The email from our eight-year-old daughter’s camp—the same one I attended when I was her age—asked us to pack her favourite junk food to share with her bunk mates on their first night. Funnily, I didn’t remember a junk-food party from back when. My wife, Stacey, and I chatted some and, despite our reservations, eventually decided to send along our daughter’s favourite chips; we assumed the bulk of what she’d be offered there would be sweet.
As a parent and as a doctor, I am worried about sugar. In my day job, I work with parents in an Ontario Ministry of Health–funded, year-long childhood-obesity program; as a father of three, my vantage is also personal. There’s no doubt that excess sugar is not in our children’s best interests. The World Health Organization, the American Heart Association, and Canada’s Heart and Stroke Foundation have all called for strict limits on added sugars—a daily maximum of between six to twelve added teaspoons for adults, and no more than six for kids. (I estimate that my daughter was offered an average of sixty-three teaspoons of added sugar a day during her week-long stay at camp .)
Some researchers suggest that sugar is in and of itself uniquely and dramatically toxic—that independent of its effect on weight, sugar increases the risk of heart disease, diabetes, fatty liver disease, and other illnesses. Others see sugar as a driver of illness only in terms of its contribution to weight gain. I’m not wholly convinced that added and free sugars—those incorporated into foods during processing or preparation and those found in honeys, syrups, and fruit juices—are markedly worse than highly refined carbohydrates, but I also don’t think we need to wait for a medical consensus on sugar’s inherent toxicity in light of the sheer quantities of it this generation of children is consuming.
What I can say with certainty is that the world has become one giant candy store. Its sugar “pushers”—a term generally associated with those who encourage the use of recreational drugs, and which I am using intentionally—are everywhere. There are pushers in schools, hawking candy as a reward for good behaviour. There are pushers in our parks, slinging sport drinks as a reward just for showing up to play. There are pushers in our grocery stores, selling chocolate bars to support local charities. There are pushers in our friends’ homes, handing out loot bags and just because treats. At family gatherings, sugar pushers are often better known by the names Grandma and Grandpa (or, in my kids’ case, Bubbie and Zaidi). However, unlike drug pushers, sugar pushers hawk their wares out in the open, and their offers are considered fun and normal. And that’s the problem.
Each may be well intentioned, but collectively they are unwitting conscripts of the food industry, and they reflect a society that has normalized the distribution of junk food to pacify and reward our children.
How much sugar is being pushed on our kids? Over the course of a full year a few years ago, Stacey and I set out to answer this question. Every night before bed, we’d ask our three daughters—then aged eight, six, and four—about who offered them what junk food that day, and then we meticulously recorded the item, the pusher, and the occasion. While my wife and I are by no means purists—birthdays and holidays and other celebrations in our family include sugary indulgences—we also try to use quality building materials in our girls’ growing bodies, and we wanted to know just how many sweet, granulated, white bricks were being added to their foundations when we weren’t looking. We gave our girls no instructions in terms of whether to refuse the offerings, nor did we vilify sugar or its pushers. We explained that we simply wanted to keep track.
The numbers were staggering. Over the course of the year, friends, family members, teachers, camp counsellors, neighbours, and others pushed forty-one pounds of sugar on our kids, distributed across 921 different offerings. That’s over 4,600 added teaspoons—just shy of ninety-seven cups. Some sources of added sugar were predictable, like cake at friends’ birthday parties. Others were a surprise, including the Halloween-sized boxes of Smarties chocolate all three girls were offered by a pharmacist when they received their flu shots. One of them was given an extra because she was crying.
Sugar is found naturally in a wide variety of foods and is responsible for their sweet taste: it is glucose and fructose in fruits and vegetables, maltose in grains, and lactose in milks. One study has found that, in one form or another, sugar is also added to a full two-thirds of packaged foods and drinks in Canada, including in some items you might not expect, such as tomato sauce, yoghurt, and frozen dinners.
Regardless of source, the cells of your body use sugar for energy. When sugar is consumed and absorbed, the body produces insulin, which regulates the level of sugar in the bloodstream. Sugar that’s not being used immediately for energy can be stored—in finite amounts of glycogen, in the muscles and liver, and also in the form of lipids in our fat cells, where there isn’t really a limit on storage (because fat cells multiply). Diets high in sugar are associated with obesity, heart disease, stroke, diabetes, various cancers, and, of course, cavities.
