Sugar, Salt, Fat: Less is Best!

Most parents look forward to their children’s annual physicals to see how that mark on the kitchen wall will compare to the pediatric growth chart.Growth spurts are natural and expected in kids. But adult diseases like diabetes, heart disease, and fatty liver are not. Unfortunately, recent research indicates that 1 in 3 children are obese. With unwanted weight gain comes unexpected chronic diseases. 1While I don’t advocate for putting kids on weight loss diets, it’s important to pay attention to what’s in their beverage bottles and backpacks.Last week we took a look at the top 10 nutrients kids need to learn and grow. In this second post for Let’s Get Kids Healthy, we’ll take a look at what kids are eating (and drinking) the most, then give some guidance on obesity prevention.How Sweet It Isn’t:It’s no surprise that sugar tops the list of what kids should consume in moderation. From sugar-sweetened cereal in the morning to granola bars for snacks and sports drinks after school, our kids are on sugar overload.A recent Chinese study indicates that sugar is one of the key causes of weight gain in children and teens. The study (in over 1800 children and teens combined) found that excess sugar from sugar-sweetened beverages (SSBs) was consumed by 44% of overweight and obese subjects. The threshold to cause weight gain was 25 grams per day, equivalent to 8 ¼ teaspoons daily. Efforts to reduce sugar should be made to reduce the chance of weight gain. 2A systematic review evaluating beverage intake in children and adults also found that the majority of studies (80%) showed a correlation between SSB intake and adiposity. Results were not always consistent within studies that had various outcome measures. The same was not true in children consuming 100% juice, though it is still a source of calories. 3Pass the Salt, PleaseAs the availability of fast food and snacks increases, so will sodium consumption in kids. Too much sodium is linked with hypertension and heart disease, even at young ages. A recent study evaluating the salt intake of children compared to their parents found that 91% of children consumed more than the recommended daily allowance for sodium. Kids’ sodium intake mimicked their mothers more than their fathers. Almost 60% of the 633 children studied had sodium intakes that exceeded their parents. 4A recent study in Nutrients also points to salt and sugar intake as an issue in kids. Children have a natural taste for sweets as infants and their taste for salty food develops within a few weeks of age. If they develop a habit of salting food at the table or consuming higher-sodium foods, their intake may extend into adulthood, which puts them at further risk for essential hypertension and arterial disease. 5Fat, Fat, FatAccompanying many sugary treats and fried, salty snacks is dietary fat. While avocado slices, nuts, and seeds provide essential fatty acids and important micronutrients like zinc and potassium, trans and saturated fats in snacks and fast food aren’t doing kids any favors.As mentioned previously, weight gain may be associated with fatty liver disease, even in children. A recent study found that a Western-style diet of refined carbohydrates and fried foods was positively associated with hepatic fat fraction -- a measure of fat content in the liver.The study in nearly 400 multi-ethnic youth showed that those following a diet high in fruits and vegetables had lower hepatic fat while a Western diet was associated with higher hepatic fat fraction. 5Reducing saturated and trans fat in children’s diets may also improve their lipids and blood pressure. A systematic review of randomized control trials in children aged 2 to 19 indicated that a diet low in saturated fat reduced total cholesterol, LDL, and blood pressure compared to control diets. Reducing these fats may aid in lowering the risk for cardiovascular disease later in life. 6How Can We Reduce Obesity and Disease in Kids?

1. Teach your clients how to read labels. Give them guidance on acceptable, realistic limits on sugar, fat, and sodium.
2. Substitute seltzer water for sugary soda.
3. Be a role model. Add more fruits and veggies to your meals or snacks and be sure to have your kids see you eating them.
4. Don’t reward kids for finishing everything on their plate. This only encourages overeating!
5. Make simple meals at home like black beans and rice and reduce fast food intake. This cuts back on sugar, fat, and sodium as well as cost!
6. Choose lightly salted nuts or seeds over fried chips for snacks.
7. Offer fruit for dessert in place of ice cream, pastries or other treats.
8. Give kids stickers over suckers for a job well done.

By Lisa Andrews, MEd, RD, LDFree Handout: Help Kids Stay HealthyReferences:

1. Kumar S, Kelly AS. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc. 2017 Feb;92(2):251-265. doi: 10.1016/j.mayocp.2016.09.017. Epub 2017 Jan 5. PMID: 28065514..
2. Yu L, Zhou H, Zheng F, Song J, Lu Y, Yu X, Zhao C. Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB). Front Nutr. 2022 Jun 28;9:885704. doi: 10.3389/fnut.2022.885704. PMID: 35836588; PMCID: PMC9274200.
3. Mayer-Davis E, Leidy H, Mattes R, Naimi T, Novotny R, Schneeman B, Kingshipp BJ, Spill M, Cole NC, Bahnfleth CL, Butera G, Terry N, Obbagy J. Beverage Consumption and Growth, Size, Body Composition, and Risk of Overweight and Obesity: A Systematic Review [Internet]. Alexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul. PMID: 35349233.
4. Genovesi S, Giussani M, Orlando A, Orgiu F, Parati G. Salt and Sugar: Two Enemies of Healthy Blood Pressure in Children. Nutrients. 2021 Feb 22;13(2):697. doi: 10.3390/nu13020697. PMID: 33671538; PMCID: PMC7927006.
5. Perng W, Harte R, Ringham BM, Baylin A, Bellatorre A, Scherzinger A, Goran MI, Dabelea D. A Prudent dietary pattern is inversely associated with liver fat content among multi-ethnic youth. Pediatr Obes. 2021 Jun;16(6):e12758. doi: 10.1111/ijpo.12758. Epub 2020 Dec 9. PMID: 33296951.
6. Te Morenga L, Montez JM. Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis. PLoS One. 2017 Nov 17;12(11):e0186672. doi: 10.1371/journal.pone.0186672. PMID: 29149184; PMCID: PMC5693282.