CHAPTER SEVEN

Cutting Sugar: Seven Sugarproof Strategies That Work

Now it’s time to talk about some specific strategies for change. We have found that seven simple strategies are key to the success of Sugarproof. Supported with research, these strategies work for kids and adults. They’re even more effective when the entire family implements them together. How many you tackle at once is up to you. Some families like to start with one or two strategies that seem the most doable, and build from that; others implement all of them at the same time.

SEVEN SUGARPROOF STRATEGIES:

  1. Set everyone up for success with breakfast.

  2. Ditch the liquid sugar.

  3. Avoid fructose.

  4. Use snacks to your advantage.

  5. Choose sweet treats wisely.

  6. Set guidelines for major culprits.

  7. Work a menu like a pro.

Sugarproof Strategy #1: Set Everyone up for Success with Breakfast

Dr. Jekyll or Mr. Hyde? Some kids can be either, depending on what they eat in the morning. When breakfast lacks protein but is full of sugar—think toast with jam or a pastry—most kids will take a ride on the sugar roller coaster, whining, complaining, and asking for more sweets. But with a low-sugar or no-sugar breakfast, like scrambled eggs and veggies and whole-grain toast, most kids will be calm, attentive, curious, and happy.

In addition to its effects on mood and energy levels, breakfast sets the tone for eating habits for the rest of the day. If kids hop onto the sugar roller coaster first thing in the morning, they will usually stay aboard all day long. One sugar high and crash fuels another. Kids can spend the whole day riding this cycle without realizing it. Breakfast with protein and fiber will solve the problem, providing steady energy throughout the day.

One problem: The older your kids get, the harder it can be to get them to eat any sort of breakfast. National data shows that more than 95 percent of kids ages two through five eat breakfast. However, this number falls to 90 percent for six-to-eleven-year-olds. In teens, those numbers go down again: only 76 percent of teen boys and 69 percent of teen girls eat breakfast. Whether it’s an issue of time, personal preference, family finances, or a desire to diet, skipping breakfast hampers a child’s academic performance and cognitive function, and can also nearly double the risk of becoming overweight. Skipping breakfast also leads to eating more carbohydrates and fat in the evenings. If you eat a balanced breakfast, you decrease the chances you’ll binge on a huge, unhealthy meal for dinner. For kids of any age, the first important step is to incorporate breakfast into the daily routine.

The second step is to choose breakfast foods that keep blood glucose levels as steady as possible. Sweetened cereals, waffles or pancakes with syrup, muffins or other pastries, convenience items like Pop Tarts or breakfast bars, toast with jam, packets of sweetened instant oatmeal, apple or orange juice, and hot chocolate all create spikes in blood glucose levels. These spikes are followed by a crash, a state of low blood sugar that turns on your child’s hunger and desire to eat again. When kids start their days with foods that are lower in sugar and higher in protein and fiber, they have better glycemic control, they experience increased fullness, and their brains are better able to regulate appetite and eating behavior.

I (Michael) once performed an experiment to test my own response to breakfast. I tried out three different breakfasts on three consecutive days: toast and marmalade, plain steel-cut oatmeal, and toast with two eggs (Figure 8). I wore a glucose monitor that measured my blood sugar over the course of the entire day. When I had toast and marmalade, I boarded the sugar roller coaster. My blood sugar rose quickly, peaked at about one hour after breakfast, dropped, and then after about two hours there was a second rise and fall. I went up and down that second “hill” because when glucose falls rapidly, there is a compensatory response. The body produces and releases more glucose into the circulation. When I had oatmeal for breakfast, the first spike wasn’t as extreme, and the crash was not as severe, but it was still there and there was still a second rise after about two hours. In contrast, the breakfast of toast with eggs gave me steady energy with no spike or crash. My blood glucose was stable and steady all morning. The difference was the protein and fat in the eggs that balanced out the carbohydrate in the toast and lowered the overall glycemic index of the breakfast.

Figure 8: Michael’s Blood Glucose Levels over 2.5 Hours after Three Different Breakfasts

We realize that breakfast can be the hardest meal of the day for parents. You’re trying to manage everyone’s taste preferences, get yourself and the kids dressed, and locate lost homework—all while keeping an eye on a clock that’s quickly counting down the seconds. We’re here for you with some easy ways your whole family can rethink breakfast.

The Cereal Fix

Kids love breakfast cereal, especially ones high in sugar. It’s crunchy, sweet, and the boxes feature fun characters, secret codes for video games, and even small toys. It’s a quick, easy solution that kids can often serve themselves. What’s tricky about boxed cereal is not just the sugar content, but also the portion size that kids often eat. For example, even if the nutrition label on a box of cereal indicates that a serving is ¾ cup or 1 cup, kids will typically consume much more in a normal bowl of cereal, especially when they serve themselves. To test this at home, have your kids pour a bowl of cereal and measure the number of cups. You might discover that your kids are eating 2 cups, which is at least two servings. If the nutrition label indicates 10 grams of sugar per 1-cup serving, your child’s bowl will contain 20 grams—or 5 teaspoons of added sugar, which is the total daily recommendation for a ten-year-old.

