‘Just six spoonfuls of sugar’

RX FOR READERS.

By JUDY SIEGEL-ITZKOVICH
CANDY FOR sale by the kilo in Jerusalem (photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
CANDY FOR sale by the kilo in Jerusalem
(photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
My son and daughter-in-law are appalled at the amount of sugar that their children, aged five and two, are given in nursery school, particularly at celebrations such as birthday parties. When my son spoke to their pediatrician about the amounts of sugar the children are given, he was told that there are no scientific data indicating that sugar is bad for children, apart from the obvious effects of obesity and on their teeth.
When I checked the Internet, I found much anecdotal evidence, including warnings about the effect of sugar on children’s brain development, but no scientific data in reputable scientific journals. In fact, the one article I found by a Dr. Wolraich stated just the opposite: “The meta-analytic synthesis of the studies to date found that sugar does not affect the behavior or cognitive performance of children. The strong belief of parents may be due to expectancy and common association.
However, a small effect of sugar or effects on subsets of children cannot be ruled out” (JAMA 1995; 274:1617-1621).
Do you know if there are other scientific articles that do prove that sugar is bad for children not only regarding obesity and dental problems but also for brain development and behavioral problems? B.Y., Jerusalem
Senior diabetologist Prof. Itamar Raz, head of the Israel Diabetes Council, replies: This is a very hard question to answer. The only way to give a clear-cut response, far from being perfect, would be if we could prospectively follow young children who are exposed to different levels of sugar. Meta-analysis and retrospective data are misleading and may be wrong.
From adults, we know that exposure to a large amount of glucose can lead to fatty liver and heart disease and is a direct cause of inflammation of these organs. This can cause severe liver and heart disease; the effect on the brain is still debatable.
Exposure to a high level of glucose at a young age is similar to exposure to nicotine and cocaine and will cause the young adult to become adapted to glucose exposure and insulin resistance.
It will also increase the risk of obesity, diabetes, liver disease and heart problems.
The US is the best example for the deleterious effect of sugar over time. In 1970, the level of sugar was increased due to the US Food and Drug Administration’s request to decrease fat in the food; the fat was replaced by sugar. Within 45 years, obesity increased from less than 10% to 40%; diabetes rose from 4% to 15%; pre-diabetes went up from 5% to 20%; and metabolic syndrome rose to nearly 40% of the adult population.
The only way to make a change is in the education of children from the age of two not to eat more than six teaspoons of sugar a day. In Israel, children consume four times more than that, and we lead the OECD in this respect.
We must start to change this situation through intervention in childhood education.
My seven-year-old son snores on a regular basis, and he often sleeps with his mouth open. What could be the cause of this? Is he in danger of sleep apnea, in which one momentarily stops breathing during sleep? I.N., Jerusalem
Ear, nose and throat surgeon Dr. Anat Shatz of the pediatric airway service at Jerusalem’s Shaare Zedek Medical Center answers: These symptoms may be caused by a variety of factors, including enlarged adenoids and allergic conditions of the nasal mucous membranes.
Your son needs to be examined by an ENT specialist to find out the exact cause of his symptoms and be treated accordingly.
In the Hadassah Magazine’s January-February issue, there was an article describing the work of Prof. Ora Paltiel, an internal medicine specialist and head of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine called “Searching for the causes of lymphoma.”
Paltiel, who has studied the increased incidence, causes and risk factors of lymphoma, claims that if an infant is hospitalized with a high fever, the child’s chances of onset of lymphoma later in life are increased.
My son, who is now over 40 years old, was hospitalized when he was a year old with a high fever of unknown causes. Has it been proven that he is at a high risk of lymphoma? If so, is there any test or treatment before diagnosis?
S.D., Petah Tikva
Prof. Ora Paltiel replies: Many more children were hospitalized for infection in early life than will ever develop lymphoma. A risk factor means that, statistically, chances of developing a disease are higher with than without this factor, but they are still low. I myself was hospitalized because of the Asian flu at the age four months! There are no tests for early detection of lymphoma and no evidence that treatment prior to symptoms improves outcomes.
I wish you and your son good health.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.