How to help your kid cut down on sugar and juice

New guidelines suggest that kids up to one year old avoid juice altogether and those up to three stick with no more than ½ cup per day. Older kids can have a tad more — up to a cup.
Image: How to get your kids off of juice and sugar
The big problem with juice is that it’s easy to slurp down a whole lot of it without getting full.Adrian Lam / NBC News
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By Samantha Cassetty, RD

I hate to break it to you, but juice isn’t as healthy as you might think. Sure, it might contain a day’s worth of vitamin C (along with other nutrients), but it also contains a concentrated source of natural sugar — far in excess of what mother nature provides in fruit itself. When consumed as fruit, kids get the benefit of those health protective vitamins and minerals as well as fiber, which is lacking in juice and also under-consumed by kids.

New recommendations that have the support of the American Academy of Pediatrics, the American Heart Association, the Academy of Nutrition and Dietetics, and the American Academy of Pediatric Dentistry suggest that kids up to one year old avoid juice altogether and those up to three stick with no more than ½ cup per day. (Measure that out; it’s not a lot.) After that, the upper limit inches up to ¾ cup for kids up to 5 years old. (Older kids can have a tad more — up to a cup.) But that’s if you serve juice at all. These new guidelines make it clear that whole fruit, whether fresh, or unsweetened frozen or canned, is a better choice.

Setting juice aside, there’s a good chance you’re unknowingly serving other foods and drinks with hidden sugars — even ones disguised as healthy products. Uncovering sources of hidden sugar — and then limiting them in your children’s diet — will help you create lifelong healthy eaters and reduce their burden of diet-related diseases. Here’s what you need to know.

Why is too much juice unhealthy?

The big problem with juice is that it’s easy to slurp down a whole lot of it without getting full. That leads to consuming a whole lot of concentrated fruit sugars, which translates to a whole lot of calories— often in excess of what kids need. That can promote weight gain and a life of complications stemming from excess body weight.

“Children are forming dietary preferences early in life — between birth and age five — so what you introduce early on has a big impact,” says Anisha Patel MD, MSPH, Associate Professor of Pediatrics at Stanford University and co-author of the forthcoming book, "Half the Sugar All the Love". She explains that introducing small children to super sugary foods can heighten their preference for sweets, making it harder for them to accept wholesome plain foods, including plain milk. But the reverse is true, too: Limiting juice and other overly sweet foods early on enables children to better accept the flavor of naturally sweet whole fruit as well as more bitter foods, like veggies. “When kids develop poor eating habits or health problems early in life, those challenges persist,” she says, explaining that addressing added sugar in the diet “sets them up for healthier living.”

The problem with plant based milk

OK, so maybe you know that excessive juice intake is a no-no, but the new recommendations suggest sticking with plain dairy milk instead of the ever-growing field of plant based options.

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The truth is, plant based milks vary considerably in the amount of added sugar as well as the nutrition they supply. “Milk alternatives don’t supply the same nutrients in the same amounts as dairy milk, and even when fortified, it’s unclear how available these nutrients are to growing bodies,” explains Patel. Even if you’re being careful about choosing a no added sugar oat or almond milk, the protein, calcium, vitamin D, and other nutrients might not be optimal or optimally available.

The recommendations make exceptions for kids with allergies as well families whose religious or dietary values necessitate a plant based option, but if your family consumes meat or poultry and your child isn’t allergic, plain cow’s milk is his or her best bet.

The problem with too much added sugar

Added sugar doesn’t just get your child hooked on sweets, but it’s linked to a long list of health concerns from cavities to high blood pressure and cholesterol to type 2 diabetes to excess weight. Many of these issues linger into adulthood, and over time, can lead to other health problems that can interfere with quality of life.

According to the American Academy of Pediatrics about half the sugar in children’s diets comes from drinks, but the other half comes from foods. That means that in addition to drastically limiting sugary beverages, including juice, other juice drinks (like lemonade), coconut water (considered juice, per the report), flavored milks (such as chocolate or strawberry milk), sodas, sports drinks, and for older kids, coffee drinks, it’s important to reduce added sugars in meals and snacks.

