PRESCRIPTIONS
Trials fail to prove link between sugar, behavior

By Dr. Landis Lum

Q. My 5-year-old granddaughter throws temper tantrums quite often, and her mother thinks that it tends to happen when her sugar intake is more than usual, as when there is a classmate's birthday party at school, so she stops giving her any treats after dinner on school days. Is it true that excess sugar can cause bad behavior? (By the way, they don't call it temper tantrums — they call it "meltdowns.")

A. Dr. Mortimer Gross of Chicago Medical School found that refined sugar (sucrose) caused a hyperkinetic boy and his mother to have headaches, irritability and hyperactivity — and they did not have these reactions with glucose, lactose or saccharin.

To test how common this was, he found 50 hyperactive children whose mothers had claimed that they "knew" or were "sure" that their keiki's hyperactivity and general behavior were much worse after eating foods containing refined sugar, and gave each of them either a glass of lemonade sweetened with saccharin or lemonade sweetened with refined sugar, and repeated this three times. In this "blinded" experiment, reported in 1984 in the journal Pediatrics, not even one of these 50 kids had a worsening of their behavior after drinking the lemonade containing refined sugar.

Ten years later, a study in the New England Journal of Medicine was done in 25 normal preschool children and 23 school-age children who were described by their parents as sensitive to sugar. They were put on diets that were high in either refined sugar, aspartame, or saccharin. They were on each diet for three weeks, but were not told which diet they were on. All the diets were essentially free of additives, artificial food coloring and preservatives. They found that there were no consistent differences among the three diets in any of 39 behavioral and cognitive variables that were measured each week, and concluded that neither refined sugar (sucrose) nor aspartame had negative effects on children's behavior or cognitive function.

Similarly, 12 other double-blind, placebo-controlled studies of sugar challenges failed to provide any evidence that sugar causes disruptive behavior in children with attention-deficit hyperactivity disorder or normal children.

Likewise, none of the studies testing candy or chocolate found any negative behavioral effects. Therefore, for children with behavioral problems, diet-oriented treatment does not appear to be appropriate. So unfortunately (or fortunately for your granddaughter), depriving her of after dinner treats won't reduce meltdowns — this may be a topic of a future column — but for now, talk to your family doctor, pediatrician, or psychologist about how to decrease temper tantrums.

Dr. Landis Lum is a family practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine.

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