Topic 4 Cutting down free sugars

QUESTION: All sugars are the same?


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Sugars consumption in European children and adolescents exceeds current recommendations First of all, not all sugars are equal in terms of metabolic and health effects. In fact, they can be divided into sub-categories as follows:


  • Free sugars are different from intrinsic sugars found in whole fresh fruits and vegetables or sugars naturally present in milk, which are not associated with adverse health effects. On the contrary free sugars must be limited in a healthy diet.
  • Intake of free sugars should be reduced and minimized with a desirable goal of <5% energy intake in children and adolescents aged ≥2 to 18 years. Intake should probably be even lower in infants and toddlers <2 years (1)
  • With respect to honey, it is also a source of free sugars and although it could be apparently healthier, it isn´t and should be avoided.

How to reduce free sugars in children’s diet?

Sugar should preferably be consumed as part of a main meal and in a natural form as human milk, milk, unsweetened dairy products and fresh fruits and vegetables. Cutting down free sugars is essential for a dietary intervention in overweight/obesity. These tips could be useful for families:

Although many parents do not realize, one of major contributor of added sugar in childhood and adolescence are sugary drinks, such as soda, soft drinks, flavored milks, sports drinks, flavored water with sugar and juice drinks contain added sugars. Is crucial to eliminate and substitute them for healthier drink options, being water the best one. As it was explained before, drinking water reduces energy density and sugar content of diet.

In case of energy drinks, after water, sugar is the main ingredient, and apart from high quantity of sugar, level of caffeine could be harmful. Furthermore in adolescence, co-consumption with alcohol is increasing.

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Myth or fact?

100% fruit juice is as healthy as fruit


Sugar is added to many processed foods frequently consumed in children such as breakfast cereals and bars, candy, bakery, juices, sweetened, milk/dairy milk and yogurt, desserts, etc.

Unfortunately, including quantity of added sugars in food labels is not yet mandatory in many countries. So, at the moment parents could test if a product contains added sugar, only by reading the list of ingredients. As they are listed in a descending order according to their ingoing weight, skip foods that include “sugar” as the first or second ingredient. However, it not that simple, the growing use of alternative sweeteners can make it difficult to determine which ingredients count as sugar, because there are multiple sources of sugar with different names: maltose, sucrose, cane sugar, dextrose, sucrose, maltodextrin, etc.

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The use of non-nutritive sweeteners could lead to weight stabilization or a small degree of weight loss by helping lower total caloric intake, especially among children and adolescents with obesity. However data are conflicting as the use of non-caloric sweeteners may promote the intake of sugary food and drinks by affecting taste preferences.

Parents should be advised that a processed “sugar-free” product does not mean that it is healthy.

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Foods that are used as rewards often become extremely liked. They tend to be unhealthy foods and restricted foods in a weight control diet. Thus is important to avoid reward a good behavior of children with sugary treats. Instead, offer experiences or a sticker, a comic, a little toy, etc. depending on child preferences.

Far too often we celebrate holidays, birthdays, and other special occasions with sweets. There are healthier alternatives of snacks and homemade bakery, that parents could include


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