Food as Medicine: Limiting Sugar in the Diet

What is sugar?

Sugar is a sweet-tasting carbohydrate that is a source of energy (calories).

Sugar is a natural part of healthy foods, like milk and fruits. These foods also provide other nutrients such as protein, calcium, fiber, potassium, and vitamin C.
When sugar is added to other foods it adds calories without adding nutrients. Sugar is added to foods like bread, beverages, snack foods, yogurts, salad dressing, and ketchup.
Sweeteners made from fruits are the sugar part of the fruit without the other nutrients. Examples: fruit juice crystals, coconut sugar, and date sugar. These are considered added sugars.
Infant formulas and nutrition supplements contain different types of sugar in specific amounts to provide an energy source necessary for growth.

Does not make you feel full and provides excess calories. This can lead to excess weight gain and obesity.
Feeds harmful bacteria in the gut microbiome and can lead to inflammation.
Can be difficult to absorb and cause symptoms like diarrhea, bloating, and increased gas.
Feeds harmful bacteria in the mouth, which can lead to tooth decay.
Increases risk for chronic health issues; like type 2 diabetes, fatty liver, high blood pressure, high cholesterol, heart disease.

The American Academy of Pediatrics and American Heart Association recommend:
- Avoid added sugar for children under 2 years old.
- Children 2 to 18 years old should have less than 25 grams added sugar per day.
You can find “added sugar” on the label of many foods. Look at grams of total sugar and see if sources of added sugar are listed in the ingredients.

Words that end in –ose: dextrose, glucose, fructose, sucrose, lactose, maltose
Cane products: juice, sugar, syrup, solids
Syrups: cane, carob, corn, golden, pancake, malt, maple, refiner’s, brown rice
Agave, dextran, honey, molasses, muscovado, panocha, sorghum, sucanat, treacle
All types of sugar:
- Sources: beet, coconut, corn, date, maple
- Forms: brown, caster, confectioners, demerara, glazing, granulated, invert, malt, powdered, raw, superfine, table, white, yellow
Fruit juice crystals and concentrate, nectar

Beverages:
- Mostly drink water and milk. Unsweetened caffeine-free tea is also a good choice.
- Limit 100% juice, which contains more sugar than fresh fruit.
  - Infants under 1 year old: Do not give fruit juice
  - Children ages 1-3 years: no more than 4 ounces
  - Children ages 4-6: 4-6 ounces
  - Children ages 7-14: 8 ounces
Drink less than 8 ounces sugar-sweetened beverage per week.
- These include: soda, fruit drinks, sports drinks, sweetened tea and coffee
Enjoy sweet tasting nutritious foods.
- Fruit: enjoy fresh, frozen, and small portions of dried
- Vegetables
  - beets, butternut squash, carrot, corn, pumpkin, sweet potato, zucchini
  - roasting caramelizes the natural sugar and brings out sweetness
  - use in homemade breads and muffins
- Try coconut products like shredded coconut, flour, oil, cream, and water
Use spices like cinnamon, nutmeg, cardamom, ginger
Give your breakfast a make-over.
- Instead of sweetened cereals and baked goods, try:
  - oatmeal with dried fruit and spices
  - low-sugar cereal (see handout)
  - plain yogurt with fresh fruit
  - egg dishes: hard boiled, scrambled eggs, omelet, frittata
Experiment with new flavors and find or make favorites using ingredients without added sugar.
- Homemade salad dressing
- Mustard
- Vinegars
- Herbs and spices
- Soy sauce
- Stevia and monk fruit
Reward your child in other ways.
- Favorite activities, play dates, simple treats like stickers, hugs or high fives, time outside

Young children should avoid added sugar while they are learning to like the flavors of nutritious foods.
If your child prefers sweet tastes, try avoiding added sugar for a week or a month. Then you may add foods that you miss in limited amounts. Avoid artificial sweeteners. They can help avoid excess calories but will prevent your child from adjusting to the less sweet flavors of healthy foods.