Eliminating sugary cereal is the best way to go, but if you just can’t, then look for brands that have fewer than 3 grams of added sugar per serving. Try cutting the portion size by using smaller bowls and offering fruit toppings. In one study, ninety-one kids at a summer day camp were randomly sorted into two group. One group could choose from three high-sugar cereals; the other group chose from three low-sugar cereals. All the kids had free access to sliced bananas and strawberries and packets of sugar. Regardless of which group they were assigned to, children reported “liking” or “loving” their choice of cereal. But children in the high-sugar group ended up consuming almost twice as much cereal. Some of the children in the low-sugar group added sugar, but overall, they consumed about half as much sugar across the entire breakfast. Additionally, children in the low-sugar cereal group were much more likely to put fruit on their cereal. The bottom line? Kids will self-regulate, but that self-regulation will depend on what’s put in front of them. Now there’s news you can use! When serving cereal, keep it low in added sugar and have chopped fruit or berries available for toppings.

Adding protein to breakfast cereal is another useful strategy. This will help turn on the body’s “feeling full” receptors. Protein reduces the impact of carbohydrates, which means kids will eat less and avoid an energy crash later. Cow’s milk, whether whole or skim, has around 8 grams of protein per cup. If you are using a plant-based milk, choose carefully, as these products often have less protein and usually contain added sugars. Look for one with no added sugars and try adding chopped nuts or seeds on top of the cereal to increase the protein.

You can also serve cereal with yogurt instead of milk. Regular plain yogurt has around 8 grams of protein per cup, similar to milk. Unsweetened Greek yogurt is especially high in protein because it is strained: 1 cup has around 20 grams of protein. It can be a little tangy or sour for kids who are not used to it, but many kids enjoy it after an initial adjustment period, especially when they can top it with a cereal they like and some fresh fruit for natural sweetness and extra nutrients. This is also a great way to limit the portion of cereal, because the yogurt itself is very filling. Using yogurt instead of milk for cereal also provides beneficial probiotics. If your children can’t eat dairy, try an unsweetened plant-based yogurt such as soy, coconut milk, or even almond milk yogurt, but check the label. Like the plant-based milks, they can have hidden sugars and a low protein value. If using a plant-based yogurt, add chopped nuts or seeds as a topping.

How Much Protein Does Your Child Need Each Day?

Daily protein requirements for children vary by age:

Age 2–3 years: 13g protein

Age 4–8 years: 19g protein

Age 9–13 years: 34g protein

Age 14–18 years: 52g protein (boys) or 46g protein (girls)

For reference, here are the protein contents of a few popular breakfast foods:

Greek yogurt, 1 cup: 20g

Plain yogurt, 1 cup: 8g

Cow’s milk, 1 cup: 8g

Almonds, ¼ cup: 7g

Black beans, 1/2 cup: 7g

1 egg, large: 6g

Sausage, 1-oz. patty: 5g

The Oatmeal Fix

Oatmeal and other hot cereals have a healthy reputation, but be careful. Like cold cereals, most types of oatmeal are just big loads of carbohydrates that break down quickly to glucose. While oatmeal is more complex to break down than straight sugar, it can still usher kids onto the sugar roller coaster, especially if it is an instant variety or is topped with brown sugar, maple syrup, or other sweeteners. There are some ways to make your oatmeal truly healthful, however.

Skip the instant oats and go for steel-cut

The premade packets of instant oatmeal are often flavored and presweetened. Skip these. Even if they’re not presweetened, the oats have been highly processed to make them ready to eat. Because they’ve been processed, they rate higher on the glycemic index, translating to a blast of energy and bigger spike in blood glucose levels. It’s much better to cook the oats from scratch. The quick-cook (not instant) oats are okay in a pinch, but the Holy Grail of oatmeal is the steel-cut kind. Steel-cut oats are the cut-up oat grain (called a “groat”). They take longer to cook, but you can save time in the morning by soaking them overnight, which significantly reduces the cooking time. See our recipe on this page for a few different methods, including one that requires no cooking at all. You can also make steel-cut oats quickly in a pressure cooker or Instant Pot. Or simply make a batch at the start of the week and reheat single servings on subsequent days. We also like Scottish oats as a second-best option, which are stone-ground into smaller pieces so that they cook faster; even when cooked with water, they have a nice creamy texture and taste.

Add protein and sweeten with fruit

Just as with cold cereal, you’ll need to balance the sugar and carbs in oatmeal with protein. Cooking oats in milk instead of water can help. And instead of the classic brown sugar or maple syrup as a sweetener, set out some fresh, frozen, or chopped dried fruits as toppings. They all have the advantage of adding fiber as well as vitamins and minerals to breakfast. Grace, who we introduced you to in Chapter 4, discovered a new favorite breakfast: oatmeal cooked with water and almond meal and topped with pecans and raspberries.

Make sure you check dried fruit for any added sugars, which are often used to sweeten tart fruits like cherries and cranberries. Keep in mind that all dried fruit contains concentrated sugar, even if it is naturally occurring. A rough target to follow is to use no more than ¼ cup per serving. Try distributing the naturally occurring sugars from dried fruits like raisins or chopped dates by cooking them with the oats. A simple apple or berry compote also makes a delicious topping for oatmeal (see Simple Fruit Compotes).

