Tips for RDs: Advice for Families Regarding AHA Recommendations on Added Sugars

The American Heart Association (AHA) is now recommending that children between the age of two and 18 limit their consumption of added sugars to less than 25 grams per day, equivalent to about six teaspoons. These are the first recommendations specific to this age group from AHA and were published in an August 22 article in Circulation. The recommendations state that added sugars can be safely consumed in low amounts as part of a healthy diet, but that intake should be reduced due to limited physical activity in most children and adolescents.

As commonly used terminology related to sugar varies, the AHA’s recommendations are focused on sugars added to prepared foods, sugars eaten separately, and sugar added to foods at the table. Concerned parents may worry that drastic changes to their children’s diet may result in children not eating enough or wasting food. However, there are easy ways to include sweet taste while also improving a child’s overall diet quality.

Here are a few tips which may be helpful to give to your patients.

• Make sure the child is not adding sugar or syrup to food at the table. It’s particularly common at breakfast to add sugar to cereal or syrup to oatmeal, pancakes, or waffles. Rather than sugar, consider adding fresh, frozen, or dried fruits to cereals and oatmeal or a nut butter on waffles and pancakes. Another great option is to provide savory breakfast foods, such as scrambled eggs, with spinach and cheese wrapped in a tortilla or on an English muffin.
• Boost the child’s dairy intake by giving them a smoothie made with plain yogurt or plain milk blended with fruits and vegetables and some grains such as oatmeal. When looking at recipes, remember that portion size may need to be smaller for the child. Some children, especially those that are lactose intolerant, may prefer to eat cheese, which is a dairy option that is unsweetened.
• Be aware of healthier options when checking out the local coffee shop. On-the-go parents who stop at coffee shops or similar places should be aware of the options at the counter. Check the menu as many of these shops now offer sandwiches and fresh fruit that have less calories and added sugar than sweet muffins and cookies found in the case. Kids may also enjoy a flavored iced tea or an Italian soda made with carbonated water and light flavored syrup rather than many of the sweeter options available.
• Talk to the child about the importance of not swapping food with classmates at school and make sure they are bringing their uneaten food home so parents can adjust lunches based on what the child is actually eating.
• Make sure the child is getting enough sleep since not getting enough sleep can often lead to a preference for sweet tasting foods.

It is also important to consider a child’s level of physical activity and encourage kids to exercise if they aren’t already. Athletic kids who are very active are more likely to eat a greater amount of calories to support their growth compared to their friends who are not active. They may also need more carbohydrates during vigorous activity lasting longer than one hour and sufficient calories after endurance activities to ensure their recovery. The Academy of Nutrition and Dietetics (AND), Dietitians of Canada (DC), and American College of Sports Medicine (ACSM) recommendations for Nutrition and Athletic Performance are a helpful resource for your discussions with athletic patients while ACSM also provides the latest evidence related to physical activity and cognition and brain function if your patients need convincing to increase their physical activity.

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