Candy Crushed

Our kids were get­ting too much su­gar, so my wife and I took mat­ters into our own hands

The Walrus - - CONTENTS - by Yoni Freed­hoff

The email from our eightyear-old daugh­ter’s camp— the same one I at­tended when I was her age — asked us to pack her favourite junk food to share with her bunk mates on their first night. Fun­nily, I didn’t re­mem­ber a junk-food party from back when. My wife, Stacey, and I chat­ted some and, de­spite our reser­va­tions, even­tu­ally de­cided to send along our daugh­ter’s favourite chips; we as­sumed the bulk of what she’d be of­fered there would be sweet.

As a par­ent and as a doc­tor, I am wor­ried about su­gar. In my day job, I work with par­ents in an On­tario Min­istry of Health– funded, year-long child­hood-obe­sity pro­gram; as a fa­ther of three, my van­tage is also per­sonal. There’s no doubt that ex­cess su­gar is not in our chil­dren’s best in­ter­ests. The World Health Or­ga­ni­za­tion, the Amer­i­can Heart As­so­ci­a­tion, and Canada’s Heart and Stroke Foun­da­tion have all called for strict lim­its on added sug­ars—a daily max­i­mum of be­tween six to twelve added tea­spoons for adults, and no more than six for kids. (I es­ti­mate that my daugh­ter was of­fered an av­er­age of sixty-three tea­spoons of added su­gar a day dur­ing her week-long stay at camp .)

Some re­searchers sug­gest that su­gar is in and of it­self uniquely and dra­mat­i­cally toxic — that in­de­pen­dent of its ef­fect on weight, su­gar in­creases the risk of heart dis­ease, di­a­betes, fatty liver dis­ease, and other ill­nesses. Oth­ers see su­gar as a driver of ill­ness only in terms of its con­tri­bu­tion to weight gain. I’m not wholly con­vinced that added and free sug­ars — those in­cor­po­rated into foods dur­ing pro­cess­ing or prepa­ra­tion and those found in hon­eys, syrups, and fruit juices — are markedly worse than highly re­fined car­bo­hy­drates, but I also don’t think we need to wait for a med­i­cal con­sen­sus on su­gar’s in­her­ent tox­i­c­ity in light of the sheer quan­ti­ties of it this gen­er­a­tion of chil­dren is con­sum­ing.

What I can say with cer­tainty is that the world has be­come one gi­ant candy store. Its su­gar “push­ers”—a term gen­er­ally as­so­ci­ated with those who en­cour­age the use of recre­ational drugs, and which I am us­ing in­ten­tion­ally—are ev­ery­where. There are push­ers in schools, hawk­ing candy as a re­ward for good be­hav­iour. There are push­ers in our parks, sling­ing sport drinks as a re­ward just for show­ing up to play. There are push­ers in our gro­cery stores, sell­ing choco­late bars to sup­port lo­cal char­i­ties. There are push­ers in our friends’ homes, hand­ing out loot bags and just be­cause treats. At fam­ily gath­er­ings, su­gar push­ers are of­ten bet­ter known by the names Grandma and Grandpa (or, in my kids’ case, Bub­bie and Zaidi). How­ever, un­like drug push­ers, su­gar push­ers hawk their wares out in the open, and their of­fers are con­sid­ered fun and nor­mal. And that’s the prob­lem.

The time has come to call out our com­mu­nity su­gar push­ers. Each may be well in­ten­tioned, but col­lec­tively they are un­wit­ting con­scripts of the food in­dus­try, and they re­flect a so­ci­ety that has nor­mal­ized the dis­tri­bu­tion of junk food to pacify and re­ward our chil­dren.

How much su­gar is be­ing pushed on our kids? Over the course of a full year a few years ago, Stacey and I set out to

an­swer this ques­tion. Ev­ery night be­fore bed, we’d ask our three daughters — then aged eight, six, and four—about who of­fered them what junk food that day, and then we metic­u­lously recorded the item, the pusher, and the oc­ca­sion. While my wife and I are by no means purists — birth­days and hol­i­days and other cel­e­bra­tions in our fam­ily in­clude sug­ary in­dul­gences — we also try to use qual­ity build­ing ma­te­ri­als in our girls’ grow­ing bod­ies, and we wanted to know just how many sweet, gran­u­lated, white bricks were be­ing added to their foun­da­tions when we weren’t look­ing. We gave our girls no in­struc­tions in terms of whether to refuse the of­fer­ings, nor did we vil­ify su­gar or its push­ers. We ex­plained that we sim­ply wanted to keep track.

