Sugar Intake and Cardiometabolic Health in Children

On a Sunday morning, a busy couple and their school-age children enter a superstore for their weekly grocery shopping. As they move through the center of the store, their shopping cart fills with packs of flavored yogurt, fruit sauces, fruit bars, fruit juices, flavored milk, prepared school lunches, snacks, and family meal packs.

How many of us know how healthy these foods are? How much added sugar are we consuming with them? What long-term impact do these foods have on our children’s cardiometabolic health?

In a recent community-based intervention, researchers from the Center for Weight and Health at the University of California, Berkeley, concluded that carbohydrates, fat, and protein differ in the risk they confer to cardiometabolic health in overweight and obese African American children. They found a detrimental relationship between insulin sensitivity and children’s intake of carbohydrates, specifically sugars, but not their intake of overall energy, protein, and fat. This has major implications for future health recommendations for children with regard to preventing childhood obesity and diabetes.

Greater intake of carbohydrate energy was associated with several undesirable effects, including increases in several classes of plasma lipids and higher insulin resistance, which is related to risk of diabetes. This comparison of the risks associated with fat, protein, and carbohydrates was published in the journal Nutrition & Metabolism by Sharma et al.

In a follow-up analysis, the authors evaluated the relationship between intakes of different types and sources of carbohydrates and selective markers of cardiometabolic risk in children. When carbohydrates were divided into non-sugars versus sugars, only the sugars were significantly related to higher plasma lipids (TG, VLDL-C, IDL-C) and increased insulin resistance.

Similar trends were observed for sugars classified as added sugars, sugars in candy and soda, sugars included in beverages, and sweetened dairy products. Sugars consumed as fresh, dried, and preserved fruits and unsweetened dairy products did not show significant associations with these markers of risk. This analysis (published in Nutrition & Metabolism by Sharma et al) suggests that increases in carbohydrate energy, especially in the form of sugar, may be detrimental to the cardiometabolic health of overweight and obese children.

These findings strengthen the American Heart Association’s (AHA) recent statement that in the setting of a worldwide pandemic of obesity and cardiovascular disease, there should be heightened concern about the adverse effects of excessive consumption of added sugars. The findings also suggest that the recommendations for adults regarding sugar intake may apply to children as well. Parents are advised to minimize their children’s intake of beverages and foods with added sugars, Suggests Dr. Sushma Sharma, Specialist at Atkins Center for Weight and Health, University of California at Berkeley.

More information about this project and related publications can be found at

Sharma S, Roberts LS, Hudes ML, Lustig RH, Fleming SE. Macronutrient intakes and cardiometabolic risk factors in high BMI African American children. Nutrition & Metabolism 2009..

Sharma S, Roberts LS, Lustig RH, Fleming SE. Carbohydrate intakes and cardiometabolic risk factors in high BMI African American children. Nutrition & Metabolism 2010.

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