We need a war on sec­ond­hand sugar

The Washington Post Sunday - - SUNDAY OPINION - BY MICHAEL I. GO­RAN AND EMILY VEN­TURA Michael I. Go­ran is a pro­fes­sor of pre­ven­tive medicine and pe­di­atrics at the Univer­sity of South­ern Cal­i­for­nia and co-di­rec­tor of the school’s Di­a­betes and Obe­sity Re­search In­sti­tute. Emily Ven­tura is a writer, nu­trit

If you saw a preg­nant woman smok­ing, you would un­doubt­edly be con­cerned about the health of her child. But if you saw a preg­nant woman drink­ing a soda, would you bat an eye? The com­par­i­son may seem ex­treme, but the par­al­lels be­tween to­bacco and sugar run deeper than you might imag­ine.

There is no de­bate that sec­ond­hand smoke is harm­ful. Now sci­en­tists are dis­cov­er­ing sim­i­lar risks of “sec­ond­hand sug­ars” in in­fants and chil­dren, specif­i­cally that our high-sugar en­vi­ron­ment can harm chil­dren’s de­vel­op­ment and their long-term health.

We are find­ing that sugar ex­po­sure can be­gin to af­fect a child even be­fore birth. The sug­ars that a mother con­sumes while preg­nant or nurs­ing can be passed to her baby, dis­rupt healthy growth and de­vel­op­ment, and pose risk for obe­sity.

In­vol­un­tary ex­po­sure to sugar can also con­tinue be­yond preg­nancy and lac­ta­tion. In­fant formula and baby foods of­ten con­tain added sugar, and many chil­dren are ex­posed to sug­ary bev­er­ages from in­fancy. One study from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, which fol­lowed the di­ets of 1,189 in­fants over six years, showed that those who were given sug­ary bev­er­ages just three times per week at 10 to 12 months of age had twice the risk of be­com­ing obese.

Chil­dren are too young to make in­formed eat­ing choices and are ex­posed to ag­gres­sive mar­ket­ing cam­paigns for sweet foods. Once school-age, many chil­dren — es­pe­cially those from low-in­come fam­i­lies — rely on pub­lic school meal pro­grams, which are of­ten high in sugar. A child can eas­ily grow up in an en­vi­ron­ment loaded with sugar, cre­at­ing a foun­da­tion for obe­sity and the as­so­ci­ated risk of dis­ease.

Does this all seem alarmist? Isn’t sugar just the most re­cent nu­tri­tional vil­lain? In re­al­ity, the sit­u­a­tion with sugar and kids has got­ten out of con­trol, and we are start­ing to un­der­stand the reper­cus­sions. Cer­tain types of sugar — es­pe­cially fruc­tose and ar­ti­fi­cial sweet­en­ers, which have dra­mat­i­cally in­creased in our diet within the last gen­er­a­tion — are par­tic­u­larly dam­ag­ing dur­ing crit­i­cal pe­ri­ods of growth and de­vel­op­ment in chil­dren.

Fruc­tose is com­monly thought of as healthy be­cause it is found in fruit. But con­sump­tion of bev­er­ages made with high fruc­tose corn syrup and fruit juice con­cen­trates de­liver a much higher level of fruc­tose than in a piece of whole fruit. In an an­i­mal study con­ducted by our col­lab­o­ra­tors at the Univer­sity of South­ern Cal­i­for­nia, we found that higher lev­els of fruc­tose con­sump­tion caused cog­ni­tive im­pair­ments and in­flam­ma­tion in the brain — but only when sug­ars were con­sumed dur­ing the an­i­mals’ ado­les­cent growth pe­ri­ods.

An­other study cur­rently un­der­go­ing peer re­view from USC, in col­lab­o­ra­tion with the Univer­sity of Ok­la­homa Health Sci­ences Cen­ter, found that fruc­tose was de­tectable in breast milk and was the only sugar in breast milk as­so­ci­ated with obe­sity in in­fants. This is im­por­tant to con­sider be­cause, from an evo­lu­tion­ary per­spec­tive, fruc­tose is not nat­u­rally present in breast milk and in­fants are not de­signed to han­dle it.

Sim­i­larly, while we have lim­ited in­for­ma­tion about how ar­ti­fi­cial sweet­en­ers af­fect child­hood de­vel­op­ment, we do know that they present an­other source of po­ten­tially dan­ger­ous sec­ond­hand sug­ars. A re­cent study from Canada in­clud­ing more than 3,000 women showed that con­sum­ing diet soda dur­ing preg­nancy dou­bled their in­fants’ chances of be­com­ing over­weight.

Only af­ter ac­knowl­edg­ing that sug­ars have sec­ond­hand ef­fects in in­fants and chil­dren can we take ac­tion to pro­tect these vul­ner­a­ble by­standers. The re­al­iza­tion that sec­ond­hand smoke in­creased cancer risk in non­smok­ers led to pub­lichealth pro­grams that have greatly ben­e­fited our na­tion’s health by chang­ing cul­tural norms and re­duc­ing smok­ing be­hav­iors. We need a sim­i­lar level of at­ten­tion given to the pre­ven­tion of sec­ond­hand sug­ars.

In the big­ger de­bate of how to re­verse the obe­sity epi­demic, govern­ment and in­dus­try of­fi­cials of­ten ar­gue against pub­lic pol­icy ap­proaches by fram­ing obe­sity as a be­hav­ioral is­sue. It’s clear, though, that obe­sity starts with non-vo­li­tional ex­po­sure to sugar in the womb and dur­ing crit­i­cal pe­ri­ods of de­vel­op­ment.

New poli­cies and ed­u­ca­tional pro­grams for preg­nant women, new moth­ers and chil­dren can be de­signed to specif­i­cally pre­vent sugar ex­po­sure, not only in the home but also at school and in other pub­lic set­tings. We also need the food and bev­er­age in­dus­try to step up and de­velop safer and health­ier prod­ucts that avoid harm to chil­dren. Only through re­spon­si­ble busi­ness prac­tices can we pre­vent obe­sity, di­a­betes and other chronic dis­eases in the next gen­er­a­tion.

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