The num­bers were stag­ger­ing. Over the course of the year, friends, fam­ily mem­bers, teach­ers, camp coun­sel­lors, neigh­bours, and oth­ers pushed forty-one pounds of su­gar on our kids, dis­trib­uted across 921 dif­fer­ent of­fer­ings. That’s over 4,600 added tea­spoons—just shy of ninety-seven cups. Some sources of added su­gar were pre­dictable, like cake at friends’ birth­day par­ties. Oth­ers were a sur­prise, in­clud­ing the Hal­loween-sized boxes of Smar­ties choco­late all three girls were of­fered by a phar­ma­cist when they re­ceived their flu shots. One of them was given an ex­tra be­cause she was cry­ing.

Su­gar is found nat­u­rally in a wide va­ri­ety of foods and is re­spon­si­ble for their sweet taste: it is glu­cose and fruc­tose in fruits and veg­eta­bles, mal­tose in grains, and lac­tose in milks. One study has found that, in one form or an­other, su­gar is also added to a full two-thirds of pack­aged foods and drinks in Canada, in­clud­ing in some items you might not ex­pect, in­clud­ing to­mato sauce, yo­ghurt, and frozen din­ners.

Re­gard­less of source, the cells of your body use su­gar for en­ergy. When su­gar is con­sumed and ab­sorbed, the body pro­duces in­sulin, which reg­u­lates the level of su­gar in the blood­stream. Su­gar that’s not be­ing used im­me­di­ately for en­ergy can be stored — in fi­nite amounts of glyco­gen, in the mus­cles and liver, and also in the form of lipids in our fat cells, where there isn’t re­ally a limit on stor­age (be­cause fat cells mul­ti­ply). Di­ets high in su­gar are as­so­ci­ated with obe­sity, heart dis­ease, stroke, di­a­betes, var­i­ous can­cers, and, of course, cav­i­ties.

Cur­rently, nu­tri­tion-la­belling rules al­low each of su­gar’s many vari­ants to be listed sep­a­rately. As a con­se­quence, while su­gar may be the first or se­cond most preva­lent in­gre­di­ent in a food, once it is dis­trib­uted across mul­ti­ple sources, it may ap­pear less sig­nif­i­cant to shop­pers — even those who are con­cerned about healthy eat­ing. (There are cur­rently 152 dif­fer­ent ways to list su­gar with­out call­ing it su­gar on Cana­dian food la­bels, in­clud­ing bar­ley malt syrup, de­hy­drated cane juice, fruit juice con­cen­trate, mal­todex­trin, and potato syrup solids.) Cur­rent reg­u­la­tions also al­low prod­ucts with added fruit con­cen­trates, purées, and evap­o­rates to as­sert that there is “no su­gar added” — some­times even in the case of prod­ucts such as “fruit snacks” that by weight are 86 per­cent su­gar and are mar­keted to par­ents as fruit equiv­a­lents. Both of these in­con­sis­ten­cies stand to be cor­rected in 2022, the dead­line for man­u­fac­tur­ers to im­ple­ment new Health Canada la­belling poli­cies, which will re­quire that all of a food’s var­i­ous su­gar con­trib­u­tors be com­bined into one, and cur­tail those “no su­gar added” claims.

So how did the over­con­sump­tion of su­gar be­come the norm? It is easy to point to the mil­lions of dol­lars that the food in­dus­try spends mar­ket­ing junk food. But does that alone ex­plain why the prin­ci­pal of an On­tario ele­men­tary school pro­vided eight-year-olds with pack­ages of Oreos along with the stan­dard­ized tests they were writ­ing, or why a chief psy­chol­o­gist of an­other school board de­fended that prac­tice to me on Twit­ter? We also can’t just blame the in­creas­ing por­tion sizes that the food in­dus­try has foisted on us over the past five decades, or gov­ern­ment rec­om­men­da­tions to de­crease sat­u­rated fats (which some ar­gue have led to an ac­com­pa­ny­ing in­crease in the con­sump­tion of high-carb, high-su­gar pro­cessed foods), or in­dus­try fund­ing of sci­en­tists, or weak school food poli­cies. No ex­pert that I’ve con­sulted has iden­ti­fied any sin­gle cul­prit.

