Every Bite Counts: Is there room for added sugar in babies diet?
My sweet little Winston at 6 months old enjoying some plain whole milk yogurt with fresh fruit.
“Every bite counts”. Nutritional exposures during the first 1,000 days of life not only contribute to long-term health but also help shape taste preferences and food choices. Newborn babies have an innate preference for sweet flavor, and human milk contains much higher levels of lactose, the naturally occurring sugar found in milk, compared to cow or goat milk. Sweetness evokes a positive hedonic response across the lifespan, but infants and toddlers consistently prefer more concentrated sugar than adults.
RECOMMENDED SUGAR INTAKE FOR BABIES
Over the Summer of 2020, the US advisory panel proposed the first-ever plan for infants and toddlers for the 2020 dietary guidelines for Americans. One key takeaway is no amount of added sugar is ok for a baby’s development. The committee stated to avoid foods and beverages with added sugars during the first 2 years of life compared to the previous 2015-2020 guidelines which stated a maximum limit of less than 10 percent of calories from added sugars in all age groups.
SUGAR INTAKE OF TODDLERS
In the transition year from 12 to 24 months, breastmilk/formula is typically replaced by cows milk with greater emphasis on complementary foods. High-energy, low-quality foods were commonly offered to toddlers between 6 and 24 months, for instance, 1 in 3 toddlers consumed candy, 2 in 5 consumed dessert items, and 1 in 10 consumed frozen dairy desserts. Research shows that 1 in 4 American toddlers consume less than one vegetable per day, and instead are more likely to consume sweet and salty tasting snacks. Further, by age 4, most children’s calories come from sweets (>15%) whereas ~5% come from vegetables. Research found that infants learn about flavors of foods well before their first taste of solid foods from the transmission of dietary volatiles from the mothers’ diet to the infants’ via amniotic fluid and breast milk.
FIRST 1,000 DAYS OF LIFE PROVIDE A WINDOW OF OPPORTUNITY
Gestation and the first two years of life represent a “window of opportunity” for humans to learn to eat nutritious diets that help to protect against the risk of childhood obesity. This sensitive period lays the foundation for flavor preference throughout life since humans are born with an innate taste preference for sweet, and a rejection or sour/bitter tastes. The first 1,000 days of life are a crucial time to facilitate the acceptance of the bitter flavors most commonly found in vegetables. Repeated exposure to these foods is necessary so that infants and toddlers learn to like them. It may take 10 or even 15 times of exposure to induce acceptance of novel flavors and textures and so it is important for caregivers to offer new foods repeatedly and in novel ways such as offering bitter or sour foods when hunger is highest.
SUGAR AND CHILDREN’S HEALTH
Added sugars are not naturally found in foods and consist largely of high fructose corn syrup and sucrose. Evidence suggests that diets high in added sugars, especially fructose, cause dysregulation of lipid and carbohydrate metabolism. There are approximately 43 million children aged 0 to 5 years old worldwide who are overweight or obese representing an increase in the prevalence of 60% since 1990. Parents are key influencers regarding the development and maintenance of children’s eating behaviors. Infant feeding practices, the timing and introduction of solids, children’s eating habits, and time spent watching television are among the most identifiable factors that contribute to early-onset of childhood obesity.
Exposing infants to a wide variety of healthy foods and different textures while limiting exposure to sweet and salty foods allows infants to develop healthy food preferences. Children’s diets are saturated with inexpensive “palate pleases” of sugar creating a need for greater public health efforts to change the marketing practices and foods targeted towards these very young consumers.
DON’T ASSUME PRODUCTS MARKETED TOWARDS BABIES DO NOT INCLUDE ADDED SUGAR
Parents may simply assume that foods marketed towards babies and toddlers will adhere to higher nutritional standards and may not scrutinize the label so much. For example, teething biscuits are marketed to parents as teething aids, not cookies, making it reasonable to assume they will not contain added sugars or a lower sugar profile, but many contained sugar hidden below multiple flours on the ingredient list.
BOTTOM LINE
The first 1,000 days from conception to a baby’s second birthday are a key time when parents and caregivers have the opportunity to set their baseline and taste preferences. To prevent obesity and its associated problems, added sugars during pregnancy and throughout infancy should be avoided. Begin introducing a variety of tastes and textures from various healthy foods to develop their palette from a young age.
REFERENCES
Rodgers A. Executive Summary. Published online 2020:13.
Murray RD. Savoring Sweet: Sugars in Infant and Toddler Feeding. Ann Nutr Metab. 2017;70 Suppl 3:38-46. doi:10.1159/000479246
USDA: Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Published online July 2020.
Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach. Published online February 2017. https://healthyeatingresearch.org/wp-content/uploads/2017/02/her_feeding_guidelines_report_021416-1.pdf
Stanhope KL. Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci. 2016;53(1):52-67. doi:10.3109/10408363.2015.1084990
Campbell KJ, Lioret S, McNaughton SA, et al. A Parent-Focused Intervention to Reduce Infant Obesity Risk Behaviors: A Randomized Trial. Pediatrics. 2013;131(4):652-660. doi:10.1542/peds.2012-2576
Wen LM, Baur LA, Simpson JM, Rissel C, Wardle K, Flood VM. Effectiveness of home based early intervention on children’s BMI at age 2: randomised controlled trial. BMJ. 2012;344. doi:10.1136/bmj.e3732
Elliott CD, Conlon MJ. Packaged baby and toddler foods: questions of sugar and sodium. Pediatr Obes. 2015;10(2):149-155. doi:https://doi.org/10.1111/j.2047-6310.2014.223.x
