Unhealthy habits can start young: Infants, toddlers, and added sugars

A new study in the Journal of the Academy of Nutrition and Dietetics, published by Elsevier, found that nearly two-thirds of infants (61 percent) and almost all toddlers (98 percent) consumed added sugars in their average daily diets, primarily in the form of flavored yogurts (infants) and fruit drinks (toddlers). Infants were 6-11 months, and toddlers were 12-23 months.

The analysis documented some good news in the decline over the study period (2005-6 and 2015-16) in the percentage of infants and toddlers whose daily diets include added sugars, as well as the amounts they consumed. Yet the widespread intake points to a serious and persistent problem: the early development of eating patterns associated with negative health conditions.

"Our study, which is the first to look at trends in added sugars consumption by infants and toddlers, documents that most infants and toddlers consume added sugars. This has important public health implications since previous research has shown that eating patterns established early in life shape later eating patterns," explained lead investigator Kirsten A. Herrick, PhD, MSc, Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA. She cited an earlier study that found that 6-year-olds who had consumed any sugar-sweetened beverage (SSB) before the age of one were more than twice as likely to consume an SSB at least once a day compared to 6-year-olds who had not consumed any before the age of one.

Dr. Herrick noted, "Previous research into the diets of children over two years old associated sugar consumption with the development of cavities, asthma, obesity, elevated blood pressure and altered lipid profiles."

Health organizations in the United States promulgate guidelines that recommend limiting sugar intake to 9 tsp or less for adult men, and 6 tsp or less for adult women and children between 2 and 19. With no comparable research available for infants and toddlers prior to this study, only one organization, the American Heart Association, provided any guidance for children under age 2. "Our study's findings about infant and toddler diets should raise awareness among health organizations and practitioners and inform future guidelines and recommendations," she added.

The investigators analyzed data for 1,211 infants and toddlers (6-23 months) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016, a nationally representative study conducted by the US Centers for Disease Control and Prevention. They used the Food Patterns Equivalents Database and the United States Department of Agriculture's What We Eat In America's list to categorize foods. Sugars contained in breast milk and formula were not included in the consumption estimates.

The results showed that infants consumed about 1 teaspoon (tsp) of added sugars daily (equivalent to about 2 percent of their daily caloric intake), while toddlers consumed about 6 tsp of sugars (about 8 percent of their daily caloric intake). No differences were detected in added sugars consumption by sex, family income level, and head-of-household, but there were some distinctions by race/Hispanic origin: non-Hispanic Asian toddlers consumed the fewest added sugars (3.7 tsp) and non-Hispanic black toddlers consumed the most added sugars (8.2 tsp). The top food sources of added sugars for infants included yogurt, baby snacks and sweets, and sweet bakery products. For toddlers, the top sources included fruit drinks, sweet baked products, and sugar and candy.

According to Dr. Herrick, parents should be mindful of added sugars levels in the foods chosen when weaning their infants. "The transition from a milk-based diet (breast milk and formula) to table foods has an impact on nutrition, taste preference, and eating patterns. More work is needed to understand this critical period." She recommends discussing which solid foods to introduce during weaning with a child's healthcare provider and pointed to the Nutrition Facts label as another resource to support informed decisions. While the federal requirement to include added sugars content of a food or beverages on the Nutrition Facts label is not mandatory until January 2020, many labels already include this information.

In September 2019, the Academy of Nutrition and Dietetics joined the American Heart Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics to recommend breast milk, infant formula, water, and plain milk as part of a new set of comprehensive beverage recommendations for children, outlined by age (birth through age 5). They caution against beverages that are sources of added sugars in young children's diets, including flavored milks (e.g., chocolate, strawberry) and sugar- and low-calorie sweetened beverages, in addition to a wide variety of beverages that are on the market and targeted to children that provide no unique nutritional value.

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Materials provided by Elsevier. Note: Content may be edited for style and length.

Shortage of Gulf Oysters Threatens Southern Culinary Heritage

In Louisiana, normally the nation’s largest oyster-producing state, months of severe weather have caused shortages of the beloved bivalve. According to The New York Times, flooding along the Mississippi River—swollen by Midwestern rain and snow throughout the spring and summer—overwhelmed coastal marshes, lakes, and bays with freshwater, and killed oysters by the millions.

Oysters, which have been cheap and abundant in the Gulf Coast region for centuries, are central to the area’s restaurant and cooking culture.

As the Times reports, shortages and soaring prices have led some Gulf Coast raw bars to replace local oysters with ones from other regions, though many are reluctant to do so, in large part due to regional pride.

“I have nothing against those other oysters,” explained Steve Pettus, a managing partner of the restaurant group Dickie Brennan & Company, which owns Bourbon House in New Orleans, “but they’re not ours.”

