Experts say sugar not linked to hyperactivity in children

MEDICAL MATTERS

June 23, 2006|By JUDY FOREMAN

Does sugar make kids hyperactive?

Parents of young children never believe this, but the answer, at least according to some experts, is no.

The American Academy of Pediatrics, in a book called The Official, Complete Home Reference Guide to Your Child's Nutrition, says that "when put to the test, the sugar-behavior link does not hold up." One study referenced by the doctors' group found "no effect on behavior or the ability to concentrate when sugar intake was far above normal, even among those whom parents identified as `sugar sensitive.'"

Another study the group referenced found that "when boys whose parents believed them to be sugar reactive were each given a large dose of sugar, they were actually less active than before." Several other studies that compared blood sugar levels found that even kids with Attention Deficit Hyperactivity Disorder had the same response to sugar consumption as children without the disorder.

Medline, a service of the National Library of Medicine and the National Institutes of Health, does note that refined sugars may have some effect on children's activity. "Because refined sugars and carbohydrates enter the bloodstream quickly, they produce rapid fluctuations in blood glucose levels."

It is possible, the site continues, that this "might trigger adrenaline and make a child more active."

But Dr. Michael Shannon, chief of emergency medicine at Children's Hospital in Boston, said, "I have taken care of children for 25 years. I have never believed or seen what I thought was an association between sugar and hyperactivity."

What may be confusing for parents, he said, is that many sugary foods also contain caffeine, which can hype kids up - so it's not always obvious which foods contain this stimulant. "I do think there is an association between caffeine and hyperactivity," Shannon said, "but not between sugar and hyperactivity." If you have reflux, should you get an endoscopy?

Reflux is an extremely common problem, affecting an estimated 20 million Americans. It occurs when food and acid from the stomach back up into the esophagus, or food tube.

The most common symptom is heartburn, but reflux can also show up as hoarseness (backed-up acid attacks the vocal cords), sinusitis (acid irritates tissues in the nose) and asthma (droplets of acid are inhaled into the lungs).

Mostly, reflux is an annoyance. But in some people --- about 3 million Americans at any given time - reflux leads to Barrett's esophagus, a pre-cancerous state in which the body tries to combat the acid by transforming normal esophageal cells into intestinal cells that pump out protective mucus, said Dr. Rosalind Barron, a gastroenterologist at Mount Auburn Hospital in Cambridge, Mass.

Once you get Barrett's esophagus, the chances are still small - about 5 percent - that it will turn into difficult-to-treat esophageal cancer. But it does often enough that esophageal cancer is now the fastest-rising cancer in the country. According to American Cancer Society figures, it will strike about 14,550 people this year and kill 13,770.

"It seems to be almost an epidemic," said Dr. Hiroshi Mashimo, a gastroenterologist at VA Boston Healthcare and Brigham and Women's Hospital.

So, the trick is to spot those people with reflux who may be heading down this path by screening them with an endoscope, a small viewing tube that is passed down the esophagus to the juncture with the stomach.

Because they are at higher risk (for unclear reasons), white males with long-standing reflux - such as heartburn several times a week for several years - should have at least one endoscopy in midlife to rule out Barrett's esophagus, said Barron. So should anybody who has trouble swallowing and anyone with a family history of Barrett's.

People with other signs of reflux, such as hoarseness of long duration or chronic cough, should see a doctor.

Send your questions to foreman@baltsun.com.

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