Sugar refers to both naturally occurring sugar and free sugar where naturally occurring sugar is found in fruits, vegetables, some grains as well as lactose in milk and dairy products while free sugar is defined as all monosaccharides and disaccharides which have been added to foods and beverages by manufacturer, cook or consumer plus sugar naturally present in honey, syrups, fruit juices and fruit juices concentrates.

What is the impact of over consumption of sugar on health?

In an interview with HT Lifestyle, Dr Abhishek Chopra, Consultant Neonatologist and Paediatrician at Cloudnine Group of Hospitals in New Delhi's Punjabi Bagh, answered, “Overconsumption of free sugar, specially in liquid form is linked to range of health conditions, both immediately and in later life. Higher consumption of sugar is linked with significantly higher risk of obesity, cardiovascular diseases and type 2 Diabetes Mellitus. Malabsorption of sugar from fruit juice specially when consumed in excess can result in chronic diarrhoea, flatulence, bloating and growth faltering. There is increased risk of tooth decay due to free sugar and acidity. Sugar Sweetened Beverages (SSB) and fruit juices given to infants may displace human milk and decrease dietary quality as SSB intake is associated with inadequate calcium, iron and Vitamin A intake in children.”

What are the recommendations on sugar intake and drinks?

Dr Abhishek Chopra shared, “Existing recommendations for sugar focuses on free or added sugars rather than on total sugars as it is the free and added sugar which is linked to weight gain, obesity, dental caries and other adverse health effects. European Nutrition committee recommends that intake of free sugar should be less than 5% of energy intake for children and adolescents ( aged 2- 18 yrs). Free sugar intake should be even lower in infants and toddlers below the age of 2 years. The recommended intake of sugar for kids between 2 to 7 years is 15 to 20 grams, aged 7 to 13 years is 22 to 27 grams and aged 13-19 years is 27 to 37 grams.”

How sugars could be consumed ?

According to Dr Abhishek Chopra, there is no nutritional requirement for free sugar in infants, children and adolescents. He suggested, “Where possible, sugar should be consumed in a natural form through human milk, milk, unsweetened dairy products (eg. Natural yogurt) and intact fresh fruits, rather than SSB, smoothies or sweetened milk products. Sugar should be consumed as a part of main meal and not as snacks. Infants should not be given sugar containing drinks in bottles and children should be discouraged from habit of sleeping with bottle containing sugar containing drinks or milk.”

What are the recommended drinks?

The recommended beverage for children is water. Dr Abhishek Chopra explained, “Sugar containing beverages (SSB and fruit juices), fruit based smoothies and foods (sweetened milk drinks, sweetened dairy products) should be replaced by water or , in the latter case with unsweetened milk drinks/products with lactose up to amount naturally present in milk and unsweetened milk products. Replacing sugar with non caloric sweeteners ie artificial sweeteners, low calorie sweeteners is associated with reduced weight gain but impact on long term health is not currently well understood.”

Side effects of Sugar and children:

It is no secret that consuming excessive sugar can have various side effects on children and infants, affecting their health and development hence, it is important to be mindful of sugar intake, especially at a young age, to promote overall well-being. Dr Abhishek Chopra highlighted some potential side effects of sugar consumption in children and infants -

1. Dental Issues: Excessive sugar consumption, especially in the form of sugary drinks and candies, can lead to tooth decay and cavities. Bacteria in the mouth feed on sugar, producing acids that erode tooth enamel, leading to dental problems if not properly managed.

2. Increased Risk of Obesity: High sugar intake is associated with weight gain and obesity in children. Sugary foods and drinks are often high in calories but low in nutritional value, leading to excess calorie consumption and potential imbalance in energy intake.

3. Type 2 Diabetes Risk: Consistently consuming large amounts of sugar can contribute to insulin resistance and increase the risk of developing type 2 diabetes, a condition that affects the body's ability to regulate blood sugar levels.

4. Nutritional Deficiencies: High sugar foods can displace nutrient-rich foods in a child's diet, leading to potential nutritional deficiencies. If children fill up on sugary snacks and drinks, they may not consume enough fruits, vegetables, whole grains, and protein-rich foods necessary for growth and development.

5. Behavioral Issues: Some studies suggest a link between high sugar intake and behavioral issues in children, such as hyperactivity and attention problems. However, more research is needed to fully understand this relationship.

6. Increased Risk of Chronic Diseases: Excessive sugar consumption during childhood has been associated with an increased risk of developing chronic diseases later in life, such as heart disease and metabolic disorders.

7. Poor Dietary Habits: Regularly consuming sugary foods and drinks can establish poor dietary habits early in life, leading to a preference for sweet foods and potentially lifelong challenges with managing sugar intake.

Tips for Managing Sugar Intake:

• Offer whole foods like fruits, vegetables, and whole grains instead of sugary snacks.
• Choose water or milk as the primary beverages and limit sugary drinks.
• Read food labels and avoid foods with high added sugar content.
• Encourage mindful eating habits and model healthy behaviors as caregivers.

By being mindful of sugar intake and promoting a balanced diet, caregivers can help support the health and well-being of children and infants.