When it comes to sugars and sweeteners, figuring out what is best for your child can feel complicated and noisy. Plus, not all sugars and sweeteners are created equally – so what should you do?
Should children have no sugar at all, opt for sugar alternatives like stevia instead, or go another route entirely? Read on to learn more about sugar, sweeteners, and how to cut through the noise to find balance and best support your growing child.
What are some common types of sugars?
When it comes to sugar, there are many forms that are both naturally occurring and added to foods.
For example:
- Lactose naturally exists in milk.
- Fructose is naturally found in fruits, while high fructose corn syrup is added to many packaged foods.
- Maltose occurs naturally in starchy foods like bread and grains.
- Sucrose, or table sugar, is a refined form of sugar that is commonly added to foods like baked goods, sweets, and snacks.
- Glucose is added to many foods and is a naturally occurring part of maltose, lactose, and sucrose.
Are all sugars created equal?
Each of these sugars behave differently in the body. To start, all sugars are digested in the small intestine and are eventually broken down to glucose to provide energy to the brain, muscles, and the rest of the body. Some sugars are digested and broken down faster for energy, like sucrose and glucose; while others are digested and broken down more slowly, leading to longer lasting energy, like lactose, maltose, and complex carbohydrates like starches. In general, it is suggested by health organizations to reduce added sugars in the diet; while naturally occurring sugars are fine to offer without restriction as part of a balanced diet.1
What can happen when kids have too much sugar?
When foods with too much added sugar are consumed in excess, they can increase the risk of dental cavities, replace other nutritious foods in the diet, and negatively impact a child’s growth patterns.2 That said, having a diet that’s totally free of sugar isn’t realistic for most families and children, nor is it the goal. The goal is to do your best and aim to offer a varied and balanced diet that includes different food groups like fruits, vegetables, proteins, fats, and carbohydrates, with some sweet treats on occasion as it makes sense for your child and family. This way, your child has the energy, nourishment, and joy needed to grow, thrive, and build a positive relationship with all foods.
What are some common alternative sweeteners?
Alternative sweeteners, also known as non-nutritive or low-calorie sweeteners, are a form of sweeteners that tend to be sweeter than table sugar (sucrose) and lower in calories or they can lack calories entirely. While research on alternative sweeteners is limited, especially in children, the literature generally suggests that alternative sweeteners in small amounts and as part of a varied diet are generally safe to offer.3 4 5
Keep in mind that there are a variety of alternative sweeteners and they can all behave differently in the body.
There are two main groups of alternative sweeteners, including:
Artificial alternative sweeteners:
- Aspartame
- Acesulfame potassium (Ace-K)
- Sucralose
- Saccharin
- And many others.
Natural alternative sweeteners:
- Stevia
- Monk fruit (also known as Luo Han Guo)
- Thaumatin
- Polyols (such as sorbitol, mannitol, and xylitol, amongst many others)
- And others.
Are alternative sweeteners safe to offer?
While research is limited, the literature so far suggests that alternative sweeteners are regarded as safe in small amounts in the United States and Europe, as well as by the World Health Organization.6 7 8 They can also be a helpful tool to reduce sugar intake, reduce the risk of dental cavities, and offer alternatives for kids with diabetes.9
Like sugars, not all alternative sweeteners behave the same. In a 2024 review paper by Gauthier et al., the available research suggests that:10
- Using alternative sweeteners in normal amounts is generally not of concern.
- Large amounts of alternative sweeteners like saccharin and sucralose (usually in amounts that would be very difficult to normally consume) may negatively impact blood sugar regulation.
- Polyols like sorbitol may positively support the balance of good bacteria in the gut (or the gut microbiome).
- Using stevia may help reduce the risk of dental cavities and reduce sugar intake.
Takeaway summary:
- When it comes to sugar, aim to reduce added sugar when it’s realistic, and know that naturally occurring forms (like lactose in dairy, or fructose in fruit) are fine to offer without restrictions.
- While more research is needed, most alternative sweeteners are regarded as safe in small amounts and part of a varied diet.
- In general, with sugar and sweeteners, aim for balance, offer a variety of food groups, and remember to have fun with food!
- This way your child has the energy, nourishment, and joy needed to grow, thrive, and build a positive relationship with all foods.
Written by:
Venus S. Kalami, MNSP, RD, CSP
Board-Certified Specialist in Pediatric Nutrition
www.venuskalamird.com
https://www.linkedin.com/in/venuskalami/
Citations:
1 Guideline: Sugars Intake for Adults and Children. Geneva: World Health Organization; 2015. Executive summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285538/
2 Guideline: Sugars Intake for Adults and Children. Geneva: World Health Organization; 2015. Executive summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285538/
3 Gauthier E, Milagro FI, Navas-Carretero S. Effect of low-and non-calorie sweeteners on the gut microbiota: A review of clinical trials and cross-sectional studies. Nutrition. 2024;117:112237. doi:10.1016/j.nut.2023.112237
4 Baker-Smith CM, de Ferranti SD, Cochran WJ; COMMITTEE ON NUTRITION, SECTION ON GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION. The Use of Nonnutritive Sweeteners in Children. Pediatrics. 2019;144(5):e20192765. doi:10.1542/peds.2019-2765
5 US FDA. Aspartame and other sweeteners in food. FDA; 2023 https://www.fda. gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food
6 US FDA. Aspartame and other sweeteners in food. FDA; 2023 https://www.fda. gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food
7 Use of non-sugar sweeteners: WHO guideline. Geneva: World Health Organization; 2023. Executive summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK592245/
8 Baker-Smith CM, de Ferranti SD, Cochran WJ; COMMITTEE ON NUTRITION, SECTION ON GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION. The Use of Nonnutritive Sweeteners in Children. Pediatrics. 2019;144(5):e20192765. doi:10.1542/peds.2019-2765
9 Use of non-sugar sweeteners: WHO guideline. Geneva: World Health Organization; 2023. Executive summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK592245/
10Gauthier E, Milagro FI, Navas-Carretero S. Effect of low-and non-calorie sweeteners on the gut microbiota: A review of clinical trials and cross-sectional studies. Nutrition. 2024;117:112237. doi:10.1016/j.nut.2023.112237
FDA Disclaimer:
The information provided in this blog is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with a healthcare provider before making any changes to your child's diet or health regimen.
