There is sugar and sugar……

Although I constantly get questions about sugar in my clinic, it has become clear to me again with recent questions  I have received, how confusing the whole sugar topic can be for parents and what misinformation there is on the internet. I commonly get comments like “honey/agave is better than sugar”, “I use fruit sugar because that is better” and “there is corn syrup in the hypoallergenic formula so I do not want to give it to my child”.

I want to start by being clear that free sugars should be avoided and in excess are definitely bad for your baby (and for you). The current recommendations in the UK suggest that a diet should contain less than 5% of free sugars. I have put a link in here of the report for you to read….you will need to have some time and possibly a glass of wine to read through it.

So lets start with the basics. Dietary carbohydrates include both starches and sugars and are ultimately ALL converted to glucose which is the primary energy source for adults and children. They are divided into 4 groups, but I am going to stick to only mono- and disaccharides, which are the ones that cause most confusion. Monosaccharides are single sugar molecules and include glucose, fructose and galactose. Disaccharides have 2 linked sugar molecules and include sucrose (glucose + fructose), lactose (glucose + galactose) and maltose (glucose + glucose). Foods that contain these sugars include:

Fructose = fruits, honey and agave nectar

Lactose = breast milk and formula milk

Sucrose – table sugar and all those sweets/chocolates and sugary drinks

Free sugar is defined by the World Health Organization as all mono- and disaccharides added to foods by the manufacturer, cook, or consumer, plus sugars naturally present in honey, syrups, and fruit juices. So honey is a free sugar, so adding this to any of your child’s foods still means they have free sugars and similarly giving fruit juice also means you are giving a free sugar. Best therefore to stick to water or milk for drinks and plain fruit.

Now what about breast milk and infant formulas. Breast milk contains lactose, this is a sweet dissaccharide that consists of glucose and galactose. Formulas also have lactose in a similar amount as breast milk.  I recently read on a popular forum that some parents believe that some formulas are higher in free sugars than others. First of all the majority of sugar formula is lactose, which is the same as in breast milk.  As mentioned in a previous blog post, the formula ingredients are strictly controlled by the EU so they have to adhere to this. In some of the European Countries you may find flavoured Growing Up milks (please note these are NOT infant formula, but milks for older children). Of course these will have additional sugar and should be avoided, however standard infant formula will have a similar amount of lactose than breast milk.

Finally what about glucose corn syrup. Parents of allergic infants will notice that the majority of hypoallergenic formulas have glucose corn syrup as carbohydrate source. This sugar contains mainly glucose but also maltose. Depending on the method used to hydrolyse the starch and the extent to which the hydrolysis reaction has been allowed to proceed, different grades of glucose syrup are produced, which have different characteristics and uses….and different tastes. You will note that these hypoallergenic formulas are not sweet like syrup (on the contrary they taste bitter), but actually provide a similar amount of glucose/maltose to lactose in breast milk. This is therefore an essential ingredient that provides the majority of energy in the feed.

I will in future also write about oligo and polysaccharides, but I think for a start this is enough about sugars.



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