Try a savory porridge

Oatmeal or other hot cereals like grits or whole-grain rice cereal can easily be turned into a savory breakfast by adding a little butter or cheese, or by topping them with a fried egg. Traditional versions of savory rice porridge also include Chinese congee or Thai jok, which usually include chicken or ground pork and are topped with brightly flavored items like grated fresh ginger, cilantro, and green onion. We like to sprinkle hot cereals with furikake, which is a Japanese mixture of roasted seaweed, salt, and roasted sesame seeds that comes in a wide variety of flavors. Look for a brand that does not contain added sugars (e.g., Trader Joe’s has one)—most do have a small amount (often 1/2 gram of sugar in 1/2 tablespoon), which is a whole lot less than if it was smothered with maple syrup. Introducing savory options can help broaden breakfast horizons and be useful in getting out of a sweet rut.

The Toast Fix

Toast is a quick breakfast option that can usually benefit from a healthy makeover. Start with a whole-grain bread with no added sugar. Sourdough breads can be a relatively good choice because they typically are made without added sugar. From this base, build your toppings wisely. Jam, jelly, or Nutella puts kids right on the sugar roller coaster. Even if the jam says “no added sugar,” make sure to check the ingredient list for low-calorie sweeteners or fruit juice concentrates.

Instead, offer toppings that are full of protein, fiber, or healthy fat. Try ricotta cheese and grated lemon zest or a homemade fruit compote (see Simple Fruit Compotes). Other good options for toppings include avocado, unsweetened nut butters, hummus, smoked salmon, fried or scrambled eggs, cheese, or deli meat. Use the same strategy for bagels. Look for whole-grain bagels with no added sugar and top them with a source of protein like cream cheese or peanut butter. Bagels are bigger and denser than toast, with about the same amount of carbohydrates in three slices of bread, so consider mini-bagels or just half a bagel.

The Pancakes and Waffles Fix

Kids love pancakes or waffles for breakfast, but in addition to the sugar in the pancakes or waffles themselves, they tend to get drowned in maple syrup or covered with Nutella or chocolate chips. This sweet breakfast with no protein is a fun treat, but it can disrupt your child’s energy levels throughout the day until bedtime. Try replacing the syrup with fruit, a fruit compote, or even non-sweetened whipped cream. One eight-year-old who did our 7-Day Challenge learned to sauté bananas in a little butter for a pancake topping. As the bananas caramelize in the pan, they release more of their natural sugars, making them a naturally sweet treat.

For protein, try toppings like unsweetened nut butter, ricotta cheese, or yogurt to go along with chopped fruit or berries. If you are making your own batter, you can increase the protein content by adding an extra egg, egg white, almond flour or another high-protein flour, or protein powder. Or you can serve a high-protein side dish like an egg or some sausage or lean Canadian bacon. Making crepes instead of pancakes or waffles also reduces the carbohydrate load: see our recipe for Three, Two, One . . . Crepes! These work great with fruit toppings or savory toppings and make it easier to avoid maple syrup, as your family probably won’t expect it as much as they do when you make pancakes or waffles.

What about those convenient toaster waffles that are so easy to grab-and-go? A serving of plain toaster waffles (2 waffles) has around 4 grams of added sugar (without the syrup), and less than 1 gram of fiber. They are not a smart choice. That’s not to mention the added sugars from maple syrup that will likely get poured on top at 14 grams per tablespoon. Try replacing toaster waffles with whole-grain toast and adding some of the toppings suggested above to create a protein balance.

The Baked Goods Fix

Premade muffins, pastries, quick breads, and doughnuts are popular breakfast items, but they tend to be loaded with sugar. Your child might as well eat a slice of cake for breakfast. For example, a typical blueberry muffin from a coffee shop or bakery can easily contain 30 grams of sugar, little of which is coming from the blueberries. Cut large muffins in half to reduce the portion size and combine them with a protein like yogurt, milk, or an egg. Better yet, try making our Blueberry Banana Muffins, which contain no added sugars and a higher protein and fiber content than standard types.

The Breakfast Bar Fix

Most commercially produced breakfast bars, including granola and fruit bars, are marketed as healthy options with protein and vitamins. In reality, they contain high levels of added sugars. One package of Belvita Cranberry Orange Breakfast Biscuits, for example, contains 12 grams of sugar. Since they’re not generally very filling and don’t contain much protein, they may not satisfy a kid’s appetite. You may find your kids wanting a second package, which doubles their sugar intake. One family we worked with had two children. Each of them ate up to three ZonePerfect Double Dark Chocolate Bars each morning. With 14 grams of sugar per bar, the kids were often eating more than their total daily sugar allowance at breakfast alone. Make your own using our recipe for granola thins (see Sugarproof Granola and Granola Thins), so you can control the sugar and add enough protein and fiber to make them balanced.

Breakfast Options Based on Prep Time

NO TIME: GRAB-AND-GO OPTIONS

5 MINUTES: QUICK BREAKFASTS

10–15 MINUTES: QUICK-COOKING OR REHEATING

20–30 MINUTES: WARM OPTIONS WITH LONGER COOKING TIMES

Sugarproof Strategy #2: Ditch the Liquid Sugar

If your kids are drinking sweet drinks of any kind, including 100 percent fruit juice, then weaning them off this liquid sugar is the single most important dietary change you can make.

