Dentistry For Young People

Are You Sugar Savvy?

Date Posted: 6/10/2008

The beverage game that is part of a Nemours Health & Prevention Services program designed to teach people who work with children just how much sugar is packed into many of the drinks kids love. Kate Dupont Phillips, a Nemours program and policy analyst who conducted the recent training at the Nemours office in Newark, gave the audience a jarring image at the start: measuring cups filled with the amount of sugar in popular drinks. A 12-ounce can of Coca-Cola, for example, has almost 10 teaspoons of sugar. A 24-ounce bottle of Pepsi-Cola has 21. Popular sports drink Powerade packs 15 teaspoons of sugar in a 32-ounce bottle.


The visuals made an impression on Amanda Cole, a camp counselor in Wilmington. "Seeing it in teaspoons really helps put it in perspective," said Cole, also a student and track athlete at Temple University, in Philadelphia. "As an athlete, you hear about those drinks having a lot of sugar but I didn't know they would be that much."

Sugary beverages, including fruit juice, besides causing cavities have been associated with childhood obesity. The American Academy of Pediatrics recommends no more than 4 to 6 ounces of juice per day for children 1 to 6, and no more than 8 to 12 ounces for children 7 to 18. For soda, most experts recommend even less. Yet many kids are drinking significantly more.

Cole said it's difficult to know how much sugar actually is in various drinks because nutritional labels list the sugar content in grams. But the Nemours demonstration brought the information into focus.

"If you put it into a cup for them, they can conceptualize it," Phillips said.
Know your grams

Nemours emphasizes five servings of fruits and vegetables a day, less than two hours of TV, at least one hour of physical activity.  Limit soft drinks (sodas), sports drinks or fruit drinks that aren't 100 percent juice.

Some Nemours primary care offices display the sugar amounts of popular drinks. Children also may learn about sugar content in beverages at child care centers and schools.

The formula to keep in mind is this: 4 grams of sugar equals a teaspoon of table sugar. Sugar grams can come in many forms, including high-fructose corn syrup, honey, sucrose and dextrose.

Most sugar is digested in the small intestine. An enzyme in the lining of the intestine breaks down the sugar into glucose and fructose molecules. Glucose flows into the bloodstream, and proteins take it to every cell in the body, where it's converted into energy. Fructose, with a similar makeup to glucose, is converted into glucose by the liver.

So sugar provides fuel for cells, but when more sugar is consumed than needed -- no matter what type -- it gets stored as fat. That's why excessive consumption of sweetened beverages can quickly become a problem.
Fruit juice versus fruit drink

There is, however, a difference between fruit juices and fruit drinks. The Food and Drug Administration mandates that any product labeled as a fruit juice must be 100 percent fruit juice. Any beverage that is less than 100 percent fruit juice -- often called a "fruit drink" or "fruit cocktail" -- must list the percentage that is pure fruit juice. Typically it's only about 10 percent juice.

Dr. Christine Wood, a California pediatrician and expert on child nutrition, said parents often mistakenly lump those drinks in with 100 percent fruit juices.

The American Beverage Association doesn't address on its Web site how much sugar is in fruit drinks, nor does the industry trade group address the fact that energy drinks are loaded with sugar. Those drinks also contain excessive amounts of caffeine, Wood said, but many teens, and some parents, believe they are the ideal beverages to drink during physical activity.

The FDA limits the amount of caffeine in cola beverages to 65 milligrams per 12 ounces, but it doesn't regulate caffeine in energy drinks. Reload, a popular energy drink, has 130 mg of caffeine in 11.6 ounces. Excessive amounts of caffeine can cause anxiety, panic attacks, stomach problems and even an irregular heartbeat.

"Kids shouldn't be having caffeine and lots of stimulants in their diets, and parents shouldn't get in the habit of giving these drinks to them," said Wood, who runs the Web site KidsEatGreat.com.

Research hasn't shown that diet soft drinks, which use artificial sweeteners rather than sugar, are unsafe for children. But Wood said children who routinely consume diet soft drinks are at higher risk for Type 2 diabetes and obesity because they often consume more calories from unhealthy foods.

"Sometimes it gives us a false sense that we're doing something good," she said.
Drink water

Keely Maegerle is determined to make smart choices when it comes to beverages for her and her family. A second-grade teacher at North Star Elementary School in Hockessin, she had seen the sugar demonstration before she attended the recent Nemours training session. She has a 17-month-old daughter and is pregnant.

"My kids won't be drinking any Gatorade or soda," she said.

Ressel, who lined up the bottles at the recent training session at Nemours, rarely buys juice for her two daughters. "My first choice is milk or water for them," she said.

To reach the multitude of children who aren't aware of the amount of sugar in drinks, Maryanne Bourque heads to local schools. Bourque, a registered nurse and community education coordinator for the Alfred I. duPont Hospital for Children, shows the demo each week to about 360 students in kindergarten through fifth grade.

"The visual is very dramatic," she said. "When they see what a serving looks like, the kids say 'Really? Get out of here! No way!' "

Bourque has them spoon the sugar into measuring cups as a way "to get through to them."
Underestimating calories

A 1.5-ounce chocolate candy bar has about 5.5 teaspoons of sugar, whereas a 12-ounce soda has twice that amount. What's more, it's often easier for people to consume two or more sodas or fruit drinks in a sitting than two or three candy bars.

Concentrated liquid sources of sugar are easy to quickly consume, said Joan Salge Blake, spokeswoman for the American Dietetic Association and a nutrition professor at Boston University. "I think the issue is that when people drink the fruit [drinks] they don't equate it to calories because there's no chewing at all," she said. "They underestimate how many calories they're getting from these sweetened beverages."

Bourque's recent demo at St. John the Beloved School in Milltown made an impression on fifth-grader Emily Tomlinson. She said she learned that "fruit that is better is real fruit and not just fruit that was made into a drink with extra sugars."

Her parents, Sharon and Roger, try to keep 11-year-old Emily and her 7-year-old sister Jenne on a healthy diet. "I don't even buy pop," Sharon said. "It has no nutritional value."

But until recently, both parents were under the impression that the 100 percent apple juice that Emily drinks at lunch was good for her. Then they found out that a 6.75-ounce juice box has 22 grams of sugar -- or 5.5 teaspoons per serving.

"That's shocking," Roger Tomlinson said. "... Now I'm a little hesitant to give it to them." Added Sharon: "Emily's going to start drinking milk and water."

They may not get much of a fight from their daughter. "Twenty-two grams is a lot more sugar than I thought it was," she said.

 

What's In a Drink?

Hi-C Blast:

6.75 ounce serving= 25 grams/6.25 tsp sugar

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Welch's 100% Apple Juice:

10 ounce serving=35 grams/8.75 tsp sugar

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Coca-Cola:

12 ounce serving=39 grams/9.75 tsp sugar

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Starbucks Frappuccino:

9.5 ounce serving= 31 grams/7.75 tsp sugar

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Snapple Lemon Iced Tea:

16 ounce serving=46 grams/11.5 tsp sugar

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PowerAde:

32 ounce serving=60 grams/15 tsp sugar

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Source: The Daily Times/DelmarvaNow.com
Originally published June 4, 2008