Sugar and Childhood Obesity

After 4 months of research, my review of the literature on childhood obesity and overweight is DONE and I can finally share my results! Some of what I found was surprising even to me. We are all quick these days to blame sugary foods for our kids' increasing waist lines, but there's more to the story.

I screened over 1200 papers and selected just 41 for my review. Dietary sugar from all sources were included, including sugar-sweetened beverages, milk, 100% fruit juice, sweets and candy. Here's the low-down on my findings:

My review concluded that the impact of sugar on childhood and adolescent obesity and overweight is negligible; however, some aspects of a high sugar diet may contribute to lower nutrient intake and poor diet quality. Studies looking at high sugar beverages as the source of sugar were the most likely to report a relationship to BMI, weight or waist circumference, but not all sugar-containing beverages had the same impact. Flavoured or plain milk, and 100% fruit juice, were shown to positively affect nutrient intakes, without adeversely affecting BMI. Therefore, focus on the elimination of all sugar-containing beverages does not appear to be an appropriate measure for addressing this issue. Some sugar-containing beverages may play a beneficial role in the growth and development of children and adolescence.

Although sugar alone may not impact BMI directly, unhealthy dietary patterns in which sugar is a significant component were shown to impact the weight status of children. The results of the dietary pattern studies suggest that sugar is only one component of a multi-dimensional dietary issue contributing to obesity. The complex nature of this issue, and failure to properly control or treat obesity as of yet, indicates a need for the expansion of research into multiple different causes, not just fat, sugar, or exercise alone.

Some studies found that high sugar foods were negatively associated with BMI, which may be representative of the inverse relationship between sugar and fat intake, and suggests that obesity may be completely unrelated to sugar intake in certain situations.

Added sugar intakes have been implicated in this issue for a number of reasons. Firstly, added sugars have been linked to various negative health outcomes and poor quality of diet. In addition, foods containing high amounts of added sugars are often lower in nutritional value and more energy dense. In the form of SSBs, added sugars may also be less satiating than in solid form, thereby resulting in increased energy intake and weight gain. This dietary change has been seen around the world, and can contribute to a malnourished, yet overweight population .

The evidence presented in this review suggests that the impact of total sugar intake on childhood obesity and overweight is negligible, and disputes the hypothesis that sugar intake is associated with increased BMI and obesity in children and adolescents. However, some aspects of a high sugar diet may contribute to lower nutrient intake and poor diet quality. Conclusive evidence was not found to indicate that total added sugars contribute significantly to increased BMI or obesity, however, specific added sugars, such as fructose, and high sugar dietary patterns, may still play a role. In addition, high fat, energy dense dietary patterns involving high sugar intakes were linked to increase weight and BMI in children and adolescence.

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