The American Heart Association has set its sights on the high levels of sugar in children’s diets, recommending that consumption of added sugars be limited to 25 grams or less per day to minimize the increased risk of cardiovascular disease, according to a scientific statement published Aug. 22 in Circulation.
“In part because of the lack of clarity and consensus on how much sugar is considered safe for children, sugars remain a commonly added ingredient in foods and drinks, and overall consumption by children and adults remains high,” wrote Miriam B. Vos, MD, of Emory University, Atlanta, and her coauthors.
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The group conducted a literature search of the available evidence on sugar intake and its effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. They also used dietary data from the 2009-2012 National Health and Nutrition Examination Survey (NHANES) to estimate added sugar consumption (Circulation 2016 Aug 22. doi: 10.1161/cir.0000000000000439).
The NHANES data revealed that on average, 2- to 5-year-olds consume 53.3 g of added sugar, defined as all sugars used as ingredients in processed and prepared foods, eaten separately or added to foods at the table, per day; 6- to 11-year-olds consume 78.7 grams a day; and 12- to 19-year-olds consume 92.9 grams per day.
The writing group found there was evidence supporting links between added sugars and increased energy intake, adiposity, central adiposity, and dyslipidemia, which are all known risk factors for cardiovascular disease. They also found that added sugars were particularly harmful when introduced during infancy.
In particular, they found that consumption of sugar-sweetened beverages was strongly associated with an increased risk of obesity across all ages, and there was also a clear dose-response relationship between increased sugar consumption and increased cardiovascular risk.
Based on this, they recommended that children and adolescents drink no more than one 8-oz. sugar-sweetened beverage per week, and limit their overall added sugar intake to 25 g (around 6 teaspoons) or less per day, while added sugars should be avoided entirely for children aged under 2 years.
The group also identified significant gaps in the literature around certain issues such as whether there is a lower threshold for added sugars below which there is no negative impact on cardiovascular health, whether added sugars in food are better or worse than added sugars in drinks, and whether the sugars in 100% fruit juice have biological and cardiovascular effects in children that are similar to those of added sugars in sugar-sweetened beverages.
“Although added sugars can mostly likely be safely consumed in low amounts as part of a healthy diet, little research has been done to establish a threshold between adverse effects and health, making this an important future research topic,” wrote Dr. Vos and her colleagues.
One author reported a consultancy to the Milk Processor Education Program, and another reported having advised the Sugar Board. No other conflicts of interest were declared.