When I first implemented my son’s ADHD diet, sugar was the hardest part to grasp. I was told he should reduce sugar consumption, but I didn’t know what that really meant. It took some research, but I’ve found some guidelines for how much sugar to consume and which sugars and sweeteners are best.
What I’ve also found is that it takes a lot of work for the average American to reduce sugar in their diet, so it’s good to know why you’re doing it before you get too discouraged. You may have seen studies that claim sugar makes no difference in the expression of ADHD symptoms, but there are arguments to refute these findings*. In the meantime, blood sugar highs and lows, the nutrient depletion that occurs during digestion and the long-term accumulative effects of sugar consumption don’t set your brain up for success. An ADHD diet is all about creating the best environment for brain health. Sugar reduction, among other goals, is part of this process.
How much sugar should I or my child consume?
I’m going to settle one thing right away. When the doc tells you reduce sugar, they aren’t talking about the stuff that naturally occurs in fruit or dried fruit with no sugar added. The sugars in fruit provide an ideal and essential energy source for your brain and come packaged with fiber, making it easy for the body to break down (unlike other sugar sources). In an ADHD diet, you could eat the same recommended daily amount of fruits as everyone else because it is broken down by the body so effectively.
Information on how much fruit to eat per day varies and not everyone agrees with government guidelines. That being said, here is a chart showing what America recommends for fruit servings per day, proceed with caution:
Let’s move away from fruits and talk exclusively about sugar. Recommendations on daily sugar intake vary and all seem to be opposed by one group or another. But somewhere between the differing views of the American Heart Association, Institute of Medicine and unaffiliated rogue hippy nutritionists, all can agree on one thing: ADDED sugars are the problem.
Added sugars are, simply put, the sugars that are added to food. They do not exist in food, they exist in “food products.”
Why would you add sugar to food? It extends the shelf life. It’s cheap to use. And we’ve become accustomed (if not addicted) to the taste. But do we need added sugars in our bodies to properly function? Heck no. In fact, studies show that the overabundance of ADDED sugar consumption in the American diet leads to rising health issues like diabetes, depression, Alzheimer’s and cancer. It’s not helpful for brain function or the treatment of ADHD.
I’m inclined to suggest that the guideline for added sugar consumption should be: none. But let’s be realistic, added sugar is everywhere and SUGAR IS GOING TO HAPPEN. The trick is figuring how much more than “none” is ok to consume. I haven’t seen any guidelines specifically for ADHD, probably because the medical community doesn’t agree that sugar exacerbates ADHD symptoms. If there’s something out there for ADHD sugar consumption guidelines, I’d like to know right away. Perhaps someone could leave a comment. In the meantime, I’m going to use the recommendation for sugar intake from the Institute of Medicine. (Not everyone agrees with the Institute of Medicine. There’s more, just bear with me). IOM guidelines apply to everyone, not just people with ADHD. Since the average American consumes too much sugar, the average American with ADHD probably consumes too much sugar, too.
The IOM says calories from added sugars shouldn’t be more than 25% of your daily caloric intake.
To figure out how many you can consume, multiply your daily caloric intake by 0.25 to get the max recommended sugar calories per day. That number isn’t very helpful, though, because food labels list sugar in grams, not calories. There are 4 calories in every gram of sugar, so divide your max calories by 4 and you’ve got the max GRAMS per day.
To find your daily caloric intake, check out Mayo Clinic’s handy online calorie calculator based on gender, age, weight, height and activity level. If you are figuring out daily caloric intake for a kid, Mayo’s calculator won’t work. However, WebMD has a chart with guidelines for kids. They’re broader than Mayo’s calorie calculator, but you should double check on this stuff with your doctor anyway because I’M NOT A NUTRITIONIST, DIETITIAN OR DOCTOR BY ANY MEANS. I’m just a mom trying to figure this garbage out, then help other people since I’m doing all this homework anyway. And quite frankly I’m a little perturbed that this information isn’t already packaged up in a neat little bundle since ADHD has been a thing since the 1970s. But I digress…
I will use myself as an example. Based on Mayo’s calculator, my daily caloric intake should be 1,800 calories. I multiply that number by 0.25 to get my daily sugar intake, which is 450 calories. Food labels list sugar in grams, so I divide that number by 4 and get 112.5 grams.
112.5 grams is higher than what the American Heart Association recommends for women, which is 25 grams. It is also higher than the World Health Organization’s recommendation for added sugar consumption (as of March 2014), which is 5% – 10% of daily caloric intake, 5% being the target. According to the WHO, my diet of 1,800 daily calories intake would allow for 22.5 – 45 grams of sugar per day.
