 7 grain milk, which obviously contains wheat
  • UHT milk undergoes ultra-high temperature processing or ultra-pasteurization to allow it have a longer shelf life, even if not refrigerated, at least until the carton is opened
  • although some experts warn about cross reactivity, like between peanuts and green peas, the Food Allergy Research & Education website states that “If you are allergic to peanuts, you do not have a greater chance of being allergic to another legume (including soy) than you would to any other food.”
  • raw cow’s milk, in addition to being a risk for bacterial contamination and outbreaks of Escherichia coli, Campylobacter, and Salmonella, is very low in vitamin D and has no proven health benefits over pasteurized milk
  • reduced-calorie and no added sugar flavored cow’s milk often use artificial sweeteners
  • some brands of almond milk contain only about 2% of almonds, which leads some critics to say that you should just eat a few almonds to get even more nutritional benefits

But don’t forget about cost. Plant based milk can be at least two to four times more expensive than cow’s milk.

So again, remember that while each type of milk has its fans, in general, unless your child has food allergies or intolerances, the best milk is going to be the one you can afford, with the nutrients your child needs, and which he is going to drink, whether it comes from a cow, soybean, almond, or hazelnut, etc.

For More Information On The Best Milk For Kids: