A Child's Sugar Intake and How It Impacts Their Health

Sugars are sweet-tasting carbohydrates that supply the body with energy. The adult brain consumes around 140 g of glucose per day, which can account for up to 50% of total carbohydrate consumption.¹

How Much is Consumed?

In Spain, the consumption pattern of sugar in food has remained pretty constant, while the consumption of soft drinks has increased in the last four years. According to the Spanish national nutrition survey (Encuesta Nacional de Ingesta Dietética de España, ENIDE) (AESAN, 2011), 20% of carbohydrate consumption comes from sugar (sugar, chocolate and derivatives, dairy-free drinks and others).^2,3

Sugar consumption and its association with several potential negative health implications remains a hot topic for debate, however. Excessive sugar intake is linked to a whole range of health risks: obesity, type 2 diabetes, heart diseases, osteoporosis and cancer, although there are not any convincing evidence-based connections with these health concerns.^1,4,5

New WHO Guideline

In the new guideline "Sugars intake for adults and children", the World Health Organization is recommending a reduction in the amount of free sugars consumed over a person's entire lifetime. Both adults and children should reduce free sugar consumption to less than 10% of their total calorie intake. A reduction to less than 5% of total calorie intake would also have additional health benefits.⁶

In Spain, The Spanish Society for Community Nutrition (Sociedad Española de Nutrición Comunitaria, SENC) also suggests not exceeding a 10% share of added sugars and recommends moderate, occasional consumption.⁷

Dental Caries and Sugars

Sugar heavily contributes to the development of dental caries. The presence of sugar raises the speed and extent of plaque build-up and creates the perfect environment in the mouth for bacteria. The development of caries is also influenced by other factors, such as fluoride intake, oral hygiene, food composition, frequency of mealtimes or snacking. Sugar is not the sole cause of dental caries.⁸

The increased risk of caries in children is linked to highly frequent (more than four times a day) consumption of cariogenic sugars (primarily sucrose, glucose and fructose) and not with the total amount of sugar in their diets. There is evidence to suggest that frequent consumption of sweets, confectionery and fizzy drinks is linked to an increased risk of dental caries.^{8, 9, 10}

Recommendations for Children

The World Health Organization and other public health bodies have stated that children should not consume sugar before the age of two. 

To minimise cases of caries over the course of their lives, as well as to decrease their chances of developing metabolic diseases, diabetes, obesity or heart diseases, children between the ages of 2 and 18 should not have a sugar intake of more than 5% of their total calorie intake. What does 5% realistically mean?

Children between the ages of 2 and 18 should only be consuming up to 25 g or 100 calories of sugar per day. For example, two chocolate biscuits contain around 100 calories, which means consuming more than this would push a person over the limit.

The negative effects of caries are cumulative, and they carry over from childhood into adulthood. Since dental caries are the result of life-long exposure to a risky food substance (free sugar) it is also important to reduce the risk of caries in later life. You should keep your intake of free sugar as low as possible, in order to reduce your risk of caries over your entire life.^{6, 11, 12}

Although fluorine can reduce dental caries to a certain extend and delay the start of the cavitation process, it does not completely prevent caries.

Summary

The best dietary advice as far as the general public is concerned is to consume a varied and well-balanced diet with food and nutrients from different sources. This diet should be combined with movement and physical activity. In other words: it is best to consume sugar in moderation.

Frequent consumption of sugary foods can cause increased risk of caries, particularly if no preventative measures are taken. It is not just the amount of sugar consumed that plays a critical role in the development of caries, but also oral hygiene, exposure to fluoride, frequency of consumption and various other factors. 

Dentists should provide their patients with useful dietary advice, including making reference to how a person's consumption of free sugars can be reduced. It is therefore important that health professionals have access to the relevant information. Their ability to advise patients correctly will have a positive effect on the general health of the population.