Be­cause the del­uge of su­gar has many sources, there isn’t one clear or easy way to stop it: peo­ple—rightly—claim that fill­ing any one par­tic­u­lar sand­bag won’t stop the flood. And, in­deed, the ar­gu­ments that tend to get trot­ted out in junk food’s de­fence are “but it’s just one treat” and “par­ents (or kids) can just say no.” My fam­ily’s year of track­ing re­futes both those claims. It wasn’t just one, or even two or twelve, but hun­dreds of oc­ca­sions on which my kids were of­fered su­gar, from those flu-shot treats to the choco­late milk they could get at school sev­eral days a week. To ex­plore that com­mon ex­am­ple: one small choco­late-milk car­ton con­sumed daily for a 195-day school year pro­vides a child with 10.5 pounds, or twenty-four cups, of su­gar, about half of which are added. To serve it to chil­dren be­cause they’ll drink it more read­ily than plain milk is akin to serv­ing daily ap­ple pies to kids who don’t like ap­ples.

But while par­ents can say no, and the­o­ret­i­cally so can chil­dren, I’m not sure a re­al­is­tic so­lu­tion to a flood is just re­mind­ing peo­ple to swim. Es­pe­cially this flood. Back when we sent our daugh­ter to her camp party with chips, some peo­ple dis­puted the ap­proach; one sug­gested that we could have sent maca-and-date balls with her in­stead. Though I’m still not en­tirely clear on what a maca ball is, I am con­fi­dent that had we done so, my daugh­ter would have run the risk of be­ing called Maca Ball for the sum­mer. And, truly,

Serv­ing choco­late milk to chil­dren be­cause they like it more than plain is akin to serv­ing daily ap­ple pies to kids who don’t like ap­ples.

this isn’t and wasn’t her fight. Re­ly­ing on eight-year-olds to re­sist so­ci­ety’s su­gar push­ers is un­re­al­is­tic and un­fair. Our chil­dren’s re­la­tion­ship with food mat­ters— but so do their re­la­tion­ships with peers, ed­u­ca­tors, grand­par­ents, coaches, and neigh­bours. Teach­ing kids to take a rigid stand when of­fered treats risks those re­la­tion­ships. Yes, kids liv­ing in flood plains should know how to swim, but it’s wiser to build them some lev­ees.

My wife and I have joined many oth­ers, and we’ve started to fill some sand­bags. We be­gan when our el­dest daugh­ter was about two. As Stacey re­mem­bers it: “It was around that time that we be­gan to no­tice the num­ber of treats that [she] was be­ing of­fered on a reg­u­lar ba­sis , not just on Hal­loween when we were ex­pect­ing it. It was frus­trat­ing for us be­cause while we wanted to en­joy the pleasures of giv­ing our daugh­ter treats — tak­ing her for ice cream, bak­ing cook­ies with her—we felt that the amount of su­gar she was be­ing of­fered... was al­ready more than her lit­tle body ought to be con­sum­ing.” Waiting for the food in­dus­try to do the right thing would have been an ex­er­cise in fu­til­ity—the right thing would lead to de­creased su­gar con­sump­tion and a de­crease in prod­uct sales — and so we de­cided what we needed then, and what we prob­a­bly need even more now, is some guer­rilla in­ter­ven­tion.

The place to launch your nu­tri­tion cam­paign is at home. It may be as sim­ple as check­ing the la­bels of your di­etary sta­ples for large sources of added sug­ars and look­ing for health­ier al­ter­na­tives. Or maybe it’s swap­ping one pro­cessed meal a week for one you cook to­gether. (It need not be fancy: one of our sta­ples is eggs-in-a-hole, with heart shaped cut-outs.) You can also tackle the su­gar at birth­day par­ties. By no means am I sug­gest­ing that there shouldn’t be cake, but do your kids’ friends re­ally need to leave with a loot bag full of su­gar? We’ve given out stick­ers and bub­bles, and thrown craft­ing par­ties so the kids each make some­thing to take home. There have been no com­plaints, and we’ve no­ticed more of our daughters’ friends giv­ing out non-junk loot bags, too.