But even a whopping 112.5 grams can be a tall order in the typical American diet, my friends. And if you’re tracking a kid, it’s even less. Because of this, you might want to start with the most basic form of a food whenever you can, then sweeten it only if you need to. Example: you start with plain old oatmeal that needs some sweetness to appeal to little Johnny’s palette. If you control the sugar that’s added, you can add LESS and pick which type. Some kinds are better than others.
But you can’t always start from scratch, so a bit of exposure to labels will make you familiar with which foods are ridiculous sugar sources and which are mild. I’m going to make an example of soda since it’s obviously NOT a good option for an ADHD-friendly diet. It has about 44 grams of sugar per serving. Organic versions of Rice Chex-style cereal are a good option for ADHD because they only have about 5 grams of sugar (watch out for additives like BHT on the labels of mainstream varieties, though). Plain yogurt has about 10 per serving, but add fruit flavor and it can jump into the 20’s or 30’s. Over time you’ll build up a mental inventory of where the most commonly used foods fall. You can also determine whether or not the sugar comes from a legitimate source by checking the ingredients. The 44g of sugar in soda is from high fructose corn syrup. The sugars in Rice Chex style cereals are from table sugar. The sugars in organic fruit leather are from fruit juices. Any labeled food is not ideal, but the more legitimate the sugar source the better.
Below is a list of some common sugars. This will help you learn which sugars are more legit than others, what to look out for on labels, and what to use in your kitchen.
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GUIDE TO COMMON SUGARS, ADDED SUGARS AND SWEETENERS
Helpful tips before diving into the list:
Keep glycemic index in mind when considering sugars for an ADHD diet. The glycemic index is a scale that goes from 0 to 100 and measures how quickly a carbohydrate will make blood sugars rise. You’re probably familiar with it as a tool for diabetics but it’s also helpful in managing an ADHD diet. Avoiding blood sugar spikes means avoiding blood sugar crashes, and the ADHD brain operates better in a stable environment. High GI’s are over 70 and low GI’s are under 55. I’m a nice person, so I found a link with a list of most of the sweeteners on my guide (and then some) and their GI’s . . . CLICK HERE FOR THE HELPFUL GI LIST.
Also, blood sugar spikes are reduced when sugar is consumed with fiber or protein. Keep this in mind while looking at labels or working in your kitchen.
High fructose corn syrup
This highly processed sugar is overwhelmingly villianized by the general public even though it isn’t much worse than table sugar. Until scientists figure out how much worse it is, there is still definitely a problem with HFCS – it’s EVERYWHERE!! Bread, BBQ sauce, flavorings, ketchup, fruit snacks…the list goes on because it’s cheap! And if you see it on a label it’s probably among a host of multisyllabic cheap “passable” additives and preservatives. The ADHD diet needs none of that. If HFCS is on a label, you are most likely looking at an EVIL, heinous “food product,” not a food. Gingerly set that box/bottle/package down, then run away screaming.
Just a touch less processed and easier for the body to break down than HFCS, corn syrup still has the “food product” ingredient status. You can find it organically, but it’s no better than table sugar. Run/walk screaming.
Table sugar – sucrose
When someone says sugar, this is what most people think of. This is what you are trying to avoid. Like HFCS, corn syrup or any other refined sugar it has no nutrient value and leaches nutrients from the body in order to be digested. So it’s not particularly evil among sugars other than that it exacerbates ADHD symptoms, and a lifetime of over consumption can lead to many forms of death. So, use sparingly!
Also known as confectioners sugar, this is the same as table sugar, but finer. Since it’s typically used to create frosting and decorative dustings you can easily cut it out if your diet. But every once in a while there’s a celebration where cake and icing is involved. In that case, create your own powdered sugar by putting a better crystallized sugar choice into a coffee grinder or blender. Then you have more CONTROL of how much sugar is used!
Molasses is extracted from the sugarcane or sugar beet when table sugar is made. It carries some of the nutrients left behind. Between the light, dark and blackstrap varieties, blackstrap is the best choice. It has the most nutrients and minerals of the three and some people use it as a supplement. If you have to sweeten something, why not use sugar with a bit of nutrients? It also causes a lower blood sugar spike than a lot of sugars, which is ideal for ADHD. But all varieties are still sugar, so don’t be going crazy, now!
Brown sugar is white sugar with a small amount of molasses added. It has a teenie tiny trace of the nutrients from molasses, but not enough to make it a superior health choice among sugars. It’s the same thing as white sugar. If you’re adding sweetness to your food and you like the taste of brown sugar, you could use blackstrap molasses instead and get a touch of nutrient value.
