Hyperactivity is behavior characterized by overactivity, impulsivity, distractibility, and decreased attention span. Though it has not been scientifically proven, many people believe that children are more likely to be hyperactive if they eat higher amounts of sugar.
Names for added sugars that appear on food labels
Hyperactive children vary from 3%–15% of all children. As of 2012, the U.S. Centers for Disease Control and Prevention (CDC) reported that 9.5% of children had ever been diagnosed with attention deficit hyperactivity disorder (ADHD) in the United States. American sugar consumption hit a record high in 1999, at an average of 155 pounds per person annually. Data indicates that this amount had decreased slightly by 2012. The U.S. Department of Agriculture (USDA) stated in 2000 that the average American, who consumes about 2,000 calories per day, can healthfully eat up to 10 teaspoons (40 g) of added sugars if he or she eats a healthful diet containing all the recommended servings of fruits, dairy products, and other foods. However, sugar is added to seemingly all food products, making it difficult to stay within the recommended range.
Hyperactive children tend to be overly energetic and have constant difficulty paying attention. Normal activity levels in children vary with their age. It is appropriate for a toddler to have a shorter attention span than an older child. Attention levels may also vary depending on the child's interest in the activity. Hyperactive children are those whose activity level is consistently higher than expected for their age group.
The hyperactivity–sugar controversy arose due to numerous claims made by parents after observing hyperactivity in children who ate foods containing sugar or artificial sweeteners, such as aspartame. However, most researchers hold to the belief that the effects of sugar on children are negligible, with several studies reporting that sugar does not cause hyperactivity in children.
From a physiological point of view, however, sugar should affect children's activity, simply because it can enter the bloodstream quickly, producing rapid changes in blood glucose levels and triggering adrenaline. Adrenaline is the substance produced by the body when it falls under stress, providing a short-term energy boost to cope with the stressor. A 1995 study by pediatric researchers at Yale University confirmed that sugar did affect adrenaline when ingested. In the study, healthy children were given large doses of sugar on an empty stomach; within a few hours, their bodies released large amounts of adrenaline, which induced shakiness, anxiety, excitement, and concentration problems. These reactions were observed only in children, and an examination of their brain waves revealed significant changes in their ability to pay attention. However, no direct link was established with dietary sugar, since the study involved the ingestion of large amounts of sugar on an empty stomach.
The causes of hyperactivity can include:
A widely publicized study conducted by Dr. Ben Feingold in the early 1970s suggested that allergies to certain foods and food additives caused the characteristic hyperactivity of ADHD children. Although some children may have adverse reactions to certain foods that can affect their behavior (for example, a rash might temporarily cause a child to be distracted from other tasks), follow-up studies have uncovered no link between food allergies and ADHD.
The U.S. Food and Drug Administration (FDA) notes that they have not found a cause and effect relationship between dyes and hyperactivity in children. On its website, the FDA states that “food and color additives are strictly studied, regulated and monitored. Federal regulations require evidence that each substance is safe at its intended level of use before it may be added to foods. Furthermore, all additives are subject to ongoing safety review as scientific understanding and methods of testing continue to improve. Consumers should feel safe about the foods they eat.”
Continued studies are needed to further examine hyperactivity in children who consume food with and without artificial coloring. Future studies may yield new and beneficial results shedding light and a better understanding on this subject.
It can be difficult to distinguish between hyperactivity and the normal activity level of a child. Because adults are rarely as active as small children, a child may be normally active for his or her age but deemed hyperactive by caregivers.
A medical evaluation will reveal whether hyperactivity is due to neurological disorders or hyperthyroidism. In the case of ADHD, the American Academy of Pediatrics (AAP) has issued guidelines for pediatricians to clarify the issue. Child psychologists can also determine whether the hyperactivity has an underlying emotional origin. The following tests may be used to evaluate hyperactivity:
If the hyperactivity is related to an underlying neurological or psychological cause, treatment of the condition will result in improvement. For hyperactivity unrelated to a medical condition, the following measures can help:
Children need plenty of fiber in their diet to keep adrenaline levels as steady as possible throughout the day. Fiber is found in whole grain products, such as whole grain bread, brown rice, high-fiber cereals, fresh and dried fruits, vegetables, and beans. It is also recommended to limit the amount of processed sugars that children eat as much as possible. High-sugar foods tend to have fewer vitamins and minerals and should be replaced by more nutritious foods. Processed foods that are high in sugar can cause tooth decay and contribute to obesity. It has also been established that the brain of a child may be more sensitive than the adult brain to the effect of low blood sugar, causing children to be more prone to sugar cravings. Since sugar enters the bloodstream quickly, its effects can be reduced if it is consumed along with other nutrients, such as fat and protein. As a rule, sweet desserts consumed after mixed meals that include protein, fat, complex carbohydrates, and fiber are preferable to eating sweet snacks between meals. Besides sugars, many sodas also contain caffeine, a stimulant that contributes to hyperactivity. These soft drinks should be avoided and replaced by water, juices, and caffeine-free drinks.
