Sugar and Added Sugar

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

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?

Nope.

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…

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. 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

What’s Wrong with Homemade Baby Formula?

Stick to breastmilk or an iron fortified baby formula until your baby is at least twelve months old. There are no benefits to feeding your baby a homemade baby formula and there are certainly some risks. Those risks go up even more if you use raw goat milk or leave out key nutrients.

Once upon a time, before we had commercial baby formula, didn’t everyone make their own homemade baby formula if they couldn’t breastfeed or were separated from their baby?

Not necessarily.

Some parents hired a wet nurse and others simply fed their baby wheat containing porridge or milk from camels, cows, goats, or even pigs. Of course, wet nursing was the safest option by far.

History of Homemade Baby Formula

There were recipes for ‘baby formula’ though, which often “consisted of a liquid ingredient (milk, beer, wine, vegetable or meat stock, water), a cereal (rice, wheat or corn flour, bread) and additives (sugar, honey, herbs or spices, eggs, meat).” These recipes were missing foods with vitamin C and were later missing vitamin D, iron, and protein, as they were mixed with more water and less meat and eggs.

Before commercial baby formula was widely available, public health nurses had to sometimes teach new moms how to make their own baby formula.

Fortunately, there were several major breakthroughs in the mid-nineteenth century that offered hope to babies who couldn’t breastfeed, including the invention of the rubber nipple and other feeding devices, improved methods of hygiene and later pasteurization, and the first commercial baby formula.

Many of the first baby formulas basically looked like homemade recipes, such as the Leibig formula – a powder made up of wheat flour, malt, and potassium bicarbonate that was added to diluted cow’s milk. Later, there were recipes to make baby formula from condensed and then evaporated milk (mixed with corn syrup).

And eventually, in the 1950s, we got the commercial baby formulas that we still use today.

What’s in Baby Formula

Like breastmilk, baby formula has three main components that provide the calories:

  • a sugar
  • fats
  • proteins

Different combinations of these proteins (cow’s milk vs soy), sugar (lactose vs corn syrup), and fats (vegetable oils), etc., help produce cow’s milk based, soy based, and elemental baby formulas.

And then, to make it more like breastmilk, lots of other stuff can be added to baby formula, including DHA, probiotics, and nucleotides, etc.

Enspire, the newest formula from Mead Johnson, also adds lactoferrin, Milk Fat Globule Membrane (MFGM), and prebiotics, to try and make it their “closest formula ever to breast milk.”

What’s Not in Baby Formula

Are you still confused about what’s in your baby’s formula?

While it might make you feel better to feed your baby goat milk, it won’t make your baby feel any better, and could make them sick… (CC BY-ND 2.0)

It’s possible that you are just confused about what you think is in your baby’s formula?

Kristin Cavallari has written that she made her own homemade baby formula because “I would rather feed my baby these real, organic ingredients than a heavily processed store-bought formula that contains ‘glucose syrup solids,’ which is another name for corn syrup solids, maltodextrin, carrageenan, and palm oil.”

So what are glucose syrup solids and why are they in your baby’s formula?

While cow’s milk based baby formulas use lactose (glucose plus galactose) as their source of sugar, non-milk based formulas usually use use sucrose (cane sugar) and corn syrup solids (glucose).

Should you worry about cane sugar in some organic formulas?

What about the corn syrup in formula? Isn’t that bad for them?

No. These are just different types of sugar. Even maltodextrin is simply glucose polymers made from corn starch that is used as a thickening agent in baby formula and other foods.

And no, corn syrup solids don’t have anything to do with high fructose corn syrup.

Goat Milk Formula

In addition to warning about making homemade formula, pediatricians have long warned about feeding baby’s goat milk and goat milk based baby formula.

Goat milk is very high in sodium and protein, giving almost three times the amounts present in breast milk. And cross-reactivity that occurs between proteins means that babies who are sensitive or allergic to cow’s milk will likely have problems with goat milk too.