Fruit juice is often thought of as a breakfast staple, but it delivers a rapid and high dose of fructose. If you’ve worked to balance breakfast cereal or toast with protein to avoid a sugar crash, adding juice will spoil your efforts. Dr. Alaina Vidmar, a colleague at Children’s Hospital Los Angeles, calls juice “an interesting drug.” As she explains, after children are introduced to juice, they start consuming it in vast quantities and have a hard time giving it up. Parents often feel that juice is a healthier option than soda. But in fact, juice can be just as addictive and harmful.

Of course, there’s no shortage of other sweet drinks for kids. Some are marketed for breakfast, some for sports, and some for all day long: Strawberry Quik. Chocolate milk. Frappuccinos. Sodas (regular or diet). Gatorade. Coconut water. If your kids are hooked on these drinks, you’ll need some help. The goal is to help your child transition to water (plain or naturally flavored) as their primary beverage. A moderate amount of unsweetened milk, such as one or two glasses a day, is also usually fine for most children and even recommended, though it’s best to consult with your pediatrician for specific guidance. Here are some tactics that will help you make the shift to reduce and maybe even eliminate liquid sugar.

Scratch soda and juice from your grocery list

The best way to cut back on sodas and sugary drinks is to stop buying them at the grocery store. Research shows that children and teens consume most of their soda or juice at home. If you don’t bring them home, you have already cut back on consumption. Remember that we also do not recommend diet drinks that have artificial or other LCS in them.

Dilute, dilute, dilute

Instead of asking kids to give up sweet drinks cold turkey, you can wean kids from their sugar by gradually diluting them. The trick is using the right unsweetened mixer to dilute your children’s favorite beverages. For soda, try plain sparkling water, club soda, or adding more ice. Many soda fountains feature unsweetened soda water as an option, which you can use to dilute the soda right at the fountain. Dilute juice or sports drinks with plain or sparkling water. Dilute flavored milk with plain. Add progressively more of the mixer until your children can give up the sweet drink and enjoy just the mixer (plain water, sparkling water, or milk) as a beverage. For coffee drinks or tea, the trick is to gradually cut back on the sugar or sweetener until kids develop a new taste for the less sweet drink. For drinks that are made from sugared or sugar-free powdered mix, like Nesquik, Kool-Aid, or Crystal Light, use less powder until you arrive at plain water or milk.

Keep water handy and make it appealing

Make plain water the default drink at home, with meals, and at school. If your refrigerator does not dispense cold water, keep large glass bottles or pitchers of water in the refrigerator. Keeping cold water in the fridge means it’s always ready for mealtimes. If your tap water doesn’t taste very good, consider investing in a basic water filter pitcher like a Brita or an in-home water filter or reverse osmosis system. The investment you make in the water your family can drink at home will pay for itself as you wean your kids off sugary drinks, both in their improved health and your reduced grocery bill.

Before leaving for an outing, prepare water bottles to take with you so that there will be less temptation to buy other drinks while you’re out. Let your kids choose a fun, colored, stainless steel, insulated water bottle for school. For younger kids, make sure to keep portable cups or child-friendly water bottles accessible to them no matter where they are playing. These bottles will keep water tasting cool and fresh and will also be good for the environment by reducing single-use plastic water bottles.

Add flavor without sugar

Kids who are used to sweetened drinks often crave flavor when switching to drinking plain water. Try making pitchers of naturally flavored water to keep in your refrigerator. You can easily add sliced citrus like lemon, lime, orange, or grapefruit or other fruit like apples, kiwi, berries, watermelon, or even sliced cucumber or fresh mint. You can also try adding individual pieces of frozen fruit to water bottles for school or sports practice. If your kids like sparkling water, look for a brand that’s flavored but unsweetened. Make sure you check the label to avoid both sugar and LCS. You can also look into a machine like a SodaStream that carbonates plain water with a charged cartridge of CO2. Your kids will have fun making their own sparkling water fruit drinks with fresh or frozen fruit.

Take time for tea

Warm or iced tea is a great way to enjoy a beverage socially with family or friends instead of ordering a sweet, coffee-based drink. Herbal teas, also called tisanes, are “teas” that contain no tea leaves or caffeine but include flowers, botanicals, and even spices and bits of citrus peel. There are many types of flavorful herbal teas, and you can involve everyone in picking out new types to try that taste good with no added sugar or sweetener. They are usually good both iced and hot. Teas are also a great option for kids who want to go to the coffee shop with their friends. Most coffee shops carry a wide variety of tea, which means that your teen can enjoy time with their friends and skip the sugar without feeling left out. Just be sure to avoid teas with caffeine, especially before bedtime.

Drink wisely when eating out

Sometimes it can be hard to resist sweet options at cafés or restaurants, especially if it is a special occasion. Try ordering one drink to share and pour it into a few glasses, then add water. My (Emily’s) kids like to order plain sparkling water at restaurants, and even though it is an extra expense, it helps them feel that they’ve ordered something special. When at a café and ordering a flavored coffee drink, ask for fewer pumps of syrup or sweetener or fewer scoops of powder. Try the drink at 75 percent sweetness, then work your way down to see if 25 percent sweetness is acceptable.