How to cut added sugars

“Most added sugars are consumed at home so it’s important to develop strategies for selecting packaged products that reduce added sugars as well as for taking cooking shortcuts that make it easier to prepare healthful meals,” Patel says. This typically begins in the supermarket, where you can read labels to look for products that keep added sugars in check. Here are some pointers to help you shop and cook smarter.

  • Learn label lingo. A food label shows you added sugar amounts in grams instead of more common household measurements, like teaspoons or tablespoons. A teaspoon of sugar is approximately four grams so you’ll have to do the conversion in your head. While you’re at it, make sure you’re factoring in the serving size. Finally, when you scan the ingredient list, look at where sugar first shows up and how often. Ingredients are listed in order of predominance so if a source of added sugar is at the top of the list, you know the item has more sugar than anything else.
  • Learn other words for added sugar. If only it were as easy as looking for the word "sugar". It isn’t. There are actually about 60 names of sweeteners that might be used, but some of the most common ones include brown rice syrup, honey, maple syrup, fruit juice concentrate (such as pear or apple juice concentrate), cane juice crystals, and organic cane sugar. Some of these sound healthier than others but essentially, your body processes them the same way.
  • Buy unsweetened or unflavored packaged foods. Unsweetened whole grain cereal and yogurt are healthy options, but flavored versions are less so. Start with a plain version and add your own fruit. “Even if you add a drizzle of honey, chances are, it’s less than the packaged version,” says Patel.
  • Try cooking more meals from scratch. Fast food is tempting after a long day, but when you cook more often, you’re in control of what goes in your food. In one study, people who cooked dinner at least twice per week consumed less sugar compared to those who cooked less often, although they weren’t necessarily aiming for that. Instead, simply substituting meals out with meals cooked in leads to better diet quality. Patel suggests combining healthier, lower sugar packaged foods with fresh items to trim down the time it takes to prep and cook meals.
  • Make sweet substitutions. Certain fruits and veggies can naturally sweeten sauces and baked goods without adding sugar (or at least without adding much of it). Sweet potatoes, canned pumpkin, ripe bananas, dates, pineapple, and unsweetened applesauce are some to try.
  • Stock your pantry with the right ingredients. Cinnamon, ginger, cardamom, and vanilla extract can be used to boost sweetness as can shredded, unsweetened coconut and coconut flour. “Peanut, almond, and sunflower seed butters add creamy sweetness to recipes with no added sugar,” says "Half the Sugar All the Love", co-author Jennifer Tyler Lee, adding that you need to read labels to make sure you’re buying a no added sugar variety. “Like nut and seed butters, toasted nuts and seeds can amplify flavor without added sugar. Nuts and seeds also add texture and interest, which helps to round out low sugar recipes,” she adds.

How to get your kids off sugar

As parents, there’s no need to get hypervigilant about treats and sweets. There will absolutely be times when your child will indulge in cookies, cakes, and candies, and as a parent myself, I can pretty much guarantee that on occasion (like every Halloween and birthday party), it will be excessive. It’s OK to give your kids permission to eat super sweet foods sometimes, but for the most part, focus on playing up other healthier, lower sugar foods at home.

If your children are already consuming more than the suggested cap of six teaspoons per day of added sugar, here are some ways to ween them off.

  • Dilute juice with water until their juice intake is in line with current recommendations.
  • Apply the same strategy with flavored milks, serving a mix of plain milk with sweetened milk. Keep lowering the amount of flavored milk until your child is more accustomed to the taste of the plain drink.
  • Find ways to liven up plain water. Sliced cucumber or lemon are easy ways to bring flavor without any sugar.
  • Explore ways to remaster recipes with and less added sugar. It can be as simple as adding pineapple to a stir-fry to cut the amount of teriyaki sauce (a high sugar condiment) needed. For baked goods, Tyler Lee recommends egg yolks, which help bind low sugar cookies and cakes so that they stay moist and tender.
  • Make lower sugar swaps that don’t compromise on taste. “With 60 to 63 percent cacao, bittersweet chocolate lends a wonderful richness and depth of flavor to recipes with less added sugar than its semisweet counterpart. It’s an easy swap that most kids won’t notice,” offers Tyler Lee.
  • Focus on whole food snacks, such as fruit, veggies, nuts, and seeds. Supplement with lower sugar packaged snacks for convenience or for healthier alternatives to more sugary fare.

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