Agave syrup is a natural sweetener made from agave leaf juices. It causes a lower blood sugar spike than table sugar, is cheaper than some other natural sugars, and tastes good. Because it doesn’t cause a high blood sugar spike it’s a better option among refined sugars, but it doesn’t have a higher nutrient value like molasses. It receives nit-picky bad press sometimes, which is mostly backlash from consumers who were duped into thinking it was a superior health choice. It’s not, it just has a lower GI.
When we started my son’s diet, the health food store clerk escorted me to the maple syrup – 100% pure maple syrup, that is. Most pancake syrups are filled with HFCS. Pure maple syrup is natural and adds lovely flavor, sweetness, and a bit of minerals. It’s still sugar, though.
This seemed like a cute concept when I bought a $6 8oz bag at the health food store. Sugar with maple flavor – fantastic! I don’t know what other people have experienced, but when I tested it at home I had to use A LOT before I noticed it. By the time it was finally sweet, I was no better off than if I had used a serving of agave syrup. So if you like to spend extra money to get stupid on sugar with a hint of maple, this is the stuff for you.
The clerk at the health food store also escorted me to this sugar because it comes unrefined and therefore has some nutrient value (the refinement of sugar is what removes its nutrients). Like maple syrup, it’s made from sap, but it’s dehydrated. You certainly don’t get enough nutrients in coconut sugar to replace a daily multivitamin, but it’s better than NO nutrient value. It also doesn’t cause as high of a blood sugar spike as table sugar. When I’ve used it in liquids I’ve found that it doesn’t dissolve right away. Just give it a minute to soak, then come back and it will stir up nicely.
This is the same thing as coconut sugar, but it comes from species of palm tree that don’t grow coconuts. Since the sugar is made from tree sap there’s not much difference to be had. People like to know if their sugar source has fruit growing on it, I guess.
Like the other natural sweeteners, honey can be a good option in moderation. It can also carry vitamins in its raw form (as well as insect parts…no charge on the extra fiber!). Watch out for shady sources though, it can pack lead and mercury. But other than checking into where it came from, this can be a good option. The bad stuff was from China, so you ought to be ok with local honey.
Rice syrup / Brown rice syrup
Before I did research on sugars I would see this ingredient on a label and freak out. I’m not sure why it looked so insidious to me. It’s actually pretty good stuff – one of those unrefined options with a touch of nutrients that doesn’t make blood sugars rocket. It looks like honey and is less sweet than table sugar. Health food bloggers like it. Heck, even Alicia Silverstone likes it. It’s hard to find any bad information on it. So I went out and bought it, and I like it, too!! But it’s still sugar.
Cane sugar – Evaporated Cane Sugar – Sugar In The Raw – Turbinado
This is just a slight wee wee bit more angelic version of table sugar. Table sugar is made from the juice of the harvested sugarcane plant. The juice is boiled, molasses and minerals are separated from the part of the juice that becomes refined, then the refined part evaporates into crystallized sugar. In one more step (bleaching and further stripping) you would have straight up table sugar. Evaporated cane sugar looks fancy on a label to people like myself who are just visiting the health food store, but it’s not really better than table sugar because most of the damage is done when it’s boiled and the molasses/nutrients are removed. You may as well opt for a sugar with some nutrient value.
Rapadara, Whole Cane Sugar, Sucanat
This is unrefined cane sugar. The sugarcane juice goes through JUST an evaporation process, not a boil/evaporation process like refined table sugar. The molasses doesn’t separate and it retains its nutrient value, even more than blackstrap molasses because it doesn’t go through a boiling process first. This includes nutrients that prevent sharp blood sugar spikes. In America you’re likely to see it sold as sucanat (sugar cane natural). Use this stuff as a table sugar replacer if you can!
Beets are a vegetable so this should be healthy, right? Ha, nice try. Beet sugar is made from the sugar beet, the only plant besides sugarcane that truly competes in the sugar market. It goes through a similar refinement process and makes up 20-30% of the world’s sugar production. It’s table sugar. There are better choices out there.
Concentrated Fruit Juice
You’re not likely to use this in home cooking but you may see “fruit juice” referred to as a sweetener on a food label. When you take the juice out of the fruit and concentrate it, all you have left is sugar. There’s no fiber to help digest it, so it doesn’t have the same health benefits as eating fruit. It’s not as evil and sadistic as high fructose corn syrup, but it’s also not as honest and good and angelic as sucanat. In fact it’s a little misleading. How rude.
