A high sugar intake is associated with a higher risk for obesity, but so many parents may not realize what the recommended limits for sugar are for kids or how much sugar is in the foods their kids regularly eat. A recent study published in the International Journal of Obesity revealed that most parents underestimate the amount of sugar in the diets of their children. The study also found that when parents underestimated sugar content in foods there was a higher risk of their child being overweight or obese.

The American Heart Association recommends children over the age of 2 should not consume more than 6 teaspoons of added sugar per day. The table below shows how easy it would be for a preschooler to get 29 teaspoons in a day. The average teenager is consuming 35-45 added teaspoons! An adult woman should have no more than 6 teaspoons and a man no more than 9 teaspoons. To be clear, “added sugar” refers to the amount of sugar that is not naturally occurring in a food and is instead added to enhance the flavor. A piece of whole fruit has no added sugar but a “fruit cup” from the grocery store may have many added teaspoons to give it that syrupy sweet taste. If we understand how to read the new nutrition fact labels we can do a better job of reducing added sugar in our diets.

4 sneaky ways that food companies add sugar to our foods:

1. Confusing food labels: Figuring out how many added teaspoons is in a product is not always straightforward. First, food labels report sugar in grams. So remember this equation the next time you look at a label:

4 grams of sugar = 1 teaspoon of sugar

A child should get no more than a TOTAL of 24 grams of sugar per day, or 6 teaspoons (24 grams ➗ 4 = 6 teaspoons). To further complicate things, food labels historically did not break down added sugar with naturally occurring sugar. So when we look at a label on a sweetened fruit yogurt it’s often unclear how much of the sugar comes from natural milk sugars and fruit versus how much extra sugar the food company has added to enhance sweetness. Luckily most labels have been updated to include less confusing information, separately listing the total amount of sugar and the total amount of added sugar.

2. Small portion sizes: A favorite food may not look like it has much sugar per serving, but if you look closely you may notice that the serving size is much smaller than what you may actually eat. Take the example of cereal. A typical serving size for cereal may be ½ or ¾ of a cup per serving, which is much smaller than most people will actually eat (especially if it’s really sweet, you are likely to eat more!) If there are two teaspoons of sugar in a serving but you can eat three servings, that 2 teaspoons quickly multiplies to 6 teaspoons, which is the recommended daily limit for a child.

3. Sweetening with “healthier sugars”: Sweeteners like honey, agave, and maple syrup may make a food appear more healthy. While they may be more natural than refined sugar, manufacturers are still adding sugar to a food that may not need extra sweetness.

4. Using sneaky names for sugar: Sometimes it can be hard to spot sugar in an ingredient list because there are so many code names. One nutrition source reports that sugar can be spotted with as many as 61 different names. Sugar’s many code names include rice syrup, dextrose, maltose, and barley malt, and high-fructose corn syrup. This is a great tactic as companies are required to list foods by weight in decreasing order. By listing sugar with more than one name companies may be able to bury sugar further down on the list, making it seem like there is less.

5. Hiding sugar in “health foods”: Food companies lure us to foods by using labels that make foods look healthy and faking us out with buzz words like “whole grain,” “high protein,” and “organic.” These words do not necessarily mean the product is low in sugar. Remember, the real story about sugar is on the food label, not on the front of the packaging.

As a pediatrician who is focused on nutrition education, I often have conversations with families about their favorite foods. Many of the foods parents list are ones with excessive amounts of sugar. The hard part is that labels may mislead us with marketing that convinces us these foods are “healthy.” Here are some of the foods I see that may seem healthy but are often super high in sugar.

5 sneaky foods which may contain excessive added sugar:

1. Granola bars: Granola bars, protein bars, and breakfast bars may be convenient and taste great, but many of them have a lot of added sugar. A search of the nutrition label of a popular flavor of Cliff Bar shows that sugar is the first ingredient and there are 22gm (5.5 tsp.) in one bar! When buying “bars” read the ingredient list carefully and check for added sugar. As a lower sugar alternative, consider making your own trail mix with nuts, seeds and unsweetened dried fruit.

2. Breakfast Cereal: Breakfast cereals can be a huge sugar bomb in the morning. Many companies are trying to fake out the consumer by highlighting “whole wheat” or even claiming cereals are “high in protein.” Often this is an attempt to distract from the excessive amounts of added sugar. America’s favorite cereal, Honey Nut Cheerios has 9 grams per serving which add up to many teaspoons of sugar at breakfast as we pile our bowls high. If you love cereal in the morning, find varieties with little to no added sugar (like plain Cheerios) and add berries or other fruit to sweeten it naturally while adding extra fiber and nutrients.

3. Yogurt: Parents love to tell me how much their kids LOVE yogurt. It’s no wonder, because yogurt has become the latest sugar delivery product that’s masked in a health food label. A single serving of fruit yogurt may have 3-6 teaspoons of added sugar, making it more like an ice cream dessert than a healthy snack. When introducing yogurt to the youngest members of your family, start with a plain, whole fat yogurt and add fruit for flavor. If you feel it’s still lacking sweetness then drizzle it with the smallest amount of honey (remember honey is only recommended for children over one year of age).

4. Fruit Snacks: Let’s be honest, fruit snacks are hardly healthier than gummy bears. There’s barely any semblance of fruit in these snacks, and they are often artificially colored, sugary and addictive. Instead of adding to your daily intake of added sugar, stick with fresh fruit, the ORIGINAL fruit snack!

5. Juice: This one is trickier because technically the sugar in juice is considered naturally occurring sugar. However, I personally put juice in the category of processed food and consider the sugar in juice as added sugar. There is nothing natural about a child drinking the equivalent of 5 apples worth of sugar. And when we drink apple juice there is no fiber to help slow down the absorption of sugar the way there is when we eat a whole apple. Skip the juice and stick with water for hydration and whole fruit for fiber and nutrients instead. To read more about the American Academy of Pediatrics recommendations on juice and other reasons to skip the juice visit this post.

Stay on the lookout for sneaky sugar in manysavory foods like tomato sauce, crackers, ketchup, and soups. Once you know how to find it, you will see sneaky sugar everywhere! The best way to reduce added sugar is to prepare food yourselves. Check out our recipe catalog on http://recipes.doctoryum.org/ to find lots of delicious recipes with NO added sugar. The good news is, the less added sugars are in your diet, the less you may crave it!

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Sneaky Sugar Handout (printable)