Yesterday, the American Heart Association (AHA) issued new guidance suggesting that children aged 2 to 18 consume no more than six teaspoons of added sugar a day, that they limit their intake of sugar-sweetened drinks to no more than eight ounces weekly, and that children under two not consume any foods or beverages with added sugars at all:
As a kid/food writer, I can attest to the previous “lack of clarity and consensus regarding how much added sugar is considered safe for children” noted by the AHA in its press release. For example, when I wrote my free Guide to Getting Junk Food Out of Your Child’s Classroom and, more recently, when I researched my Civil Eats story on sugary school breakfasts, it was surprisingly hard to find reliable added-sugar recommendations for children.
So I’m glad the AHA made its announcement yesterday, offering parents and advocates a firm benchmark for the first time. At the same time, though, I can’t help but note that the “six teaspoons a day” warning is so out of whack with the reality of most kids’ daily diets that it feels more aspirational than achievable.
The AHA says that, on average, American children are currently eating three times the recommended amount on a daily basis and are “drinking their age in sugary drink servings each and every week.” That’s a serious problem, as eating too much added sugar is directly linked to an increased risk of obesity and obesity-related diseases. Clearly, as a society, we need to scale back significantly on the amount of sugar we all consume.
But in an effort to “keep it simple for parents and public health advocates,” the AHA chose a single added sugar benchmark regardless of a child’s age and daily calorie needs. In this respect, the recommendation is actually more stringent than the recently issued 2015-2020 Dietary Guidelines for Americans (DGA), which for the first time suggest that added sugars comprise no more than ten percent of an individual’s daily calories.
As blogger and registered dietitian Sally Kuzemchak discussed in a post on Real Mom Nutrition last year, using the “ten percent of calories” benchmark means a child’s suggested added sugar limit will vary by age. Here’s the chart she prepared based on My Plate recommendations for children’s daily calorie needs:
Even these more liberal, age-adjusted added sugar recommendations would be hard for many parents to adhere to, as the photos in Sally’s post well illustrated. But by asking parents to restrict all children’s daily added sugar intake to the level deemed appropriate for toddlers, the AHA has set a very stringent standard indeed.
For example, this morning I baked a batch of whole wheat oatmeal muffins for my kids’ breakfast (ambitious for a school day, I know!), which contained just one half-cup of brown sugar for a dozen muffins. That seemed like a reasonable amount when I chose the recipe, but if my math is correct (one half-cup = eight tablespoons = 24 teaspoons), this comes to two teaspoons of sugar per muffin. My teenaged son put away three, which means he hit the AHA’s added-sugar quota before he even left the house.
Similarly, just one dessert (such as a cup of vanilla ice cream) or two tablespoons of maple syrup on pancakes would also put a child over the 6 teaspoon limit. And, of course, sugar is present in many other foods a child typically encounters in a given day, such as peanut butter, pasta sauce, ketchup, salad dressing and yogurt.
But even if adhering to the “six teaspoons a day” limit proves difficult for many of us, the AHA benchmark is certainly consciousness-raising. And, along with the new requirement that Nutrition Facts disclose added sugars, the AHA recommendation will also likely encourage manufacturers to start scaling back on excess sweeteners, particularly in foods commonly eaten by children.
I also anticipate that the AHA guidance will prove useful for parents seeking to reduce the amount of sugary foods offered in their child’s classroom. For example, just six Jolly Rancher candies handed out as a classroom reward have almost 6 teaspoons of added sugar, while one Capri Sun juice pouch and five hard peppermint candies given to “boost energy” on standardized testing days contain almost 8 teaspoons.
Most importantly, given the almost 14 million kids who eat school breakfast every day, I’m hopeful that the AHA recommendation, along with the new DGA on added sugar, will eventually make insanely sugary school breakfasts like this one (offered in my district before recent reforms were instituted) a thing of the past:
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Maryann Jacobsen says
I totally agree Bettina. I think it’s unrealistic and actually not very helpful. I for one will not be counting the grams of sugar I feed my kids. Yes, I will continue to lower the sugar where I can, but I will continue on a balanced diet that includes a variety of nutritous foods. And for my daughter, adding some sugar or sweetness helps her accept more of those foods. Great post!
