How Much Free Sugars Intake Should Be Recommended for Children Younger Than 2 Years Old?

How Much Free Sugars Intake Should Be Recommended for Children Younger Than 2 Years Old? JPGN Volume 66, Number 3, March 2018 Letters to the Editor REFERENCES 3. Mennella JA, Bobowski NK, Reed DR. The development of sweet taste: From biology to hedonics. Rev Endocr Metab Disord 2016;17: 171–8. 1. Zizzo AN, Valentino PL, Shah PS, et al. Second-line agents in pediatric 4. Welsh JA, Welsh JA1, Sharma A, et al. Consumption of added sugars and patients with autoimmune hepatitis: a systematic review and meta- indicators of cardiovascular disease risk among US adolescents. Circula- analysis. J Pediatr Gastroenterol Nutr 2017;65:6–15. tion 2011;123:249–57. 2. Sciveres M, Caprai S, Palla G, et al. Effectiveness and safety of 5. Harrison D, Stevens B, Bueno M, et al. Efficacy of sweet solutions for ciclosporin as therapy for autoimmune diseases of the liver in children analgesia in infants between 1 and 12 months of age: a systematic review. and adolescents. Aliment Pharmacol Ther 2004;19:209–17. Arch Dis Child 2010;95:406–13. 3. Czaja AJ. Autoimmune hepatitis: focusing on treatments other than 6. Vos MB, Kaar JL, Welsh JA, et al., American Heart Association steroids. Can J Gastroenterol 2012;26:615–20. Nutrition Committee of the Council on Lifestyle and Cardiometabolic 4. Alvarez F, Ciocca M, Can˜ero-Velasco C, et al. Short-term cyclosporine Health; Council on Clinical Cardiology; Council on Cardiovascular induces a remission of autoimmune hepatitis in children. Hepatol 1999; Disease in the Young; Council on Cardiovascular and Stroke Nursing; 30:222–7. Council on Epidemiology and Prevention; Council on Functional 5. Cuarterolo M, Ciocca M, Velasco CC, et al. Follow-up of children with Genomics and Translational Biology; and Council on Hypertensio- autoimmune hepatitis treated with cyclosporine. J Pediatr Gastroenterol nAdded sugars and cardiovascular disease risk in children. A scientific Nutr 2006;43:635–9. statement from the American Heart Association. Circulation 2017;135: e1017–34. How Much Free Sugars Intake Should Response to Letter: How Much Free Be Recommended for Children Sugars Intake Should Be Younger Than 2 Years Old? Recommended for Children Younger Than 2 Years Old? o the Editor: A recent publication addressed the European Society for Paediatric, Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition position about eply: Dr Vitolo (1) asks what led the ESPGHAN CoN ‘‘to sugar in infants, children, and adolescents (1). Based on the step away from a definite statement about sugar intake and World Health Organization guideline (2), the Committee stated infants’’ in our recent Position paper (2). We would like to clarify that free sugar intake should be less than 5% of total calories for that our recommendation certainly does not mean that we are children and adolescents aged 2 to 18 years, suggesting that this ‘‘stepping away’’ or establishing a ‘‘safe amount’’ of sugars for figure should be lower to children younger than 2 years old. this age group. Establish a safe amount of sugar for infants may be a mistake The American Heart Association (AHA) recommends that because the evidence for this age group goes to the direction of ‘‘added’’ sugars should be avoided for children younger than 2 years nonexposure to the sweet taste early in life. Sweet taste experi- (3). As explained in our article, the European Food Safety Authority ence in infancy triggers the preference for this flavor, which will (EFSA) and US definitions of ‘‘added sugars’’ (4,5) do not include determine children’s poor dietary habits and consequently be a sugars present in unsweetened fruit and vegetable juice and fruit risk factor for noncommunicable diseases (3,4). Is the pediatric juice concentrate, all of which are, however, captured in the WHO clinical use of sugar as an analgesic agent during painful pro- definition of free sugars (6), which we favour. Thus, children younger cedures the main reason for the Committee to step away from a than 2 years who drink fruit juices and/or consume fruit juice definite statement about sugar intake and infants (5)? Guidelines concentrate, jellies, jams, preserves, and fruit spreads would still are intended for the general population and not for an individual be following the AHA recommendation to avoid added sugars, whilst one, which should be left open for the professional in clinical and still consuming ‘‘free’’ sugars. Our recommendations state that technical responsibility. Therefore, based on evidence, the Amer- ‘‘there is no nutritional requirement for free sugars in infants, children ican Heart Association committee recommended (6): ‘‘Because and adolescents’’ and suggest that the intake in those younger than there is minimal room for nutrient-free calories in the habitual 2 years should ‘‘probably be even lower’’ than the less than 5% of diets of very young children, added sugars should be avoided in energy intake recommended for older children (2), partly considering the diet of children <2 years of age’’. That is the statement we are the potential for sugar in infancy to influence taste and/or food expecting to be internationally widespread and hopefully help to preferences. We, however, did not provide a definitive figure because build a healthy food environment for children. we found the evidence-base for doing so in this age group is not sufficiently robust, consisting largely of observational studies. Marcia Regina Vitolo Furthermore, we have noted throughout the article the need Graduate Program of Health Sciences, Universidade Federal de to limit the intake of free sugars at all ages, and to clarify the ˆ ´ Ciencias da Saude de Porto Alegre Brazil terminology and labelling of sugars because consumers may not be aware that free sugars are present in foods and beverages, even when they are labelled as having ‘‘no added sugar’’ and ‘‘naturally REFERENCES occurring sugars.’’ We hope that such measures would contribute to 1. Mis NF, Braegger C, Bronsky J, et al., ESPGHAN Committee on building a healthier food environment for infants and children. NutritionSugar in infants, children and adolescents: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and ESPGHAN Committee on Nutrition Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017. y z Natasˇa Fidler Mis, Christian Braegger, Jiri Bronsky, [Epub ahead of print]. § jj Cristina Campoy, Magnus Domello ¨ f, Nicholas D. Embleton, 2. World Health OrganizationGuideline: Sugars Intake for Adults and #  yy Children Geneva, Switzerland: World Health Organization; 2015. Iva Hojsak, Jessie Hulst, Flavia Indrio, www.jpgn.org e87 Copyright © ESPGHAN and NASPGHAN. All rights reserved. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Pediatric Gastroenterology & Nutrition Wolters Kluwer Health

