Q: I am trying to limit sugar in my son’s diet. Is it safe to use artificial sweeteners?
A: You are wise to pay attention to how much sugar your son ingests because excess sugar intake has been associated with a higher risk of obesity, cardiovascular disease, Type 2 diabetes, tooth decay and some cancers. It may also contribute to excess inflammation within the body.
So, is it safe to use artificial or nonnutritive sweeteners in kids’ diets? The health risk in children isn’t fully understood as there have been limited studies done in children and the American Academy of Pediatrics (AAP) has no official recommendation on their use.
My recommendation is to follow the adage of “everything in moderation” and keep his daily intake of added sugars to no more than 10% of his daily caloric intake.
A significant contributor to excess sugar intake has been the increased consumption of sugar sweetened beverages (SSB). Some examples of SSBs are sodas, juices (unless 100% juice, which contain only natural sugars found in fruit), energy drinks, sports drinks, lemonade, fruit punch, and sweetened tea and coffee, to name a few.
The problem with these drinks is the amount of sugar they contain, and that they are being consumed on a regular basis by both kids and adults.
The recommended daily amount of sugar intake is less than 10% of one’s total daily calories. Four grams of sugar is equivalent to 1 teaspoon of granulated sugar, and contains about 15 calories.
One 12-ounce can of cola generally contains about 40 grams of sugar and 155 calories. So, for a moderately active 10-year-old boy, whose recommended daily caloric intake is around 1,800, this equates to 8.6% of his total. If he drinks a 12 ounce Starbucks Vanilla Frappuccino, which has 43 grams of sugar and 280 calories, this would be over 15% of his recommended daily caloric intake just from sugar.
A few other examples of 12-ounce drinks and their approximate sugar and calorie counts are: fruit juice drink (40 grams of sugar/186 calories); lemonade (12 grams of sugar/55 calories); and orange soda (52 grams of sugar/195 calories). And finally, 12 ounces of a sports drink contain 20 grams of sugar and 97 calories, in contrast to 16 ounces of water containing zero grams of sugar and zero calories.
Sugar seems to be in everything if you carefully read the Nutrition Facts Label and ingredient list (and you should!).
Look for the category of added sugar to determine how many grams of sugar have been added to the product and remember that the goal is less than 10% of one’s daily caloric intake.
To make things difficult, sugars added to foods and drinks can have many different names. Most of us are familiar with fructose, sucrose, corn syrup, and cane sugar. Many of us may not be as familiar with the following names for added sugars: maltose, anhydrous dextrose, nectar, malt syrup, lactose, maltodextrin and fruit juice concentrate.
Try to avoid sugar alcohols and “natural sweeteners.” If you want to avoid artificial or nonnutritive sweeteners, these are some ingredients of which to be aware: acesulfame potassium, advantame, aspartame, erythritol, mannitol, neotame, saccharin, sorbitol, steviosides, sucralose, and xylitol.
The best way to limit sugar intake is to encourage kids to primarily drink water and milk for the first 5 years, reserving SSBs for special occasions or as a treat.
The AAP now recommends not giving juice to kids younger than 12 months of age, limiting intake to 4 ounces for 1 to 3-year-olds, and 4 to 6 ounces for 4 to 6-year-olds.
In fact, I only recommend juice to young children to treat constipation. Serve whole fruit in place of a typical dessert to not only decrease sugar intake but to also help attain the recommended goal of consuming 5 servings of fruits and vegetables daily.
Additionally, most of us do not drink enough water. A general rule of thumb is about 8 ounces per year of age up to a maximum of 64 ounces daily, although active teens may require more. If your child does not love drinking plain water you might try to flavor it with cut up fruit, serving it with ice, or trying a fun water bottle or cup with a straw.
While we cannot conclusively state that sugar alternatives are safe, we can say, “Don’t drink your calories and do drink plenty of water.”
Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to [email protected].