No Evidence of ‘Sugar High’ in Children Found

The myth of the “sugar high” may finally be laid to rest by a comprehensive new study that concludes that consuming large quantities of sugar does not make children hyperactive, experts said Wednesday.

Many scientists have long believed that sugar-laced foods pose no threat to children other than tooth decay and obesity, but the new study, published today in the New England Journal of Medicine “should have a great impact with the general public,” said Dr. Joseph Biederman of Massachusetts General Hospital in Boston.

In the study, researchers prepared all food eaten by 48 children and their families for nine weeks and carefully observed their behavior. “There is no evidence sugar has an adverse effect on children’s behavior,” said Dr. Mark L. Wolraich of Vanderbilt University, who directed the research.

“Every well-controlled study has now shown that there is no link between sugar and behavior,” said Dr. Judith Rapoport of the National Institute of Mental Health. “This is absolutely a dead issue.”

The idea that sugar causes hyperactivity is the second widely accepted myth about the disorder to be discredited in recent years. During the 1980s, similar research disproved the belief that food additives and coloring agents, such as red dye, caused hyperactivity. That notion had caused many parents to adopt the so-called Feingold diet, in which the additives were rigorously excluded from children’s diets.

Although many insisted that the diet was effective, most researchers now believe that the perceived benefits were really a result of the increased parental attention necessary to keep the children on the diet.

The links to sugar and dyes, Rapoport said, “have nothing to do with real data, but a lot to do with people’s frustration and needing answers and better treatment that are not yet forthcoming.”

Although the elimination of sugar and food additives leaves the world without a pop-culture explanation of hyperactivity, researchers believe they are making progress in identifying its causes. Scientists are zeroing in on a gene that seems to be associated with the disorder, and others have identified subtle brain differences that may contribute to it.

Hyperactivity, more properly known as attention deficit hyperactivity disorder or ADHD, is the most common psychiatric diagnosis in American children, affecting as many as 9%. Its major symptoms include a short attention span, difficulty with or inability to finish projects, a low tolerance for frustration and inability to get along with other children and adults.

Physicians had thought that most children outgrew the condition, but new evidence suggests that it can be a lifelong problem that is manifested as drug abuse, frequent job changes and even criminal behavior among adults. By some estimates, as many as 15 million adult Americans suffer from the disorder.

The most common treatment for children and teen-agers involves the central nervous system stimulant Ritalin, which--paradoxically--seems to calm children and enable them to focus on tasks. Many critics argue that Ritalin is overprescribed; recent surveys have shown that it is taken by about 3.6% of elementary school children and 1.5% of those in middle school and junior high.

Wolraich’s study involved 25 children ages 3 to 5, and 23 children ages 6 to 10. The older group had all been identified by their parents as being sensitive to sugar. Psychiatric screening identified nearly a third as having attention deficit disorder or a related disorder.

At the beginning of the study, dietitians went into each of the homes and removed all food. They provided the family with precooked meals and all the other food they needed each week, including snacks, food for guests and even food for parties at school. The families spent three weeks on each of three diets--one containing sugar, one containing the artificial sweetener aspartame (better known as Nutrasweet) and one containing saccharin. Neither the families nor the researchers knew which diets they were receiving.

Parents, teachers and baby-sitters all provided careful evaluations of the children’s activities each week.

The bottom line, Wolraich said, was that the older children’s behavior did not change, no matter what diet they were eating.

Among the younger children, small differences turned up in three of 31 measurements. In one of these, the parents’ ratings of their children’s school performance, behavior actually improved when they were on the sugar diets. The two other measurements showed that the youngsters moved more slowly on a pegboard test when they were eating sugar.

Those results suggest that sugar does not trigger hyperactivity and in some cases might actually have a calming effect, but the effect was very small, Wolraich said.

Experts noted that sugar can provide an energy boost, but that does not normally produce a behavioral change.

Wolraich concedes that his results may not convince everyone. “With some parents, it’s a belief and no matter what we say they are not likely to make a change. The best we can do is provide a good quality study and make them aware of it, and then let them make their own decision.”