When I saw this article: “Sugar, salt or sweeteners may be key to getting children to eat greens” last week in the Nutrition Resource Centre “News in Brief” email I knew that I had to read more. I mean, were the authors really suggesting that we should add sugar to veggies to get infants and toddlers to eat them? Or was this just a case of a misleading or misinterpreted press release? I found a copy of the full article: Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables and set about reading.
One thing that struck me right away was that this study was done with adults, no infants or toddlers, or children of any age were involved in the research. Adult participants were provided with puréed vegetables (broccoli, kale, and spinach) with varying concentrations of added sugar. They were asked to rate them on various attributes, and most importantly, they were asked to indicate whether or not they liked or disliked each sample. I was surprised that the conclusion would be drawn that adding sugar to green vegetables is a reasonable means to encourage infants to eat them (I’m saying infants because these were puréed veggies and as such are really only suitable for babies just starting to eat solid foods) based on ratings by adults. After all, adults have very different palates than infants and have very different relationships with food that have been shaped over decades. To me it seems inappropriate to conclude that because adults preferred sugar sweetened veggies that infants will as well. The authors themselves also state that, “It should be noted that infants and toddlers are also not merely small adults”. However, they also use the analogy of adults beginning coffee consumption with added sugar and gradually weaning off the sugar as justification for proposing adding sugar to vegetables when the World Health Organization, among many other bodies, is currently encouraging reduced consumption of added sugars.
The second thing I wondered about was precisely how much sugar was added to each serving of vegetables. The news article, and much of the journal article, references 1% and 2% concentrations but what did that translate to in teaspoons or grams? It sounds pretty innocuous, right? 1% or 2% is hardly anything. Well, in actuality the 1% was equivalent to the addition of 1/2 teaspoon per serving and the 2% was equivalent to 1 teaspoon per serving. Not an insignificant amount when you’re talking about toddlers who are generally only consuming a tablespoon or two of a food in a serving. Interestingly, the researchers asked parents how comfortable they would be offering their babies vegetables with added sugar in amounts of 8 calories, 16 calories, 1/2 teaspoon, or 1 teaspoon. The 8 calories = 1/2 teaspoon = 1% concentration. The 16 calories = 1 teaspoon = 2% concentration. Essentially asking: how can we frame this added sugar to make it more palatable to parents who are trying to feed their children healthy diets?
Despite the general conclusion that adding sugar to vegetables may encourage young children to eat them, even the ratings by adults were not overwhelmingly improved by the added sugar. For broccoli and kale purées both 1% and 2% sugar increased overall liking. For spinach the 2% sugar (but not the 1%) increased overall liking. For broccoli and spinach the sugar increased the ratings of liking from disliked to liked. However, for kale, even at the highest sugar level ratings never rose above the midpoint (i.e. neither like nor dislike). So, these adults did not like any of the green vegetables to begin with (at least not in puréed form) but after adding higher quantities of sugar they liked the spinach, and even with the smaller quantity of added sugar they liked the broccoli. But neither amount of sugar was enough to get them to like the kale. Would babies have different initial reactions to these vegetables? Would the addition of sugar cause them to change these reactions? I don’t know and I don’t think anyone can say based on the results of this study alone.
Just for fun, I took a look at the funding sources for the study after I finished reading it. Can you guess what one of the funding organizations was? If you guess the Sugar Association you’d be correct. I think this explains a lot because honestly I was a bit baffled as to why anyone would be looking into adding sugar to get babies to eat vegetables and why such tenuous conclusions would be drawn and publicized based on the actual findings. But who other than the Sugar Association would think that we need to encourage babies to eat more sugar?
I think a better analogy than the sugar sweetened coffee for this research would be the argument that chocolate milk is a good way to get kids to drink milk or that baking apples into a pie is a good way to encourage fruit consumption. In some ways it’s even worse because infants are at the mercy of their caregivers when it comes to what foods are offered to them and encouraging a preference for only sweet foods at such a young impressionable age could have long lasting implications for their food choices and health throughout their lives.