For some fam­i­lies, change may stop here. Life is com­pli­cated. Not ev­ery­one has the time, en­ergy, money, or ca­pac­ity to tackle other venues. If you do want to ex­pand be­yond this, I have learned that the ba­sic recipe for be­com­ing a guer­rilla nu­tri­tion ac­tivist is straight­for­ward, and the one in­gre­di­ent that re­ally spoils the mix is anger. Get­ting mad at peo­ple who gen­uinely care about my chil­dren isn’t a good way to build trust or ef­fect change. The teach­ers and coaches and camp coun­sel­lors who give out candy for good be­hav­iour aren’t do­ing so to un­der­mine my chil­dren’s health; they’re do­ing it be­cause it works, and be­cause that’s what ev­ery­one else does.

I have been able to make the most dif­fer­ence when I lead with kind­ness—when I start by rec­og­niz­ing the care some­one is pro­vid­ing my child and then point out that there’s one area, though, where their usual con­cern doesn’t seem to shine, where there’s a con­tra­dic­tion, even: the junk food. I try to ex­plain that re­ally, it’s not just one treat, and that I don’t think it’s fair to have my child sin­gled out for turn­ing down a group treat. And then I sug­gest an al­ter­na­tive and of­fer to help.

Fur­ther proof that kids are just as happy with non-junk-food re­wards: Hal­loween. En­cour­aged by a study that found kids val­ued toys just as much as candy, Stacey and I stopped hand­ing out the sweet stuff in 2006. At the time, we were liv­ing in dense, young sub­ur­bia; the streets were thick with lit­tle su­per­heroes, pi­rates, and princesses. As the af­ter­noon of Hal­loween gave way to dusk, it was eggs, not mon­sters, that Stacey and I feared as we pre­pared to hand out some­thing other than candy. But we de­cided we had to give it a shot. We handed out small Play-doh con­tain­ers that we found at Costco; they cost us twenty cents per gob­lin. Other years, we’ve given out glow wands, and swords pur­chased in bulk at the dol­lar store. Our house has yet to be egged or toi­let pa­pered.

Schools may be your next ob­jec­tive. There are many bat­tle­grounds here, but it may be eas­i­est to fo­cus on your child’s class­room, es­pe­cially if treats are used as a re­ward. There are dozens of non-food ideas that har­ried teach­ers can choose from in­stead: dance par­ties, py­jama days, sit-wher­ever-you-want passes — the list goes on. (When one of my daughters was in grade five, her teacher de­cided the stu­dents would get to choose a colour and streak her hair with it as their year-end cel­e­bra­tion. She told me that she wanted to mo­ti­vate the kids to read through­out the year “and what bet­ter way than [at­tempt­ing] to hu­mil­i­ate your teacher!”) Then there’s that school sta­ple: the bake sale, part of a ubiq­ui­tous prac­tice of junk-food fundrais­ing (think doorto-door choco­late sales and sports team fund­ing drives). There is no short­age of other fundrais­ing op­tions you can sug­gest, from rum­mage sales to sell­ing flower bulbs in place of candy bars.

Larger-scale change is pos­si­ble as well. On­tario’s Mid­dle­sex County, for in­stance, launched their Healthy Side­line Snacks project in 2016; their goal is to re­turn their sports fields and are­nas to the days of wa­ter and fruit slices in place of our sug­ary norms. Through pledge sheets, so­cial-me­dia en­cour­age­ment, and per­se­ver­ance, par­tic­i­pa­tion grew from six­teen teams in the first year to forty-four in 2017. Mid­dle­sex County es­ti­mates that over 500 chil­dren have ben­e­fited.

Over our past decade as nu­tri­tion gueril­las, my wife and I have learned a great deal about our­selves and our com­mu­nity. Most im­por­tantly, we now un­der­stand that politi­cians’ short man­dates and the food in­dus­try’s un­will­ing­ness to cur­tail its own sales, when cou­pled with the mis­guided be­lief that in­di­vid­u­als can eas­ily opt out of our per­va­sive junk food cul­ture, smoth­ers change. In­deed, like with any health-im­prove­ment pro­gram, change must be­gin with our own words and ac­tions—by way of thought­ful nu­tri­tion and cre­ative, of­ten col­lab­o­ra­tive, so­lu­tions spread­ing from one home to an­other and then an­other and then to our schools, are­nas, camps, and com­mu­ni­ties. We can work di­rectly with the su­gar push­ers among us to change our sweetly toxic food cul­ture.

yoni freed­hoff is an Ot­tawa-based fam­ily doc­tor. He is the au­thor of The Diet Fix: Why Di­ets Fail and How to Make Yours Work.

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