Watch out for premade smoothies

Premade smoothies or juices can seem like a simple way to add nutrients to your children’s diet. But even green smoothies or vegetable-based smoothies can be very high in added sugar or hidden sweeteners. Even if they’re labeled “all plant based” and “natural—with no added sugar,” check the ingredient list. More often than not, you’ll find ingredients like juice, fruit juice concentrate, agave, or monk fruit used as sweeteners. Yes, your kids may be getting a few leaves of spinach or kale in that green smoothie, but they may also be getting the equivalent of the juice of three apples without the fiber. If your kids love smoothies, try making them at home with fresh or frozen fruit, leafy greens or other vegetables, and yogurt or protein powder, using either water or an unsweetened milk of choice as the liquid. See our recipes for smoothies on this page and this page.

Sugarproof Strategy #3: Avoid Fructose

If your family gives up sweetened drinks, they’re avoiding the biggest typical source of fructose. But there are other ways that unhealthy amounts of fructose can creep into children’s diets. To maintain a lower-fructose diet in your house, avoid any products sweetened with high-fructose corn syrup, fruit juice concentrates, agave syrup, or fructose itself. Each of these sugars has a high fructose component. As you scan ingredient lists, also be wary of anything that says “fruit juice sweetened” or “fruit sugar.”

As we discussed in Chapter 3, some kinds of sugar have an undeserved reputation for being healthier or more natural. Ultimately, they’re all still sugar—at least, in terms of how your body and brain react to them. And sugar that is made up of a higher percentage of fructose than glucose can have more damaging effects. The table “Sugar According to Fructose Content” will help you spot the sugar products that are highest in fructose.

Sugar According to Fructose Content

SUGAR*

FRUCTOSE

GLUCOSE

COMMENTS

Fructose; crystalline fructose

100%

0%

Often labeled as “fruit sugar” and as a “healthy sugar.” Avoid any product listing fructose as an ingredient.

High-fructose corn syrup

55–90%

10–42%

Avoid.

Agave syrup

90%

10%

Sugar profile varies but typically very high in fructose. Avoid.

Apple or pear juice concentrate

70%

30%

Actual composition varies but typically high in fructose. Avoid.

Honey

50.5%

44.5%

Adds flavor, some trace nutrients, and has medicinal properties; fructose and glucose ratios can vary. Use sparingly.

Date sugar/date syrup

50%

50%

Sugar profile can vary quite a bit depending on type of date, with some higher in glucose and others higher in fructose; adds flavor; can contain fiber depending on manufacturing. Use sparingly.

Coconut sugar

50%

50%

Sugar profile can vary quite a bit; adds flavor; contains small amounts of fiber; sustainable to grow. Use sparingly.

Sucrose/sugar/brown sugar

50%

50%

Also known as table sugar and includes products like raw sugar or cane sugar. Use sparingly.

Maple syrup

48.5%

51.5%

Adds flavor and trace nutrients; amounts of fructose and glucose can vary. Use sparingly.

Grape juice concentrate

40%

60%

The actual sugar profile varies, so we suggest avoiding grape juice concentrate whenever possible.

Note: We simplified the table by dividing any sucrose in these sugars into half glucose and half fructose. Also note the values in this table are estimates, as the actual percentages can vary based on the exact sources.

Whole fruits contain fructose, but, as we’ve mentioned, they generally do not cause problems, provided your children don’t eat enormous quantities all at once. That’s because the health effects of fructose are related to how quickly it is ingested; how fast it enters the bloodstream; and whether other nutrients and components, like fiber, are present in the fruit.

To better evaluate just how bad the fructose is in fruit and fruit products—that is, how fast it will enter the bloodstream—we’ve created the Fructose Index. The faster the fructose is broken down and absorbed into the bloodstream, the more likely it will have detrimental effects on the body in both the short and long term.

Take a look at four preparations of apples to see how fructose is liberated. A good rule of thumb is “Eat fruit, don’t drink it.”

The Fructose Index

LOW FRUCTOSE INDEX/LOW RISK

Whole apple

Optimal because you get all the benefits of the fiber and nutrients in the apple and the fructose is slowly released during digestion, limiting its potential damaging effects on the liver. Also, typical serving sizes (such as a whole apple) contain a lot less sugar than in a typical serving size of apple juice.

↑
↓

Blended apple (as in a smoothie or applesauce)

When blending or pureeing fruit, the fiber is still retained, which helps slow the absorption of the fructose. Note that many commercial brands of applesauce do not include the peel. Look for an applesauce that is made with the peel or make your own.

100% apple juice, including fresh squeezed

Juicing apples frees the fructose from the fibrous cells and eliminates the fiber in the process. Some of the healthy micronutrients of the apple might be retained, but juicing essentially creates highly concentrated fructose that makes it more rapidly available for processing by the liver, where it can be converted to fat.

HIGH FRUCTOSE INDEX/HIGH RISK

Apple juice drink made with high-fructose corn syrup

Fructose is free in solution and easily available for rapid uptake from the gut and absorption into the blood for immediate delivery to the liver for conversion to fat.

