How to get hidden sugars out of your child's diet — from the start

Tabatha Griffith is a conscientious mom. When her older daughter Bellamy, now 2, was 6 months old and moving on to solids, Griffith even made some of her own baby food. In the supermarket aisles, the new parent found a wealth of products aimed at toddler palates: toy-shaped crackers, rainbow-hued yogurts, fruity drinks. Kid-friendly foods.

That is, until Griffith looked closer.

"A lot of the stuff that was geared toward kids had so much sugar," said Griffith, a middle school teacher and Gloucester County resident. "Somebody who's not a label reader wouldn't know. I was surprised. It was definitely disappointing."

Parents, do not go gently into the juice box aisle. Or, for that matter, to many of the cereals, toddler snacks, and a whole lot of other stuff that claims to be healthy.

Added sugars abound in the edibles and drinks sold in the United States, including food products routinely fed to and marketed for young children. These sugars, added during processing or preparation, go by many names: fructose, high fructose corn syrup, glucose, cane sugar, even so-called natural ingredients such as honey, to name just a few. By July 2018, added sugars — as opposed to those that naturally occur in a food — will be required by the U.S. Food and Drug Administration to be noted on the labels of most foods sold.

Last year, the American Heart Association issued guidelines that children ages 2 to 18 should consume no more than 25 grams, or six teaspoons, of added sugars a day, and children under 2 should have no added sugars. Diets high in added sugars have been linked to obesity, diabetes, high blood pressure, and unhealthy cholesterol levels, not to mention dental problems.

How does 25 grams of sugar translate into food? A 12-ounce serving of a popular brand of cranberry juice cocktail has more than twice that much. Many doctors advise limiting fruit juice to six ounces a day — and in a cup, never in a baby's bottle.

Added sugar can be a problem from the very day a child is born.

A recent study by researchers with the University of Southern California's Keck School of Medicine made the startling discovery of fructose in the breast milk of nursing mothers. Because  fructose isn't a naturally occurring sugar in breast milk — long considered the gold standard for newborn nutrition — the researchers theorized that "secondhand sugar" may have come from foods that were high in added sugar, such as processed foods or juice drinks, although they do say that more study is warranted. Fruit contains less fructose and the body metabolizes it differently.

Moreover, the researchers found that although the amounts of fructose in the breast milk varied among the women in the study, higher levels of fructose, although still small, were related to greater infant weight.

"Early life is a period of rapid development and early-life nutrition is strongly linked with long-term health outcomes," said Tanya Alderete, study co-author.

"Results from this work suggest that the composition of breast milk may be another important factor to consider in regards to infant health and perhaps future risk for overweight or obesity," Alderete said. "For this reason, mothers should try to consume a healthy diet that is low in added sugar."

As sneaky as sugars are, you can keep ahead of the game, nutrition experts say.

"Eyeball the labels," said Lore Noyes, director of clinical nutrition for Nemours/Alfred I. duPont Hospital for Children.

Know that ingredients are listed in order of amount. That includes sugars. Noyes suggested paying particular attention to "watch-out foods": flavored yogurt, cereals, crackers, peanut butter, even bread and condiments such as ketchup, which can all contain lots of sugars. Pasta sauces and applesauce also can harbor lots of the sweet stuff.

Beth Leonberg, who teaches nutrition at Drexel University, sees little reason to feed prepared baby foods, generally, but, she noted, the desserts can be real sugar havens.

"The manufacturers make baby food desserts because people buy them and kids like them," Leonberg said.

Which isn't to say you must eschew all sugars.

"The naturally occurring sugars in milk and fruit I don't worry about at all," said Megan Robinson, clinical dietitian with the Children's Hospital of Philadelphia. Fruit also contains fiber and valuable nutrients, and milk is full of the stuff needed for strong bones.

Robinson has her own go-easy list.

"Granola bars," the nutritionist said. "I call them glorified candy bars."

Again, read the labels. Some of the newer offerings are much lower on the sugar scale, she said. Look at the sugar content on those packets of instant oatmeal, too.

"I never recommend families purchase low-fat foods," Robinson added, referring to foods with reduced fat, as opposed to naturally low in fats. Often, reduced fat products will have added sugars to improve flavor lost when fat is removed. Natural peanut butter is often a better choice than low-fat or regular, she said, when it comes to sugars.

Starting a child out right can be the best defense. Robinson suggested serving plain yogurt sweetened solely with fresh fruit, or unsweetened cereal flavored with nuts and cinnamon.

Tyree Winters, a Rowan University pediatrics professor and doctor who counsels families on obesity and weight problems, is also a believer in getting children off to a healthy start when it comes to food.

Some tips: Choose fresh or frozen fruit without sugar added; provide a wide variety of fruits and vegetables and don't give up on a food until you've offered it 20 times; encourage kids to enjoy food but don't use it as a reward. And even when they are little, let them help you in the kitchen.

"I can't stress enough having your kids help you prepare food," Winters said. "They start to understand the relationship with food. They begin to voice their likes and dislikes. I'm a firm believer in letting kids have a voice. It develops this relationship of trust."

Over at the Griffith family home in Clarksboro, Bellamy has a while to go before she gets to heavy kitchen lifting, but she does enjoy mixing it up with the measuring cups and bowls while her mother, Tabatha, cooks.

Baby sister Riley is still on a liquid diet, but Bellamy has been branching out. Lunch is often dinner leftovers, cut up to toddler size. Her mother has been sticking with whole foods with recognizable ingredients, rather than the processed stuff full of unpronounceable chemicals.

"You're told to tell your kids about strangers on the playground, and then there's all this crap in the food," she said.

For now, Bellamy is content with her chicken and veggies lunches. She does enjoy the occasional Goldfish cracker snack. And she does like sweets.

"She'll ask for multiple bananas a day," her mother said. "She also likes apples."