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New England Journal of Medicine

The 5 Ways Sugar Sneaks Into Your Child’s Diet

Ask 10 parents how much added sugar their child consumes each day and there’s a good chance that at least 9 of them will have no clue or will underestimate it. In fact, research published in the International Journal of Obesity reported that 92 percent of the parents surveyed in the study underestimated the added sugar content in foods and beverages. The study also showed that kids are more likely to be overweight when their parents are misinformed about sugar in their kids’ diet. Since sugar intake is associated with an increased risk of being overweight and parents are a child’s nutritional gatekeeper, it essential that they know the ins and outs of sugar.

“Added sugars have infiltrated our lives in a pervasive way, making it crucial that parents know how to identify it and how much is too much,” says Dr. Nimali Fernando, a Fredericksburg, Virginia-based pediatrician who founded The Doctor Yum Project. “Without solid information regarding sugar intake, we may be setting our children up for possible health problems later.”

According to the American Heart Association, children should consume less than 25 grams of added sugar per day, which is equivalent to 6 teaspoons, and that children under the age of 2 should not have any sugar-added foods or beverages. They report that eating foods high in added sugar throughout childhood is linked to a higher risk of developing such diseases in adulthood as heart disease. It’s also linked to obesity and elevated blood pressure in both children and adults.

Childhood obesity has become a hot-button issue in recent years, as the number of children considered overweight and obese continues to rise, particularly among children age 2-5. According to a recent report in the New England Journal of Medicine, 57 percent of today’s children are predicted to be obese by age 35.

Parents are often confused when it comes to sugar intake with their children. Sugar that comes in the form of whole fruit is generally good, while added sugar is what parents need to really watch. Added sugars are those sugars that have been used by the food industry to enhance a food’s flavor. While a piece of fruit is a good choice, “fruit snacks” (the kind that come look like soft candy, for example) may not be, because of the added sugars. Even some foods that seem healthy may contain “hidden” added sugars, making it important for parents to get to know the terms and become label readers.

Here are 5 ways for parents to become savvy about the sneaky ways food companies add sugar to foods:

  1. Confusing food labels. Figuring out how many added teaspoons are in a recipe is not 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. 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. Luckily, by the end of 2018 most food labels will be updated to break down total vs added sugar which will make reading a label more straightforward.
  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 a half a cup or less than a cup per serving, which is much smaller than most people will actually eat (especially if it’s really sweet, because 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, the recommended daily limit for a child.
  3. Sweetening with “healthier” sugars. Sweeteners like honey, agave and maple syrup may make a food appear healthier, but that doesn’t mean they actually are. While they may be more natural than refined sugar, manufacturers are still adding sugar to a food that may not need extra sweetness. Don’t be fooled by healthier sounding added sweetener ingredients.
  4. Using sneaky names for sugar. Sometime 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. Know the sneakiest foods. There are some foods that seem to have hidden sugars in them more often than others. Be aware of and read the labels carefully on such foods as granola bars, breakfast cereals, yogurt, fruit snacks, and juice. Juice is trickier because technically the sugar in juice is considered naturally occurring. However, it’s more like a processed food. 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 the way there is when we eat an apple. Skip the juice and stick with water for hydration and whole fruit for fiber and nutrients instead.

“Childhood is where many of our food habits are formed, making it that much more important that we help our children learn to sensibly navigate the nutritional landscape,” added Heidi DiEugenio, director of the Doctor Yum Project. “The more we can help them learn better and healthier food habits now, the more they will benefit from those choices and habits into the future.”

Study: Inducing Pregnant Women At Term Reduces C-Section Rate

From NPR, a new report and study suggests that inducing pregnant women at term or close to term actually reduces the C-Section Rate. Listen and follow below:



Healthy women with normal pregnancies can opt to have labor induced without worrying that the decision will make a cesarean section more likely, according to a major study published in this week’s New England Journal of Medicine.

Obstetricians currently induce labor when a delivery has failed to progress, or if a woman is far overdue for giving birth. But when women who have no medical need for induced labor have talked to their doctors, “We’ve been saying, ‘Well you know one thing you need to know is it does increase the C-section rate,’ ” says. Dr. Uma Reddy, an obstetrics researcher at the National Institute of Child Health and Human Development.

That advice was based on some older medical research. But researchers had doubts about that conclusion. So Reddy helped organize a study involving more than 6,000 first-time mothers with uncomplicated pregnancies, to put the idea to the test.

Half the pregnant women followed the normal course of labor; the other half had labor induced when the baby was full term, at 39 weeks. Overall, mothers and babies did fine when labor was induced with a drug.

“I think the most surprising finding was a decrease in the C-section rate,” Reddy says.

That rate dropped from 22 percent among the women who weren’t automatically induced to 19 percent for those whose labor was induced. Dr. William Grobman, the study’s first author and a professor of obstetrics at Northwestern University, says it’s an important goal to reduce the rate of cesarean sections in the U.S. So even a small percentage drop in the rate can have benefits overall.

But an individual woman might or might not consider that 3-percentage-point drop a big deal. “I think that’s not really for me to decide,” he says. “I think that’s for patients to decide.

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Two Studies this week extol the virtue of exposing kids to germs

Two new studies were released this week that addressed those uber cautious new parents who go above and beyond to protect their babies from dirt, germs and potentially dangerous foods to the point they end up contributing to their children developing dangerous allergies. 
One study found that parents who give their children peanut products early in life can prevent them from becoming allergic to peanuts. The trial was done on 600 babies worldwide with high risk of developing a peanut allergy. The study was published in the New England Journal of Medicine. Currently, about 400,000 US children have peanut allergies, CNN  reports
A separate Swedish study published in the journal Pediatrics found that children who lived in homes where the dishes were washed by hand were less likely to develop allergic asthma or eczema compared to children living in homes with a machine dishwasher. Researchers surveyed over 1,000 families with children between the ages of 7 and 8,
Here too there is a suggestion that exposure to an array of microbes in early life helps a child develop a healthy immune system.
Both developments speak to the importance of not going overboard to shield babies and children from germs because parents may be doing them more harm than good. 

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