And the situation, experts warn, is only getting worse. And the fact that oysters take two to three years to reach market size means that it could take years for Gulf oysters to rebound.

Losses reported so far for this season are already so severe “that we’re likely to not remain the largest oyster producer in the United States,” Patrick Banks, an assistant secretary in the Louisiana Department of Wildlife and Fisheries, told the Times.

In fact, in September, the United States Department of Commerce determined that Louisiana, Alabama, and Mississippi were suffering “a catastrophic regional fishery disaster,” making businesses in those states eligible for federal assistance.

There is concern that if the higher prices persist Gulf oysters could become a luxury item unavailable to the average diner.

“Oysters are just becoming unaffordable,” Tommy Cvitanovich, the owner of Drago’s, told the paper. “People need to start thinking about another dressing for their turkeys.”

Avocados May Help Manage Obesity, Prevent Diabetes

 

Your guacamole may hold the key to managing obesity and helping delay or prevent diabetes, according to a new study by a University of Guelph research team.

For the first time, researchers led by Prof. Paul Spagnuolo have shown how a compound found only in avocados can inhibit cellular processes that normally lead to diabetes. In safety testing in humans, the team also found that the substance was absorbed into the blood with no adverse effects in the kidney, liver or muscle.

The study was recently published in the journal Molecular Nutrition and Food Research.

About one in four Canadians is obese, a chronic condition that is a leading cause of Type 2 diabetes. Insulin resistance in diabetic patients means their bodies are unable to properly remove glucose from the blood.

Those complications can arise when mitochondria, or the energy powerhouses in the body's cells, are unable to burn fatty acids completely.

Normally, fatty acid oxidation allows the body to burn fats. Obesity or diabetes hinders that process, leading to incomplete oxidation.

 

The U of G researchers discovered that avocatin B (AvoB), a fat molecule found only in avocados, counters incomplete oxidation in skeletal muscle and the pancreas to reduce insulin resistance.

In their study, the team fed mice high-fat diets for eight weeks to induce obesity and insulin resistance. For the next five weeks, they added AvoB to the high-fat diets of half of the mice.

The treated mice weighed significantly less than those in the control group, showing slower weight gain. More important, said Spagnuolo, the treated mice showed greater insulin sensitivity, meaning that their bodies were able to absorb and burn blood glucose and improve their response to insulin.

In a human clinical study, AvoB given as a dietary supplement to participants eating a typical western diet was absorbed safely into their blood without affecting the kidney, liver or skeletal muscle. The team also saw reductions in weight in human subjects, although Spagnuolo said the result was not statistically significant.

Having demonstrated its safety in humans, they plan to conduct clinical trials to test AvoB's efficacy in treating metabolic ailments in people.

Spagnuolo said the safety trial helped the team to determine just how much AvoB to include in the supplement formulation.

 

Having received Health Canada approval for the compound as a human supplement, he will begin selling it in powder and pill forms as soon as 2020 through SP Nutraceuticals Inc., a Burlington, Ont.-based natural health products company.

He said eating avocados alone would likely be ineffective, as the amount of natural avocatin B varies widely in the fruit and we still do not fully understand exactly how it is digested and absorbed when we consume a whole avocado.

Although avocados have been touted as a weight-loss food, Spagnuolo said more study is needed. He said a healthy diet and exercise are recommended to prevent metabolic disorders leading to obesity or diabetes.

PhD student Nawaz Ahmed, lead author of the paper, said, "We advocate healthy eating and exercise as solutions to the problem, but that's difficult for some people. We've known this for decades, and obesity and diabetes are still a significant health problem."

In earlier work funded by the Ontario Institute for Cancer Research, Spagnuolo has studied the potential use of avocatin B for treating acute myeloid leukemia.

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Materials provided by University of Guelph. Note: Content may be edited for style and length.

Sweetened drinks represented 62% of children's drink sales in 2018

 

Fruit drinks and flavored waters that contain added sugars and/or low-calorie (diet) sweeteners dominated sales of drinks intended for children in 2018, making up 62 percent of the $2.2 billion in total children's drink sales, according to Children's Drink FACTS 2019, a new report from the Rudd Center for Food Policy & Obesity at the University of Connecticut.

 

 

In contrast, the report -- funded by the Robert Wood Johnson Foundation -- found that healthier drinks, such as 100 percent juice, represented just 38 percent of children's drink sales that year. The report also found that companies spent $20.7 million to advertise children's drinks with added sugars in 2018, primarily to kids under age 12.