Some good selections for an afternoon snack include:
Drug therapy is not recommended for hyperactivity that has no medical cause. Medications prescribed for ADHD that decrease hyperactivity, such as Concerta and Ritalin, may have adverse side effects and should only be considered if the ADHD diagnosis has been established.
Massage and relaxation therapies are starting to be considered beneficial for lowering hyperactivity. Studies performed on hyperactive adolescents have shown improved mood and a reduction in hyperactivity in students undergoing massage therapy for ten consecutive school days.
Other measures effective at reducing hyperactivity include choosing schools that can provide a structured classroom environment and teaching relaxation techniques at home. For instance, children might be taught to have periods of “quiet time” so that they can learn how to calm themselves.
There is no cure for hyperactivity, but with practice it can be controlled.
While there is no proven way to prevent hyperactivity, early identification may help prevent the development of ADHD and other developmental disorders.
See also ADHD diet ; Artificial sweeteners ; Casein-free diet ; Dr. Feingold diet ; Food additives ; Food sensitivities ; Gluten-free diet ; Sugar .
Brown, Richard P., and Patricia L. Gerber. Non-Drug Treatments for ADHD: New Options for Kids, Adults, and Clinicians. New York: W.W. Norton & Company, 2012.
Dorfman, Kelly. What's Eating Your Child?: The Hidden Connection Between Food and Childhood Ailments. New York: Workman, 2011.
Smith, Matthew. An Alternative History of Hyperactivity: Food Additives and the Feingold Diet. Critical Issues in Health and Medicine. Piscataway, NJ: Rutgers University Press, 2011.
Blunden, Sarah Lee, Catherine M. Milte, and Natalie Sinn. “Diet and Sleep In Children With Attention Deficit Hyperactivity Disorder.” Journal of Child Health Care 15, no. 1 (March 2011): 14–24.
Johnson, Richard J., et al. “Attention-Deficit/Hyperactivity Disorder: Is It Time to Reappraise the Role of Sugar Consumption?” Postgraduate Medicine 123, no. 5 (September 2011): 39–49.
Jones, Timothy W., et al. “Enhanced Adrenomedullary Response and Increased Susceptibility to Neuroglycopenia: Mechanisms Underlying the Adverse Effects of Sugar Ingestion in Healthy Children.” Journal of Pediatrics 126, no. 2 (1995): 171–77.
Kim, Y., and H. Chang. “Correlation between Attention Deficit Hyperactivity Disorder and Sugar Consumption, Quality of Diet, and Dietary Behavior in School Children.” 5, no. 3 (2011): 236–45.
McCann, Donna, et al. “Food Additives and Hyperactive Behaviour in 3-Year-Old and 8/9-Year-Old Children in the Community: A Randomised, Double-Blinded, Placebo-Controlled Trial.” The Lancet 370, no. 9598 (2007): 1560–67. http://dx.doi.org/10.1016/S01406736(07)61306-3 (accessed September 12, 2012).
MedlinePlus. “Hyperactivity and Sugar.” U.S. National Library of Medicine, National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/002426.htm (accessed September 12, 2012).
U.S. Food and Drug Administration. “Food Ingredients and Colors.” http://www.fda.gov/food/foodingredientspackaging/ucm094211.htm (accessed September 12, 2012.
Wilson, Philip. “Sugar Makes Children Hyperactive—and Other Medical Myths.” Consumer Reports, January 9, 2009. http://news.consumerreports.org/health/2009/01/medical-myths.html (accessed September 12, 2012).
American Academy of Pediatrics (AAP), 141 Northwest Point Blvd., Elk Grove Village, IL, 60007, (847) 434-4000, (800) 433-9016, Fax: (847) 434-8000, http://www.aap.org .
Attention Deficit Disorder Association, PO Box 7557, Wilmington, DE, 19803, (800) 939-1019, firstname.lastname@example.org, http://www.add.org .
Children and Adults with Attention Deficit Disorder (CHADD), 8181 Professional Pl., Ste. 150, Landover, MD, 20785, (301) 306-7070, Fax: (301) 306-7090, (800) 233-4050, http://www.chadd.org .
Monique Laberge, PhD
Revised by Laura Jean Cataldo, RN, EdD