Beyond choosing whole fruits over juice, some fruits are lower in fructose than others, including berries, citrus, banana, and kiwi. It’s okay for kids to eat the fruits that are higher in fructose, such as apples, pears, mango, watermelon, and grapes, as long as they aren’t having excessive amounts all at once. We definitely don’t recommend eating three apples or an entire bunch of grapes in one sitting. Generally we recommend no more than two to three servings of fruit per day, but not all at once.

Sugarproof Strategy #4: Use Snacks to Your Advantage

You pick your children up from school and they don’t even greet you. Instead, they say, “What’s for snack?” Even if you have something nutritious to give them, they scarf it down and declare they are still hungry. One snack turns into two, and then three. It’s easy for the snack situation to get out of hand. Know that you are not alone here.

Kids, especially younger children, get hungry and need a snack between meals. The issue isn’t just about the quality of the snack but also the amount of the snack and the timing. If snacks are more like balanced mini-meals or contain fresh fruits and vegetables, they’re a fine option to fill up growing bodies and keep moods and energy even. Chips, cookies, crackers, granola bars, and processed fruit snacks are all choices that take up room in a child’s diet that could otherwise be filled with healthier options. Ultimately, snack time can either be a prime chance to add nutrients to your children’s diets or a major missed window of opportunity. Here are some tactics for making snacks work for you, not against you:

Seize the moment

There are times in the day when your children are genuinely hungry, such as after school or after sports practice. You know that they haven’t eaten for a few hours and have expended energy. Here’s a chance for you to offer something healthy. Don’t waste the moment with cookies or a commercially processed granola bar that is full of sugar.

Recognize boredom and other triggers

There are other times when your child is not actually hungry but wants to snack out of boredom. When food is out on the kitchen counter or in other easy-to-reach places, it’s tempting for everyone. Snacking becomes merely something mindless to do while watching TV or playing on the computer. If your child asks for a snack, or your teen is looking in the refrigerator or freezer for something to eat, propose an alternative activity like going outside, practicing music lessons, doing homework, or contacting a friend. Or offer a simple drink like water or herbal tea—your kids may be thirsty instead of hungry.

Prepare healthy snacks at home

Research shows that most snacking occurs at home, which is good news: It gives parents more influence over what their children are eating. Stock your pantry with Sugarproof snacks or prep them in advance. When you have healthy snacks on hand, they’re also easy to drop into a backpack or lunch bag.

Involve the kids in prep

Kids love to get involved in kitchen tasks like washing vegetables or threading cherry tomatoes, basil, and mozzarella onto toothpicks for little Caprese skewers. When you have more time, spend some with your kids researching, choosing, and making snacks in advance like our Crispy Chickpea, Tamari-Roasted Sunflower Seeds, Easy No-Bake Energy Bites, or granola thins (see Sugarproof Granola and Granola Thins).

Serve a starter before the meal

Think of a pre-dinner snack as a “starter” for the main meal. If your kids are asking for snacks while you are cooking, consider prepping the vegetable component of the meal first and giving it to them as an appetizer. Or simply let them snack on raw vegetables like carrot sticks, cucumber slices, or cherry tomatoes to take the edge off their hunger.

Be flexible about mealtimes

Are your children asking for a snack at 11:00 a.m.? Is it possible instead to serve lunch? If after-school snack time is getting out of hand, can you move dinnertime earlier? This can be difficult with work schedules, but for some families, it is possible to shift mealtimes. In other cases, it may be worth it to give your kids dinner earlier than the rest of the family eats, especially for younger kids. While research definitely supports the notion that having the family eat together promotes more balanced meals, you need to evaluate your own situation. If kids can eat dinner soon after they return home from school, a parent can still sit with them regardless of whether or not the parent eats. Shifting the timing can reduce their demands for snacks, help them eat a better dinner, and also allow for an earlier bedtime if you’re also trying to make a sleep adjustment.

More quantity at meals

If your kids are asking for snack after snack, it could be that they aren’t eating enough at mealtime. For example, if you are packing only half of a sandwich at lunch, consider a full-size sandwich. Teenagers may even want or need two sandwiches or extra side items in their lunches, especially if they are athletes or stay at school for extended hours.

Reconsider snacks during screen time

Whether it’s their favorite show or scheduled video gaming time, snacking during screen time can easily turn into mindless eating. If you are going to let your kids snack while watching a program or gaming, give them something that you don’t mind they eat a lot of, such as cucumbers or carrot slices. We all know how fast a bag of cookies can disappear . . . and surprisingly, veggies will often magically disappear just as quickly.

Sugarproof Strategy # 5: Choose Sweet Treats Wisely

We are all for the occasional dessert or treat, but the trick is knowing how to enjoy it and to be careful about when and how much. As a parent, you can wisely time when kids have sweets and keep them to a reasonable portion. Eating sweets on an empty stomach is going to pack a bigger sugar punch than dessert after a meal when the stomach is already full and digestion will be slower.

One way to shift the thinking, especially for kids, is to think of sweets as dessert—not a snack. When you have already eaten a well-balanced meal, enjoying a small dessert shouldn’t cause a major spike in blood sugar. If you have that same treat on an empty stomach, you would likely notice its effect. If you encourage sweets only after a meal, kids are less hungry and will eat less, ideally just a few bites. They’ll also be more open to a much smaller portion or even sharing. It is important to have a short gap between the meal and the dessert to allow appetite signals and feelings of fullness to kick in. So a good time for a sweet treat would be fifteen to twenty minutes after a meal.

