Added sugar in fruit-flavored drinks and cola-type soft drinks undoes the good done by vegetables

American preschoolers get about 14 to 17 teaspoons of added sugar a day, on average, mostly from fruit-flavored drinks, high-fat desserts and cola-type soft drinks which displace the grain, vegetable, fruit and dairy food groups and lower the quality of their diet, a Penn State study has shown.

Dr. Sibylle Kranz, assistant professor of nutritional sciences who led the study, says, "In contrast to other researchers, we found that although the most dramatic decrease in vitamin and mineral intakes were observed when children had added sugar levels of more than 25 percent of total calories, consumption of grains, vegetables, fruit and dairy products and the proportion of children receiving an adequate intake of calcium were low even at added sugar levels of less than 10 percent of calories."

"These results suggest that the new National Academy of Sciences Dietary Reference Intake which sets a cut-point of 25 percent or less of calories from added sugar are reason for concern," she adds. "The U.S. Department of Agriculture Food Guide Pyramid limits added sugar consumption to between 6 and 10 percent, and the World Health organization recommends limiting added sugar consumption to less than 10 percent."

The study is detailed in the January issue of the Journal of Pediatrics in a paper, "Adverse Effect of High Added Sugar Consumption on Dietary Intake in American Preschoolers. " Kranz's co-authors are Dr. Helen Smiciklas-Wright, professor of nutritional sciences; Dr. Anna Maria Siega-Riz, associate professor of maternal and child health at the University of North Carolina, Chapel Hill; and Diane Mitchell, Penn State Diet Assessment Center coordinator.

The researchers analyzed the diets of 5437 preschoolers who participated in the U.S. Department of Agriculture Continuing Survey of Food Intake by Individuals from 1994 to 1996 and 1998. The participants are a representative sample of U.S. preschoolers. Children with the highest level of added sugar intake, 25 percent of calories or more, had the lowest consumption of most nutrients, and servings of grains, vegetables, fruits and dairy.

Eleven percent of the two and three year olds and 12 percent of the four and five year olds consumed 25 percent or more of calories from added sugar. Average sugar intake was lower among two and three year olds than among four and five year olds. In addition, non-Hispanic children consumed higher levels of added sugar than Hispanic children.

Forty percent of the two and three year olds and 70 percent of the four and five year olds with the highest added sugar intake did not get an adequate intake of calcium. Even at the lowest added sugar consumption level studied, 14 percent of the younger children and 39 percent of the older children didn't receive an adequate intake of calcium.

The researchers note that added sugars are mostly invisible in foods and can surprise caregivers when presented in teaspoons. For example, the average added sugar intake of the two and three year olds in the study was 13.5 teaspoons and the average intake of the four and five year olds was 17.2 teaspoons. In the highest added sugar consumption group, two and three year olds were getting 23.1 teaspoons per day and the four and five year olds were getting 26.4 teaspoons.

Kranz says, "Large, longitudinal studies, examining the long-term effect of high added sugar diets in young children might help elucidate the relationship between diet patterns and chronic disease. However, until more data are available, the DRI for added sugar might adversely affect young children in the long run."