 

Some companies have developed drinks that may be healthier for children, such as juice and water blends that do not contain added sweeteners, and these companies have begun to advertise them to parents and children, researchers say. However, common nutrition-related claims and images of fruit on packages of sugary fruit drinks and flavored waters make it difficult for parents to easily identify the healthier drinks for their children.

 

"Beverage companies have said they want to be part of the solution to childhood obesity, but they continue to market sugar-sweetened children's drinks directly to young children on TV and through packages designed to get their attention in the store," said Jennifer L. Harris, PhD, MBA, lead study author and the Rudd Center's director of Marketing Initiatives. "Parents may be surprised to know that pediatricians, dentists, and other nutrition experts recommend against serving any of these drinks to children.

 

Researchers assessed the top-selling brands of children's drinks -- including 34 sweetened drinks (fruit drinks, flavored waters, and drink mixes) and 33 drinks without added sweeteners (100 percent juice, juice-water blends, and one sparkling water) -- analyzing sales, advertising spending, children's exposure to TV advertising, nutritional content, and product packaging. Brands with at least $10 million in sales in 2018 were included.

 

Confusing Package Claims and Hidden Low-Calorie Sweeteners

 

Study authors also say that package claims on sweetened children's drinks and similarities between claims on sweetened and unsweetened drinks can confuse parents about their nutritional content. Sugar-sweetened children's fruit drinks typically contained just 5 percent juice or less, but according to the report, 80 percent of those packages included images of fruit and 60 percent claimed to have "less" or "low" sugar or "no high fructose corn syrup." Children's drinks with and without added sweeteners also had similar package sizes and types, flavor names, use of fruit imagery, and front-of-package claims for products.

 

 

In addition, low-calorie sweeteners, such as sucralose and stevia, were found in 74 percent of children's sweetened drinks, including drinks that also contained added sugars, but there was no mention of low-calorie sweeteners on the front of packages.

 

"You shouldn't have to be a nutritionist to figure out whether or not a product is healthy for your child," said Maria Romo-Palafox, PhD, RD, study author and assistant professor of Nutrition and Dietetics at Saint Louis University.

 

"The fronts of the packages make children's drinks look healthy, but there's no way to know which ones have added sugars or low-calorie sweeteners reading the front. You have to read the nutrition facts panel on the back and you have to know the names of low-calorie sweeteners, such as acesulfame potassium and sucralose, to realize they are in the product," she added.

 

This report follows a consensus statement released in September by health and nutrition experts that recommended that children under age 5 should not consume any drinks with added sugars or low-calorie sweeteners, and that they should consume limited amounts of 100 percent juice.

Other Key Findings

Positive Outcomes

 

Beverage manufacturers made some progress in developing and advertising healthier drinks for children.

•More companies sold unsweetened juice-water blends, which are healthier than sweetened children's drinks and contain only juice and water. The majority contain less than 50 calories in one box or pouch.

•With the exception of one sugar-sweetened children's fruit drink, licensed characters only appeared on children's drinks without added sweeteners (primarily 100 percent juice) -- a significant improvement compared to 2014.

•Kraft Heinz was the only company to advertise sugar-sweetened drinks directly to children on children's TV, including Kool Aid Jammers and Capri Sun Roarin' Waters.

Opportunities for Improvement

However, companies continued to extensively promote sweetened children's drinks, and many children's drinks were high in sugar despite healthy-sounding claims.

•Children ages 2 to 11 saw more than twice as many TV ads for children's sweetened drinks than for children's drinks without added sweeteners.

•One-third of all children's fruit drinks contained 16 grams or more of sugar per serving -- equivalent to 4 teaspoons, which is more than half of the maximum amount of added sugars experts recommend for children per day.

•Of the 100 percent juice children's drinks studied, only 4 of 13 came in appropriate sized boxes or pouches for a toddler (age 1 to 3 years). Some contained more than 6 ounces of juice, which is the maximum recommended daily amount for preschoolers (age 4 to 6 years).

Report recommendations include:

•Beverage manufacturers should clearly indicate that products contain added sugars and/or low-calorie sweeteners and the percent juice content on the front of children's drink packages.

•The Children's Food and Beverage Advertising Initiative (CFBAI) -- the voluntary, industry self-regulatory program -- should establish nutrition standards that conform with health expert recommendations. Specifically, drinks with added sugars and/or low-calorie sweeteners should not be advertised directly to children.

•The U.S. Food and Drug Administration could require that products with nutrition-related claims on packages meet minimum nutrition standards and prohibit the use of fruit and vegetable images on drink product packages that contain little or no juice.

•State and local taxes on sugary drinks should include children's fruit drinks and flavored waters to raise the price and discourage purchases.

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Materials provided by UConn Rudd Center for Food Policy and Obesity. Note: Content may be edited for style and length.