Sugar and hyperactivity — Angela Berrill

Sugar and hyperactivity
While sugar provides us with a burst of energy, does it cause hyperactivity?
Sugar and hyperactivity
I know, I know, we’ve heard it said a hundred times that, “giving your child sugar will make them go crazy and have them bouncing off-the-walls”. In fact, we’ve probably heard this said so many times that we have even begun to believe this is what really happens when we ply our kids with cake, lollies and soft drinks. However, the reality is sugar does not cause children to become hyperactive. Crazy, right?! Well it’s actually not as crazy as it sounds, especially when we look to the scientific evidence on this much researched topic.
The origin of the claim that sugar causes hyperactivity can be linked back to the 1970s. The Feingold diet, which eliminates artificial flavourings, sweeteners (including sugar) and preservatives, was prescribed to help alleviate the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). However, since then MANY trials and subsequent reviews have busted the long-held myth that sugar causes hyperactivity. A large review of the scientific evidence around this topic, concluded that sugar does not affect behaviour or cognitive performance in children.
Why are children more hyperactive when they have sugar?
While sugar (and any highly processed or refined carbohydrate) will provide our bodies with a quick burst of energy, the link between sugar and hyperactivity has more to do with parents’ perception, rather than reality. Our deep-seated beliefs about the impact of sugar on behaviour, often lead us to believing our children are being hyperactive when they’ve had sugar, even when it is not the case at all. In one study , children considered sensitive to sugar were given aspartame, a sugar substitute. Half of the mother’s were told their children were given sugar and the other half, aspartame. The mothers who thought their child had had sugar, rated them as more hyperactive than the controls, despite the children not having had any sugar at all!
Psychologists believe the reason kids bounce off-the-walls, is more likely to do with the environment, rather than the sugar itself. Sugary foods and drinks are often eaten at special events like birthday parties, Christmas, Halloween or local fairs. These events generally involve a whole lot of excitement where children see family and friends, play games and generally have fun, outside of a structured school setting or traditional home environment. And that’s ok - it’s just kids being kids and having fun; regardless of what they’ve had to eat or drink.
Sugar and hyperactivity is more correlation than causation. For example, on a wet and rainy day we tend to use umbrellas. However, this does not mean that using an umbrella caused it to rain. The same goes for sugar and hyperactivity. Kids might be more hyped up at events where sugar is served, but that does not mean that the sugar caused hyperactivity.
Sugar and Attention-Deficit/Hyperactivity Disorder (ADHD)
Whether sugar causes ADHD (or whether those with ADHD are more sensitive to the effects of sugar), has been the subject of many scientific studies - and, it’s a topic that continues to remain controversial. Attention-deficit/hyperactivity disorder (ADHD) is characterised by persistent symptoms of lack of attention, impulsivity and hyperactivity. Cutting refined sugar out of the diet of children with ADHD is often promoted as a way to manage symptoms of hyperactivity.
Early research indicated that those with ADHD may be more sensitive to the effects of sugar. A study in the 1980’s, found that higher sugar intakes were correlated to more disruptive and restless behaviour in children with ADHD. However, since then many well-designed trials have found the opposite. One study, found no significant association between sugar intakes and ADHD development. These findings are further supported by another very recent study, which reported that ADHD is not caused by higher sugar intakes. The researchers concluded that higher sugar intakes were perhaps a consequence of ADHD, rather than a cause of. While research indicates that sugar does not cause ADHD, it does remain possible that a small percentage of children with ADHD may be more sensitive to the effects of sugar than others. In these instances, it would be helpful to discuss your child’s dietary needs with a Registered Dietitian who specialises in ADHD.
Sugar and health
Putting sugar and hyperactivity aside, there is no denying that we all need to cut back on the amount of 'free' sugar in our diet because of it’s many implications to our health. The World Health Organisation (WHO) ‘Guideline: sugars intake for adults and children’ (2015) reports that free sugars contribute extra energy to our diets and higher intakes of free sugars have been linked to poorer diet quality, increased body weight, and non-communicable disease (NCDs) such as tooth decay. Because of these health concerns, the WHO recommends that free sugars provide less than 10% of our total energy intake per day. The guidelines further suggest that a reduction to below 5% of total energy intake per day would have additional benefits.
10 % of total energy intake is the equivalent of around 52 grams of sugar (~10 teaspoons*) and,
5% percent equates to around to around 25 grams ( ~ 5 teaspoons*) of sugar per day, for an adult of normal Body Mass Index (BMI).
What is free sugar?
Free sugar refers to sugars added to food and drinks by the manufacturer, chef or you, at home. It also includes natural sugars found in the likes of honey, syrups, fruit juice and fruit juice concentrates. Unfortunately free sugar is found everywhere in foods these days. It’s not only used to impart flavour to the food we eat, but it is also used as a preservative and even a ‘filler’. Reading Food Labels, including the Nutrition Information Panel (NIP) and Ingredients List, can help you to determine whether there has been any sugar added to your food and drinks. When comparing foods within a food category (e.g. breakfast cereal), look for products that contain the least amount of sugar per 100g. Less is best!
When it comes to the likes of coconut sugar, and other less-processed or ‘-refined’ types of sugar, they are all still sugar. The source of sugar or level of processing / refinement doesn’t make the sugar any healthier. At the end of the day, when it comes to free sugar, sugar is sugar, regardless of it’s source.
Why do we need to cut back on sugary foods?
While we don’t need to avoid sugar altogether, the Ministry of Health recommends that we choose foods and drinks with little or no added (free) sugar. Sugary foods contain a whole lot of free sugar, and therefore energy (kJs or cal), without providing much in the way of health-promoting vitamins and minerals. Therefore, they are often referred to as ‘nutrient-poor’ foods. Filling up on sugary foods can also replace more nutritious foods and drinks in the diet.
Removing the guilt around sugar
We need to remove the guilt and shame that is so often associated with eating foods high in sugar. Sugary foods are not ‘bad’ and neither do you become ‘bad’ for eating them. It’s your whole diet that counts. We need to trust our children around sugar and allow them to develop the skills to connect to their bodies, and see how eating these foods makes them feel.
Ellyn Satter’s Division of Responsibility can be a helpful tool for helping you and your child to navigate sugary treats. As the parent it is our role to be responsible for what (the foods provided), when (the timing of meals and snacks) and where (ideally at the table, away from devices) of feeding your child. It is up to the child to determine how much and whether they eat what we provide. Include sugary foods along with their snacks, without restriction. Snacks higher in protein, healthy fats and/or fibre will help to blunt the effect of sugar spikes in the bloodstream, as well as helping to fill your child up and provide them with important nutrients for their health. For example, include a biscuit or cake alongside a glass of milk. Trust your child’s judgement and be guided by their hunger and fullness cues.
While it can be easy to get fixated on specific nutrients (such as sugar), it’s important to remember that we don’t just eat single nutrients or foods in isolation. We include a variety of foods (and nutrients) in our diet, across the day, week and even year. If we focus on the bigger picture, such as eating mostly whole foods and those that are as close to what is found in nature, then the nutrients will tend to take care of themselves, sugar included.