How Much Free Sugars Intake Should Be Recommended for Children Younger Than 2 Years Old?

Free
1 page

Loading next page...
1 Page
 
/lp/wolters_kluwer/how-much-free-sugars-intake-should-be-recommended-for-children-younger-9FAEugwkrk
Publisher
Wolters Kluwer
Copyright
Copyright © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
ISSN
0277-2116
eISSN
1536-4801
D.O.I.
10.1097/MPG.0000000000001802
Publisher site
See Article on Publisher Site

Abstract

JPGN Volume 66, Number 3, March 2018 Letters to the Editor REFERENCES 3. Mennella JA, Bobowski NK, Reed DR. The development of sweet taste: From biology to hedonics. Rev Endocr Metab Disord 2016;17: 171–8. 1. Zizzo AN, Valentino PL, Shah PS, et al. Second-line agents in pediatric 4. Welsh JA, Welsh JA1, Sharma A, et al. Consumption of added sugars and patients with autoimmune hepatitis: a systematic review and meta- indicators of cardiovascular disease risk among US adolescents. Circula- analysis. J Pediatr Gastroenterol Nutr 2017;65:6–15. tion 2011;123:249–57. 2. Sciveres M, Caprai S, Palla G, et al. Effectiveness and safety of 5. Harrison D, Stevens B, Bueno M, et al. Efficacy of sweet solutions for ciclosporin as therapy for autoimmune diseases of the liver in children analgesia in infants between 1 and 12 months of age: a systematic review. and adolescents. Aliment Pharmacol Ther 2004;19:209–17. Arch Dis Child 2010;95:406–13. 3. Czaja AJ. Autoimmune hepatitis: focusing on treatments other than 6. Vos MB, Kaar JL, Welsh JA, et al., American Heart Association steroids. Can J Gastroenterol 2012;26:615–20. Nutrition Committee of the Council on Lifestyle and Cardiometabolic 4. Alvarez F, Ciocca M, Can˜ero-Velasco C, et al. Short-term cyclosporine Health; Council on Clinical Cardiology; Council on Cardiovascular induces a remission of autoimmune hepatitis in children. Hepatol 1999; Disease in the Young; Council on Cardiovascular and Stroke Nursing; 30:222–7. Council on Epidemiology and Prevention; Council on Functional 5. Cuarterolo M, Ciocca M, Velasco CC, et al. Follow-up of children with Genomics and Translational Biology; and Council on Hypertensio- autoimmune hepatitis treated with cyclosporine. J Pediatr Gastroenterol nAdded sugars and cardiovascular disease risk in children. A scientific Nutr 2006;43:635–9. statement from the American Heart Association. Circulation 2017;135: e1017–34. How Much Free Sugars Intake Should Response to Letter: How Much Free Be Recommended for Children Sugars Intake Should Be Younger Than 2 Years Old? Recommended for Children Younger Than 2 Years Old? o the Editor: A recent publication addressed the European Society for Paediatric, Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition position about eply: Dr Vitolo (1) asks what led the ESPGHAN CoN ‘‘to sugar in infants, children, and adolescents (1). Based on the step away from a definite statement about sugar intake and World Health Organization guideline (2), the Committee stated infants’’ in our recent Position paper (2). We would like to clarify that free sugar intake should be less than 5% of total calories for that our recommendation certainly does not mean that we are children and adolescents aged 2 to 18 years, suggesting that this ‘‘stepping away’’ or establishing a ‘‘safe amount’’ of sugars for figure should be lower to children younger than 2 years old. this age group. Establish a safe amount of sugar for infants may be a mistake The American Heart Association (AHA) recommends that because the evidence for this age group goes to the direction of ‘‘added’’ sugars should be avoided for