Childhood obesity rates in the United States have more than tripled since the 1970s, according to the Centers for Disease Control and Prevention (CDC). In 2015-2016, one in five school-age children was obese.

Faced with these shocking statistics, the American Academy of Pediatrics (AAP) and the American Heart Association (AHA) recently issued a joint statement outlining a range of measures designed to reduce children’s consumption of sugary drinks – a major contributor to obesity.

Despite the current Dietary Guidelines for Americans’ recommendation that children should consume fewer than 10 percent of their daily calories from added sugars (for a maximum of 25 grams per day), the average American child now gets 17 percent of their calories from added sugars – nearly half of which come from sugary drinks. That adds up to a whopping 30+ gallons (or a full bathtub!) of sugary drinks per child each year.

Besides obesity, sugary drinks contribute to a range of preventable health risks including tooth decay, diabetes, high blood pressure and heart disease.

The danger of hidden sugars

While many well-meaning parents limit the amount of soda and sugary fruit drinks their children consume, they’re often unaware of the high levels of added sugar that lurk in some of the seemingly healthy foods they give to their kids.

“Some ‘natural’ snack bars are marketed as ‘healthy’ when, in fact, one of them can contain up to 12 grams of added sugar,” says physician-scientist and registered dietitian Dr. Christina Valentine. “The same goes for fruit bars and gummies. Even though they may contain some fruit, they usually have added sugars. Plus, they’re typically low in fiber and can stick to tiny teeth, increasing the risk of dental cavities.

“Sugar can also hide in foods that are convenient to give to kids, such as prepackaged oatmeal, pasta and pasta sauces, ketchup, and cereals – even if they appear to be ‘healthier’ cereals. Many parents see yogurt as a healthy snack, but some contain high levels of added sugar – especially flavored yogurts. Instead, choose plain Greek yogurt and let your child choose which fruits to add in so that they’re involved. By doing this, they’re more likely to eat what you serve and develop healthier eating habits.”

The truth about “natural” sugars

If you’ve ever googled healthy recipes for your child, you’ve probably noticed that many of them call for honey or maple syrup instead of white sugar. But are these alternatives any healthier?

“It’s important to first establish the difference between naturally occurring sugars and added sugars,” says Dr. Valentine. “Naturally occurring sugars include those that are innate components of foods, such as fructose and lactose when they’re naturally present in fruits, vegetables and milk. Added sugars are added to foods and beverages during processing or at the table.”

So, is the sugar in maple syrup and honey naturally occurring or added? That’s a tricky question that’s raised a lot of debate around the adequate labeling of these foods within the Food and Drug Administration (FDA). Even though the sugars in maple syrup and honey are naturally occurring, these foods are no healthier than table sugar.

“While maple syrup and honey have small amounts of minerals and antioxidants, they’re still sweeteners that contribute similar amounts of carbohydrates and calories to the diet [compared to white sugar],” says Dr. Valentine. “Better alternatives to these sweeteners are foods that contain naturally occurring sugars as well as other nutrients that contribute to good health, such as milk, unsweetened yogurt and fresh fruit. For children, any added sugars in the diet should be limited and consumed as part of the meal instead of snacks.”

And while 100 percent fruit juice might seem like a healthy choice, you’re better off giving your child a piece of whole fruit because it contains more fiber, fewer calories and less sugar.

“Although fruit juice has a superior nutrient composition compared to soda, it can have a similar sugar content,” says Dr. Valentine. “The American Academy of Pediatrics recommends no fruit juice for children under one year. For toddlers aged one to three years, 100 percent fruit juice consumption should be limited to less than four ounces per day.”

Dr. Valentine’s healthy snack ideas

Keen to cut down on the amount of sugar in your child’s diet? “These snacks are rich in nutrients, low in sugar and still tasty,” says Dr. Valentine.

• Cut veggies and hummus: “While not all kids will eat vegetables, pairing them with some hummus can make them more appetizing.”
• Fresh fruit salad or dried fruit: “Fresh fruit salad is always the best. Choose a range of colorful fruits like strawberries, kiwis, clementines, pineapple, grapes and mango. You can also let kids snack on dried fruit, which has a longer shelf-life than fresh fruit, but be sure to stay away from any dried fruit with added sugars or artificial sweeteners.”
• Homemade fruit or veggie chips: “Bake your own chips out of fruits or veggies.”
• Smoothies: “A smoothie can be sweet yet nutritious. Throw in your child’s favorite fresh or frozen fruits, some plain Greek yogurt, and vegetables such as leafy greens to pack in the nutrients.”
• Graham crackers
• Natural or organic peanut butter with celery or unsalted pretzels

And don’t forget to read food labels – you might be surprised to discover how much sugar is hiding in some of your favorite foods!