Bettina Elias Siegel says
Thank you so much for this comment, Maryann! As an advocate, I want to support these guidelines fully. But as a parent, I worry that the AHA set such a high bar that people will just throw up their hands in defeat. Given that you’re a respected RD and child feeding expert, it’s really comforting to hear you say this.
EYC says
I usually don’t post comments, but I just wanted to thank you for a great post. It was a very informative article! This Summer, we started to watch our diet and count calories and sugar/carb intake to lose wight (and learn to eat healthier) since my husband has been diagnosed for pre-diabetes and my daughter for obesity. We’re amazed to know how much sugar we used to consume!! I started to make good healthy lunch everyday for my daughter as she doesn’t see any good alternative at her shool cafeteria. I hope her school district starts to offer some wholesome healthy lunch in the near future.
– Colorado Jefferson County mom
Bettina Elias Siegel says
Thank you for this comment, CJC Mom, and I wish you all the best as you help improve your family’s diet!
Maggie says
The AHA is kind of between a rock and a hard place on this, aren’t they. The recommendations are based on research and science, so how could they do anything BUT “tell it like it is”?
Still, I see your point that if it seems un achievable, will people even try? And, as always, with the current norms in society, probably even more of a challenge…like so many other concerns (sodium, for example).
As far as school food – All I’d need is to double my staff (with skilled cooks, of course!) to be able to cook from scratch. OK, I suppose I’d also need room for more people to work as well…never as simple as it sounds. I’m hoping I’ll still be involved with school food when the tide does turn – it has to someday.
Bettina Elias Siegel says
Exactly! I wouldn’t expect the AHA to soften its recommendation given that it is evidence-based (though one wonders why they didn’t at least create a sliding age scale, differentiating the toddler from a strapping teen boy, e.g.) but at the same time, it’s such a stringent bar that it feels almost theoretical! I guess, if nothing else, I wish the organization had more candidly acknowledged in its press release and other materials that this is a goal to work steadily toward, not one most families will meet overnight, and that any incremental sugar reduction is better than none. And of course I hear you re school food… you know I feel your pain! Thanks, as always, for your comments, Maggie!
Adina says
I would love a list of the “best” studies they have based this on. Is it related mostly to correlation with obesity? Or something else?
Bettina Elias Siegel says
Hi Adina: My understanding is the AHA used the “10 percent of daily calories” guideline established by the USDA (and also recommended by other organizations like the World Health Organization) and but then also chose to use a toddler’s daily calories as the benchmark. So, going back a step, here’s information from the WHO where the 10% guidance is offered, along with various study sites on which they based the recommendation. (And, by the way, the WHO says the ideal guideline is actually 5% of daily calories.) I hope this helps.
bw1 says
Question: what is meant by the term *added* sugar? You cite maple syrup as an example, but maple syrup (as opposed to pancake syrup) contains only the sugar naturally occurring in maple tree sap (although it’s concentrated by boiling out much of the water.) Is this an oversight on your part, or does it actually fit within the definition,
and, if the latter, on what basis?
Also, why is added sugar, as opposed to sugar already present in foods, the focus of concern? The naturally present sugar in fresh squeezed orange juice exceeds the overall sugar, added or otherwise present, in Gatorade, a product villified on this blog in the past. Can anyone explain how the body’s metabolic chemistry can tell the difference between added and non-added sugar? My father in law, a published biologist involved in diabetes treatment research, can’t conceive of how.
Bettina Elias Siegel says
As of March, 2016 I no longer respond to comments from this particular Lunch Tray reader: after several long years of debating with him/her, I’ve decided life’s just too short. But others can and should feel free to respond if they like.
bw1 says
“I wish the organization had more candidly acknowledged in its press release and other materials that this is a goal to work steadily toward, not one most families will meet overnight”
Who exactly do you think is the target audience? I doubt anyone without the intelligence to realize that on their own will be aware of this guideline’s existence, let alone read it.
Bettina Elias Siegel says
As of March, 2016 I no longer respond to comments from this particular Lunch Tray reader: after several long years of debating with him/her, I’ve decided life’s just too short. But others can and should feel free to respond if they like.