“It is recommended that formula-fed infants who are allergic to milk use an extensively hydrolyzed, casein-based formula. This type of formula contains protein that has been extensively broken down so it is different than milk protein and not as likely to cause an allergic reaction.”

FARE on Formula for Infants with a Milk Allergy

Of course, that doesn’t keep folks from pushing “false and potentially dangerous information” about what some think are benefits of goat milk for infants.

What’s Wrong with Homemade Baby Formula?

In her latest book, Kristin Cavallari, known for dangerous stance against vaccines, even offers a recipe for a goat’s milk baby formula that is made with:

  • filtered water
  • goat milk powder
  • pure organic maple syrup – provides calories from sugar
  • extra virgin olive oil – provides calories and monounsaturated fats
  • unflavored cod-liver oil – for extra vitamin D and vitamin A
  • unsulfured blackstrap molasses – for extra iron and calcium
  • coconut oil – for omega-6-fatty acids
  • probiotics

In this homemade formula, much of the sugar, protein, and fat and half of the calories comes from goat milk.

The majority of the sugar comes from the maple syrup though, which is just sucrose. Just like the sucrose from cane sugar that folks complain about in some organic formulas.

Extra fat comes from the olive oil.

What about the other ingredients?

They provide extra vitamins and minerals, including vitamin D, vitamin A, and iron.

What’s missing?

This homemade formula seems to be missing folate. Goat milk is deficient in folate and can lead to megaloblastic anemia and it is one of the main reasons babies should avoid unfortified goat milk.

And it is missing enough vitamin D to avoid vitamin D deficiency.

Cavallari’s recipe seems to add just 100IU of vitamin D to the whole 32 ounce batch (from the cod liver oil). That’s just 10IU per 100ml, about 6 times less than baby formula. Keep in mind that it is recommended that infants get at least 400IU of vitamin D each day.

Remember that formula is fortified with vitamin D and breastfeeding babies are supposed to take a vitamin D supplement. Depending on your water filter, this homemade baby formula recipe might also be missing fluoride, which infants start to need beginning at around six months.

Can You Find a Safe Homemade Baby Formula Recipe?

You probably can, especially if you use a full fat milk powder that has been pasteurized and fortified with vitamin D and folic acid and the right combination of other ingredients to get enough calories, protein, fat, sugar, and all of the essential vitamins and minerals that your baby needs to gain weight and development normally.

“FDA regulates commercially available infant formulas, which are marketed in liquid and powder forms, but does not regulate recipes for homemade formulas. Great care must be given to the decision to make infant formulas at home, and safety should be of prime concern. The potential problems associated with errors in selecting and combining the ingredients for the formula are very serious and range from severe nutritional imbalances to unsafe products that can harm infants. Because of these potentially very serious health concerns, FDA does not recommend that consumers make infant formulas at home.”

FDA Questions & Answers for Consumers Concerning Infant Formula

You will almost certainly have to give your baby a multi-vitamin each day too.

Also, you will have to make sure you are mixing all of the ingredients of your recipe correctly and safely, so that you don’t contaminate any of the batches.

But it still won’t be any better for your baby than store bought formula.

So just like skipping your RhoGAM shot, skipping your baby’s vitamin K shot and delaying or skipping vaccines, you will have some very big risks and absolutely no health benefits.

What to Know About Homemade Baby Formula

Stick to breastmilk or an iron fortified baby formula until your baby is at least twelve months old. There are no benefits to feeding your baby a homemade baby formula and there are certainly some risks. Those risks go up even more if you use raw goat milk or leave out key nutrients.

More About Homemade Baby Formula

Low Fat Foods for Kids

While it is important to learn to identify low-fat foods and high-fat foods so you know what your kids are eating, your overall focus should be on helping your family eat healthy foods every day.

Although most kids get too much fat in their diets, there is one age group of kids for which you shouldn’t limit fat intake — infants and toddlers under age two years.