Portions sizes are very important when it comes to dessert. Children who serve themselves can end up taking a bigger portion if there is a bigger amount available. As a parent, you set the tone for the portion size of dessert, and portion sizes influence eating behavior. Research shows that children who are offered a larger portion size will consume more food compared to when they are offered a standard portion size. One way to avoid this situation is to offer “mini-desserts” when you are going to have them at home. In Michael’s house, we sometimes have what we call mini-D: cookies, cake, ice cream, or other treats served in small portions on small plates, and often accompanied with herbal tea. This strategy has become second nature in the Goran house. Everyone is happy with a smaller portion and, most important, it reduces the expectation that dessert will be served in large portions. Smaller desserts also create a great opportunity to teach kids about mindful eating. Encourage them to slow down and enjoy each bite, thinking about the flavors and textures to increase their enjoyment.

Sometimes it can be especially hard to control portion sizes, such as when you are at a social gathering. If there is a dessert buffet where kids can take as much as they want of a larger dish, try to establish a norm for portion sizes. As children get older, they are more susceptible to food cues in the environment and less responsive to internal hunger cues. By establishing a habit of small portion sizes for desserts, you will help your children keep sugar in moderation and allow them to more accurately assess hunger no matter what type of situation they are in.

Need some more tips for keeping portion sizes under control?

Sugarproof Strategy #6: Set Guidelines for the Major Culprits

You have already instilled some basic rules in your children, such as “play nicely with others” and “always try your hardest.” You may have some other rules in your home, too, like “no taking food to your room” or “no drinks next to the computer,” or “if it’s dirty, put it in the dishwasher.” Have you considered some basic rules you might teach around sugar? In his book Food Rules: An Eater’s Manual, the journalist Michael Pollan presents simple and memorable rules such as “Eat Food. Not Too Much. Mostly Plants,” which have helped many people re-evaluate their food choices and instill an internal voice that helps guide them in making food decisions.

No matter whether your parenting style is easygoing or strict, you can give your kids a variety of clear rules for sugar consumption. If you focus on positive, supportive rules and not negative policing, you’ll find that soon these new guidelines will become second nature. You do not have to follow them every single minute of your family’s time together, but they can provide a helpful framework for decisions.

Studies show that kids who are raised in houses with healthy food rules make healthier food choices away from home. For example, researchers from Stanford collected data from 1,246 high schoolers in San Francisco and asked them to choose two snacks from an offering of ten different options that ranged in nutritional quality. The results showed that those who reported having at least one healthy eating rule at home (such as allowing junk food only on special occasions or expecting that a vegetable will be eaten with dinner) were almost two times more likely to choose a healthier snack.

Families who have tried our 7-Day and 28-Day Challenges have found that adopting sugar-related guidelines is very effective in changing old habits and establishing new norms around sugar. The guidelines might be different for each family depending on specific circumstances; it was their very existence that made them effective. Maybe you’ll have dessert only on weekends. Or maybe you will decide not to buy ice cream to keep at home, but instead go out once a month for ice cream as a family. You can guide children with rules, depending on their problem areas. If your nine-year-old consumes candy at every opportunity, maybe it’s time to set a guideline like no candy during the week, or no candy after 4:00 p.m. With a rule like this, your kids might look forward to the weekend, maybe talking about it midweek. But after a few weeks, they will likely have forgotten about the candy and won’t even bring it up. Setting guidelines can be a smart way to break the vicious cycle of sugar and its activation of the internal reward system.

The rule that families we work with find the most helpful is “one treat per day.” This guideline doesn’t mean you must have one treat per day—it means that if there has already been one treat today, then you won’t have any other treats. This strategy works well for younger children because it allows them to control their own decisions. I (Emily) raised both of my boys with this rule. By the time they each reached age three, they had internalized it and are now comfortable with it. For example, they know that if we go to a morning event and they choose to have a treat that’s offered there, then that’s it for the day. Anything else can be enjoyed on another day. It’s a great way to stick to just one a day for a child whose entire world is inundated with ads and opportunities to want sugar. Once most children know the guidelines, they’re less likely to put up a big fuss about it, especially when they know those guidelines are enforced.

Here are some other Sugarproof guidelines you could incorporate, based on whatever seems to be a major issue in your house:

Sugarproof Strategy #7: Work a Restaurant Menu like a Pro

How often do you open a restaurant menu and realize there aren’t many healthy choices? But with a few tricks up your sleeve, you—and your kids—can become pros at creative ordering, whether at a restaurant, a take-out spot, or the local coffee shop. You’ll be able to teach kids that there are usually more options available to them than just nuggets, fries, and a sugar bomb of a drink.

Know where the sugar hides

Certain dishes are more likely to have added sugar than others. Take a typical teriyaki chicken bowl or a sushi dinner with rolls drizzled with eel sauce or ponzu sauce. These healthy-sounding choices could easily contain up to 40 grams of sugar per serving, thanks to the sauces and/or the sugar that’s added to the sushi rice. The table below can give you some guidelines for items where sugar may lurk when you order out.

