Let’s play a game, see if you can pick the odd one out from the items listed below:

Set 1- Child, play, blood pressure    

Set 2- Adolescent, Type 2 diabetes, sports

If you chose- blood pressure and Type 2 diabetes, those may seem like natural choices!  It does not seem right to link these 2 words to a young child or adolescent. 

But take a moment to think again.   An article published in- Indian Paediatrics’ states- ‘The emergence of obesity and T2DM in children is a feature of the growing tide of chronic diseases and can be viewed as a symptom of the changing social norms and lifestyle resulting from urbanization and economic development.’ The Article published in 2010 calls for promoting healthier lifestyles among Indian children and teenagers. (1)

One of the culprits for the rise of obesity, blood pressure and diabetes in our children is sugar. Those seemingly harmless sparkling white crystals seem to invade our children’s diet off late. Working parents may not have time to prepare healthy food and may rely on packaged or ready to eat foods. A bowlful of cereal for breakfast, chocolate chip cookies during mid-morning break… our kids are at risk of consuming too much sugar. The American Heart Association and the World Health Organization have recognized the need to revise guidelines. They now state, “children eat no more than 12 grams or 3 teaspoons of sugar per day. Similarly, the World Health Organization (WHO) guidelines suggest that people eat less than 5% of their daily calories from sugar, versus the previous suggestion of 10%.” (2)

How can we as parents and caretakers wean our children away from this not so sweet sugar fix? We need to take a step in the right direction. Timely intervention will help create a safer and healthier tomorrow for them.

Drinks: A young child needs only water and milk. Fizzy drinks, sodas and packaged fruit juices come loaded with sugar and colour and are devoid of nutrients or fiber. Save juice for special occasions or treats. Let your child take water with meals and milk as a healthy beverage with breakfast or in the evening. Eating fruit is better than fruit juice. For one thing, fruit contains fiber and this gives satiety. Fruit juice, even the 100% kind is devoid of pulp (and fiber) and require more fruits (and more sugar) to make a single glass of juice.  For older children, you can try infused water or freeze fruit in ice cubes. During hot weather, toss an ice cube into their regular water for an added twist.

Hidden Sugars: Manufacturers are sneaky enough to hide sugar under various complicated sounding names like- high fructose corn syrup, cane sugar, nature identical flavouring substances, honey, molasses etc. Even foods that are not thought of as ‘sweet’ like sauces, ketchup, ready to eat meals and soups can contain hidden sugars. It is therefore best to ditch any kind of processed foods and take time to cook healthy meals at home. This gives one control over the amount and type of ingredients being added.

Breakfast Cereals: Cereals with words like Frosties, Chocos etc are bound to have an excess amount of sugar in them. 30 g (1 serving) of Frosties cereal contains 11 g of sugar and 140 mg of sodium, it contains just 0.7g of dietary fiber (3). With the new recommendations, a bowlful of cereal would meet your child’s sugar intake for the whole day! But we do not just stop here, through the day our children snack on biscuits, candy and sweets with amounts that far exceed the recommended guidelines.

What are the alternatives?
•    As strange as this may seem, do not put brakes on a sweet treat once in a while. Instead try downsizing portions. 
•    Try substituting creamy and sugary desserts with fruit. Pinterest and various cooking websites have several healthy fruit based dessert ideas that appeal to children.
•    Avoid ready to eat cereals and try cooking healthy Indian breakfast dishes at home. Options like vegetable upma are loaded with healthy vegetables minus the sugar. You could also try oats or ragi based porridges with fresh fruit and nuts.
•    Avoid fat free foods for children. These don’t live up to their name! To compensate for the low fat/ fat free claim, these products are usually loaded with sugar. A small portion of regular unsweetened yogurt or curd with fruit pulp makes a healthier version of the store-bought versions.
•    Snacks for school: Plan ahead parents! Take some time to think of healthy snacks for your child. Options include- vegetable sticks with hummus, fresh fruit, a handful of nuts (almond, cashew, walnuts).
•    Enforce healthy eating habits: Instead of saying things like, “Sugar is bad for you, you will get cavities.” Say things like- “vegetables and fruits are full of nutrients that will keep you healthy.” Highlight foods with specific functions, you can explain to them that milk will ‘help your bones grow strong’.
•    Parents, listen up! You are a very important role model to your child. As in other areas of a child’s development, it is important you set a good example when it comes to healthy eating.  A child’s eating habits and food preferences follow what is being cooked at home. Avoid shopping for unhealthy, sugary snacks like biscuits, cakes, pastries and desserts. When you go out to eat as a family, try skipping dessert or order something healthy like a fresh fruit salad without cream or ice cream. 

References:
1.    M. Venkat Narayan, Type 2 Diabetes in Children: A Problem Lurking for India? Indian Pediatrics 2001; 38: 701-704 
2.    http://blog.cincinnatichildrens.org/healthy-living/5-simple-ways-to-reduce-sugar-in-your-childs-diet/
3.    https://www.google.co.in/search?q=hidden+sugar&oq=hidden+sugar&aqs=chrome..69i57j0l5.3758j0j7&sourceid=chrome&ie=UTF-8#q=frosties+nutritional+information

With inputs from:
1.    http://www.todaysdietitian.com/newarchives/1216p28.shtml\
2.    http://blog.cincinnatichildrens.org/healthy-living/5-simple-ways-to-reduce-sugar-in-your-childs-diet/
3.    http://you.naturesplus.com/curbing-kids-sugar-intake-lead-to-healthier-happier-lifestyle/
4.    https://consumer.healthday.com/diabetes-information-10/sugar-health-news-644/eliminate-sweetened-drinks-cut-kids-sugar-intake-715149.html
5.    http://www.myfussyeater.com/10-easy-ways-to-reduce-sugar-in-your-kids-diet/
6.    http://pharmacytoday.org/article/S1042-0991(16)30948-3/pdf
7.    http://edition.cnn.com/2016/11/02/health/sugar-limits-for-children/index.html
8.    https://authoritynutrition.com/18-surprising-foods-high-in-sugar/
9.    Ramachandran A, Mohan V, Snehalatha C, Bharani G, Chinnikrishnudu M, Mohan R, et al. Clinical features of diabetes in the young as seen at a diabetes center in south India. Diabetes Res Clin Pract 1988; 4: 117-125