Paging Dr. Frischer - Sugar

Dear There is a commonly held belief that excessive sugar leads to hyperactivity in children. I recall taking my daughters to a baseball game years ago, where they somehow each ended up with a large soda in their hands. It was late when we arrived home, but they behaved like pinballs in a pinball machine. What was responsible? Was it the sugar, the caffeine, the excitement of the special evening, or all three? Is sugar an innocent victim of guilt by association - or is there indeed a connection?Hyperactivity refers to increased movement, impulsivity, distractibility, and decreased attention span. This definition likely applies to practically every child at some time or another; it most certainly did to mine. Activity levels in children do vary from one child to another, and from one moment to another. We can all agree that a two-year-old is typically more active and has a shorter attention span than does a ten-year-old. A child's attention level will also depend on his or her level of interest in a particular activity. Labeling a behavior as hyperactive may also depend on how high the adult's tolerance level is. Refined sugars and simple carbohydrates affect our activity levels because they enter the bloodstream quickly. This leads to rapid fluctuations in blood glucose levels - first to the high side and then to the low side, which then can lead to an adrenaline rush followed by a fall. However, despite years of debate and research on the relationship between sugars and behavior, the evidence is mixed. The Research Against: Major studies have not provided consistent scientific proof to back up such a connection. One study found that parents who were told that their children had sugared drinks reported the children as hyperactive, even though the drink did not actually contain sugar. In another, pediatricians reported in the 2008 British Medical Journal that double-blind studies could not detect any differences in the behavior of children who consumed sugar. According to a nutritional sciences professor at Cornell University, parents' perceptions often lead to assumptions about the effects of sugar on children. If a parent thinks that their child has had sugar, there is a perception of a behavior change that may not actually be there when measured objectively. Instead, those researchers concluded that it's actually the party, holiday, activity, or special occasion, coinciding with high sugar consumption, which is often responsible for behavior changes. If we observe a change in behavior, our minds may go back to the child's last treat, rather than to other circumstances that might have influenced the behavior. It is clear that most children get too much sugar in their diets, but if the child's behavior is disrupting family life or affecting their performance in school, it may be a symptom of a larger problem, such as a conduct disorder or attention deficit-hyperactivity disorder (ADHD). The Research For: A 1998 study in the Journal of the American Medical Association noted that although an extensive review of previous studies did not indicate sugar-related behavior or learning problems for most children, an effect of sugar on some children could not be ruled out. A 2006 study in Norway found that adolescents who drank four or more glasses of sugared soft drinks a day had more symptoms of hyperactivity, mental distress and behavioral problems. In 2011, a study published in Lancet demonstrated that eliminating sugar from the diet improved the behavior of children diagnosed with ADHD. The Bottom Line: The relationship between sugar and hyperactive behavior in children has been a subject of debate in both the medical and popular media for several decades, and likely will continue, due to these mixed results in the research. Although most children's behavior may not be affected by sugar consumption alone, some may be. For all children, however, sugar is responsible for tooth decay and is void of nutrition. High-sugar foods tend to have fewer vitamins and minerals, and often replace more nutritious foods in the diet. The unnecessary calories in high-sugar foods can lead to obesity, a huge problem in our country today. Adrenaline levels in our children do become more level with the addition of fiber to the diet. At breakfast time, fiber can be found in oatmeal, whole grain cereal, berries, bananas, whole-grain pancakes and whole grain breads. For lunch, fiber is found in whole-grain breads, fresh fruits, and vegetables. Behavior experts recommend "quiet time" so that children (and adults!) can learn to calm themselves at home. If your child cannot sit still when other children of his or her age can, or if he or she cannot control impulsive behavior, seek a professional evaluation. Although most children do get too much sugar in their diet, cutting back on sugar shouldn't be a substitute for addressing other issues that may affect behavior. If you have specific concerns about your child's behavior, I urge you to discuss them with a health care professional. Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: January 26, 2012 - Volume 10 - Issue 41