These children are still growing and need more fat in their diet than older kids. That doesn’t mean that you have to go out of your way to give your 18 month old French fries or have to avoid naturally low-fat foods, including most fruits and vegetables, but they shouldn’t drink low-fat milk, eat commercially made fat-free foods, or be put on a low-fat diet.

The only exception is toddlers who are already overweight or at risk of becoming overweight, who can switch to low fat milk before age two years.

Finding Low Fat Foods

As you learn to avoid high-fat foods for your children, it is just as important to learn to choose low-fat foods as part of your family’s healthy diet.

It is often easy to choose low-fat foods, as many clues are on the food label when a food is low, including nutrition claims that the food is:

  • fat free (less than 0.5g of fat per serving)
  • low fat (less than 3g of fat per serving)
  • extra lean (less than 5g of fat per serving and 2g of saturated fat)
  • lean (less than 10g of fat per serving and 4.5g of saturated fat)

Nutrition claims that are less helpful when choosing low-fat foods include the terms reduced, less, and light, since they only mean that the food has fewer calories or grams of fat than the regular version of the food.

For example, consider these chips:

  • DORITOS Nacho Cheese Flavored Tortilla Chips = 8g of fat and 140 calories per serving
  • DORITOS Reduced Fat Nacho Cheese Flavored Tortilla Chips = 5g of fat and 120 calories per
  • DORITOS Light Nacho Cheese Flavored Tortilla Chips = 2g of fat and 100 calories per serving

If you thought that the reduced fat chips were low fat, you would have been mistaken. They are not a bad choice, since they are not high in fat. You can find “potato chips” with even less fat though, including BAKED! LAY’S Original Potato Crisps, with only 1.5g of fat, and TOSTITOS Light Restaurant Style Tortilla Chips, which has only 1g of fat per serving.

Low-Fat Foods

Unfortunately, just because something is low in fat doesn’t meant that it is low in calories. So while you want to avoid high-fat foods, you also want to avoid foods that are high in sugar and calories. For example, most of the foods that rank at the top of the list for being low in fat in the United States Department of Agriculture National Nutrient Database for Standard Reference include candy, soda, and fruit drinks.

“Fat Matters, But Calories Count”

U.S. Department of Health & Human Services

Healthy low-fat foods can include:

  • Lettuce
  • Carrots
  • Tomatoes
  • Strawberries
  • Spinach
  • Egg whites
  • Baked potatoes
  • Grapes
  • Oatmeal cookies
  • Breakfast cereals (most brands, although some are high in sugar)
  • Watermelon
  • Air-popped popcorn (without added butter)*
  • Light tuna fish (canned in water)
  • Green peas
  • Wheat bread
  • Pancakes
  • Beans
  • Rice
  • Pretzels
  • Vegetable soup
  • Chicken soup with rice
  • Milk – 1% reduced fat and skim milk

In addition to the fruits and vegetables listed above, keep in mind that most raw fruits and vegetables, except for avocados and olives, are naturally low in fat.

What’s missing from the list of low-fat foods? Hot dogs, cheese burgers, French fries, milk shakes, chicken nuggets, tacos, and many other high-fat kids’ favorites.

Hidden Fats in Foods

Many low-fat foods become high-fat foods when parents unknowingly add high-fat or hidden fat ingredients to them, including:

  • oils, which are 100% fat and should only be used in limited amounts, with an emphasis on monounsaturated and polyunsaturated oils
  • butter and margarine
  • non low-fat cheese
  • mayonnaise (1 tablespoon = 10g of fat and 90 calories)
  • ranch dressing (2 tablespoons = 15g of fat and 140 calories)

Other foods made with hydrogenated vegetable oils, palm kernel oil, or coconut oil, are likely also high in fat.

What To Know About Low Fat Foods for Kids

While it is important to learn to identify low-fat foods and high-fat foods so you know what your kids are eating, your overall focus should be on helping your family eat healthy foods every day.

For More Information On Low-Fat Foods for Kids

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.

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.

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

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