children younger than 2 years nonexposure to the sweet taste early in life. Sweet taste experi- (3). As explained in our article, the European Food Safety Authority ence in infancy triggers the preference for this flavor, which will (EFSA) and US definitions of ‘‘added sugars’’ (4,5) do not include determine children’s poor dietary habits and consequently be a sugars present in unsweetened fruit and vegetable juice and fruit risk factor for noncommunicable diseases (3,4). Is the pediatric juice concentrate, all of which are, however, captured in the WHO clinical use of sugar as an analgesic agent during painful pro- definition of free sugars (6), which we favour. Thus, children younger cedures the main reason for the Committee to step away from a than 2 years who drink fruit juices and/or consume fruit juice definite statement about sugar intake and infants (5)? Guidelines concentrate, jellies, jams, preserves, and fruit spreads would still are intended for the general population and not for an individual be following the AHA recommendation to avoid added sugars, whilst one, which should be left open for the professional in clinical and still consuming ‘‘free’’ sugars. Our recommendations state that technical responsibility. Therefore, based on evidence, the Amer- ‘‘there is no nutritional requirement for free sugars in infants, children ican Heart Association committee recommended (6): ‘‘Because and adolescents’’ and suggest that the intake in those younger than there is minimal room for nutrient-free calories in the habitual 2 years should ‘‘probably be even lower’’ than the less than 5% of diets of very young children, added sugars should be avoided in energy intake recommended for older children (2), partly considering the diet of children <2 years of age’’. That is the statement we are the potential for sugar in infancy to influence taste and/or food expecting to be internationally widespread and hopefully help to preferences. We, however, did not provide a definitive figure because build a healthy food environment for children. we found the evidence-base for doing so in this age group is not sufficiently robust, consisting largely of observational studies. Marcia Regina Vitolo Furthermore, we have noted throughout the article the need Graduate Program of Health Sciences, Universidade Federal de to limit the intake of free sugars at all ages, and to clarify the ˆ ´ Ciencias da Saude de Porto Alegre Brazil terminology and labelling of sugars because consumers may not be aware that free sugars are present in foods and beverages, even when they are labelled as having ‘‘no added sugar’’ and ‘‘naturally REFERENCES occurring sugars.’’ We hope that such measures would contribute to 1. Mis NF, Braegger C, Bronsky J, et al., ESPGHAN Committee on building a healthier food environment for infants and children. NutritionSugar in infants, children and adolescents: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and ESPGHAN Committee on Nutrition Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017. y z Natasˇa Fidler Mis, Christian Braegger, Jiri Bronsky, [Epub ahead of print]. § jj Cristina Campoy, Magnus Domello ¨ f, Nicholas D. Embleton, 2. World Health OrganizationGuideline: Sugars Intake for Adults and #  yy Children Geneva, Switzerland: World Health Organization; 2015. Iva Hojsak, Jessie Hulst, Flavia Indrio, www.jpgn.org e87 Copyright © ESPGHAN and NASPGHAN. All rights reserved.

Journal

Journal of Pediatric Gastroenterology & NutritionWolters Kluwer Health

Published: Mar 1, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off