CUISINE

RED LIGHT:

Things That Tend to Have Added Sugar

YELLOW LIGHT:

Choices That May or May Not Have Added Sugar or Smaller Amounts of Sugar

GREEN LIGHT:

Choices that Tend to Be Free of Added Sugars

Mexican

Horchata, aguas frescas, mole sauce

Salsa, flour tortillas

Corn tortillas, guacamole, grilled meats like fajitas or carne asada, beans

Chinese

Dishes with sauces like sweet and sour, black bean, oyster, or orange glaze

Meat and vegetable stir-fries with garlic or ginger

Steamed brown rice, fried rice, steamed vegetables

American

Hamburger buns, ketchup, breaded proteins like chicken nuggets or fish sticks, salad dressings like French or honey mustard, barbecue sauce, coleslaw, baked beans

Marinated meats

Hamburger without the bun, grilled meats or fish, salads with oil and vinegar dressing

Thai

Pad Thai, pad kee mao, satay sauce or other dipping sauces

Curry dishes, stir-fry dishes with sauces, soups, spring rolls

Steamed brown rice, steamed vegetables

Japanese

Sushi; sweet sauces like teriyaki, ponzu, or eel sauce

Noodle soups

Miso soup, sashimi or grilled fish, steamed brown rice, edamame

Italian

Tomato sauce for pizza or pasta (especially at chain restaurants), pizza dough (especially at chains), breadsticks

Risotto, pasta with vegetables or seafood, salads, second courses like grilled meats or fish

Vietnamese

Marinated meats, noodle dishes with dressing/sauce, dipping sauces

Curry dishes, stir-fries with sauces, spring rolls, pho soup

Steamed brown rice, steamed vegetables

Be wary of the kids’ menu

Meals marketed specifically to kids are often full of fat, salt, and sugar. Too often a sweet drink and a dessert are built into the menu, making it harder to say no. But if you learn to order wisely, you can still save money and control the sugar intake. If you are going to order from the kids’ menu, consider asking for water or milk instead of juice, lemonade, or soda, or dilute them down to share. Or you can give your child the choice of the sweet drink or the dessert, but not both. You can also simply ask the waiter to skip bringing the dessert. And as a last option, you can split a sugary kid’s meal between two kids and add a healthier side dish to supplement it.

Check out the side dishes and starters

Sometimes appetizers and side dishes are just the right size for kids and can work as their meal. Try appetizers like chicken satay (minus any sweet dipping sauces) or other grilled meats on a stick, hummus with pita, or a soup. Side dishes can be great, too, such as a salad, steamed or sautéed vegetables, a baked sweet potato, or beans.

Order family style

Sharing dishes among family members can open up options for eating well. If you have two kids, you can order one main dish for them to share instead of getting each of them a kid’s meal, skipping the sweet drink and dessert that likely come with the kid’s meal. You can fill in gaps by ordering extra vegetable side dishes or salads if needed, and everyone can share these as well. If it is an occasion that calls for a special dessert, order just one (or two for a larger family) for everyone to share.

Don’t be shy about asking

Do you see something on the menu that you are interested in, but you know that it probably has a lot of sugar? Maybe it’s grilled meat with barbecue sauce or salad with a honey-mustard dressing. Don’t be afraid to ask for more information and an eventual substitution. Ask for sauce on the side, no sauce at all, or a different sauce altogether. Sometimes I (Emily) order Indian takeaway with my family. We ask for no added sugar in the curry, and the restaurant is happy to oblige.

Beat the buffet

Buffets pose special challenges. Since you’re already paying a set price, you often feel you need to get the most for your money. Most kids want to try everything—especially the desserts—which can make it harder for you to limit their choices. However, there are some ways you can help your young child choose wisely, even in the face of a real sugar smorgasbord. To help navigate this situation, treat the buffet as consisting of multiple courses. Explain that all of the sweet items fall under the dessert course. This tactic is especially useful for breakfast buffets where kids are immediately drawn to sweet items like pastries or waffles with syrup. You can help avoid overdoing it with these if you explain to kids that these fall into the “dessert” category. First identify a protein to eat, such as scrambled eggs. From there, see if there are other healthy items to add in, like some fruit or a complex carbohydrate like plain oatmeal, unsweetened cereal, or whole-grain toast. Finally, after your child has had a decent meal, they can pick one of the sweet items to try or sample a smaller portion of two items, sharing with other family members.

With these seven Sugarproof strategies, it will be easier for your family to reduce added sugars. It will be easier to maintain the changes for the long term, too. You might find that these strategies alone give your family the boost it needs to reduce sugar. But if you’d like a jump start, or if you like having a plan to follow, read on. We’ll show you how to put our 7-Day and 28-Day Challenges into place. The 7-Day Challenge asks your family to give up all added sugar, but just for one week, and the 28-Day Challenge allows families to reduce sugar gradually and to choose their priorities for sugar reduction. As you read and learn more, you can choose the one that most appeals to you, or you can try both. Either way, you’re on the road to new, healthier habits for your children.

To view the scientific references cited in this chapter, please visit us online at sugarproofkids.com/bibliography.