Malt Syrup – Barley Malt Syrup
Malt syrup is highly recommended on organic and health food websites because it’s another one of those unrefined deals. It’s made from sprouted barley, which gives it a malty flavor. But, like everything on this list, it’s a sugar, so use sparingly.
Glucose, Fructose, Galactose, Sucrose, Maltose, Lactose, Dextrose
This is just a sampling of scientific names for different types of sugars that you might see on labels. Notice anything in common? Ose, ose, ose. They can occur naturally in things like fruits, honey and milk, or combinations of them can create other sugars. For example, glucose and fructose create sucrose (table sugar). One “ose” in particular is an artificial sweetener. You have to watch out for it (below).
Aspartame (Equal, NutraSweet)
By now a no-calorie, no-sugar artificial sweetener is looking like a mighty fine option. Like sugar, aspartame has been given the green light for use in ADHD because in some studies scientists didn’t see a difference in behavior between test subjects who were using it and not using it. There are arguments against the validity of that study but in the meantime consider that aspartame, like sugar, doesn’t create a successful environment for healthy brain function. It turns into formaldehyde in the brain, people. Need I say more? Oh wait, I will. It also creates excitotoxins, which kills brain cells. I dare say that even people without ADHD should avoid it. There are better options.
This is another type of calorie-free sweetener that doesn’t cut the mustard. It’s promoted as if it will help you lose weight, but studies show that it promotes weight gain. There’s a lot of bad press on it and there haven’t been adequate studies of its effects on humans. I don’t see how it could help anyone, but it’s particularly unhelpful for an ADHD diet because it destroys good bacteria in the intestines. It’s a bit counterintuitive to mess with your guts if you’re trying to treat ADHD through diet, wouldn’t you say?
Saccharin (SweetN’ Low)
This is the oldest of all artificial sweeteners and no stranger to controversy. There have been plenty of attempts to prove that it causes cancer (in case you were wondering, cancer is NOT helpful in the treatment of ADHD) yet there hasn’t been a study that’s successfully proven it to be carcinogenic in humans. But really people, is it worth it? Should you opt for something so potentially dangerous just to reduce sugar in the treatment of ADHD? I don’t know about you, but it’s not worth it for me.
Acesulfame-K, Acesulfame Potassium (Sweet One)
Yargh, people. Do I really need to go on and on about artificial sweeteners? Do you get the point yet? They’re bad. This one has a known carcinogen in it, methylene chloride. Don’t consider using artificial sweeteners as a sugar replacement! Stop it!! Bad for you, bad for kids, and not getting you any further ahead!!
Stevia is an herb, not a sugar, and it tastes sweeter than sugar with no calories. This makes it a popular naturally-derived choice. All my bona fide whale-hugging hippy nutrition geek friends give it the thumbs up. Unfortunately I can’t cite them as legitimate resources. But my internet search turned up favorable results. Yours probably will, too. Did I mention it has no effect on blood sugar?
This interesting sweetener sounds more like a drug. Well, it is. It treats middle ear infections. It’s also a popular choice at health food stores, littering labeled foods such as chocolate bars and fish oil swirls. But this sugar alcohol (more on sugar alcohols in a moment…) is not without its skeptics. And apparently too much will make you poop yourself. It appears the amount you can consume while keeping your pants clean varies from person to person, so it’s a matter of *gulp* trial and error. I personally don’t mind the idea behind this stuff, but you may want the kind that’s derived from non-genetically modified sources (and if you’re unfamiliar with GMO’s, that’s another topic entirely).
These are very similar to xylitol in that they are sugar alcohols, and even though both are seen on food products that claim to be sugar free, they haven’t been given the press or the good image that xylitol has been getting lately. Ah, the public is fickle. They all are better than sugar for dental hygiene, a good option for diabetics, and can send you flying to the bathroom with diarrhea. Sugar alcohols have their natural sources, yet they can also be made from genetically modified corn so many people are wary. There are a lot more sugar alcohols, but I think you are seeing a pattern with the “ols” so you understand where I’m going with this. There are other sugar alcohols without the “ol” but this list could go on forever. The point is: sugar alcohols. They exist. LYCASIN, which is made out of maltitol and dextrose, has gone viral on the internet. Perhaps you are already familiar with the reviews of Haribo’s sugar free gummy bears.
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Hopefully this demystifies sugar. There is a lot to know so start with small goals and work your way toward a diet of FOOD, not food products. If you currently consume lots of processed food, check the labels to keep track of sugar intake. Add fruits and slowly move away from foods with labels. If you wean yourself over time the process is a lot less overwhelming on your taste buds, sanity, and your wallet.
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