Currently, nutrition-labelling rules allow each of sugar’s many variants to be listed separately. As a consequence, while sugar may be the first or second most prevalent ingredient in a food, once it is distributed across multiple sources, it may appear less significant to shoppers—even those who are concerned about healthy eating. (There are currently 152 different ways to list sugar without calling it sugar on Canadian food labels, including barley malt syrup, dehydrated cane juice, fruit juice concentrate, maltodextrin, and potato syrup solids.) Current regulations also allow products with added fruit concentrates, purées, and evaporates to assert that there is “no sugar added”—sometimes even in the case of products such as “fruit snacks” that by weight are 86 percent sugar and are marketed to parents as fruit equivalents. Both of these inconsistencies stand to be corrected in 2022, the deadline for manufacturers to implement new Health Canada labelling policies, which will require that all of a food’s various sugar contributors be combined into one, and curtail those “no sugar added” claims.
So how did the overconsumption of sugar become the norm? It is easy to point to the millions of dollars that the food industry spends marketing junk food. But does that alone explain why the principal of an Ontario elementary school provided eight-year-olds with packages of Oreos along with the standardized tests they were writing, or why a chief psychologist of another school board defended that practice to me on Twitter? We also can’t just blame the increasing portion sizes that the food industry has foisted on us over the past five decades, or government recommendations to decrease saturated fats (which some argue have led to an accompanying increase in the consumption of high-carb, high-sugar processed foods), or industry funding of scientists, or weak school food policies. No expert that I’ve consulted has identified any single culprit.
Because the deluge of sugar has many sources, there isn’t one clear or easy way to stop it: people—rightly—claim that filling any one particular sandbag won’t stop the flood. And, indeed, the arguments that tend to get trotted out in junk food’s defence are “but it’s just one treat” and “parents (or kids) can just say no.” My family’s year of tracking refutes both those claims. It wasn’t just one, or even two or twelve, but hundreds of occasions on which my kids were offered sugar, from those flu-shot treats to the chocolate milk they could get at school several days a week. To explore that common example: one small chocolate-milk carton consumed daily for a 195-day school year provides a child with 10.5 pounds, or twenty-four cups, of sugar, about half of which are added. To serve it to children because they’ll drink it more readily than plain milk is akin to serving daily apple pies to kids who don’t like apples.
But while parents can say no, and theoretically so can children, I’m not sure a realistic solution to a flood is just reminding people to swim. Especially this flood. Back when we sent our daughter to her camp party with chips, some people disputed the approach; one suggested that we could have sent maca-and-date balls with her instead. Though I’m still not entirely clear on what a maca ball is, I am confident that had we done so, my daughter would have run the risk of being called Maca Ball for the summer. And, truly, this isn’t and wasn’t her fight. Relying on eight-year-olds to resist society’s sugar pushers is unrealistic and unfair. Our children’s relationship with food matters—but so do their relationships with peers, educators, grandparents, coaches, and neighbours. Teaching kids to take a rigid stand when offered treats risks those relationships. Yes, kids living in flood plains should know how to swim, but it’s wiser to build them some levees.
My wife and I have joined many others, and we’ve started to fill some sandbags. We began when our eldest daughter was about two. As Stacey remembers it: “It was around that time that we began to notice the number of treats that [she] was being offered on a regular basis , not just on Halloween when we were expecting it. It was frustrating for us because while we wanted to enjoy the pleasures of giving our daughter treats—taking her for ice cream, baking cookies with her—we felt that the amount of sugar she was being offered . . . was already more than her little body ought to be consuming.” Waiting for the food industry to do the right thing would have been an exercise in futility—the right thing would lead to decreased sugar consumption and a decrease in product sales—and so we decided what we needed then, and what we probably need even more now, is some guerrilla intervention.
The place to launch your nutrition campaign is at home. It may be as simple as checking the labels of your dietary staples for large sources of added sugars and looking for healthier alternatives. Or maybe it’s swapping one processed meal a week for one you cook together. (It need not be fancy: one of our staples is eggs-in-a-hole, with heart shaped cut-outs.) You can also tackle the sugar at birthday parties. By no means am I suggesting that there shouldn’t be cake, but do your kids’ friends really need to leave with a loot bag full of sugar? We’ve given out stickers and bubbles, and thrown crafting parties so the kids each make something to take home. There have been no complaints, and we’ve noticed more of our daughters’ friends giving out non-junk loot bags, too.
For some families, change may stop here. Life is complicated. Not everyone has the time, energy, money, or capacity to tackle other venues. If you do want to expand beyond this, I have learned that the basic recipe for becoming a guerrilla nutrition activist is straightforward, and the one ingredient that really spoils the mix is anger. Getting mad at people who genuinely care about my children isn’t a good way to build trust or effect change. The teachers and coaches and camp counsellors who give out candy for good behaviour aren’t doing so to undermine my children’s health; they’re doing it because it works, and because that’s what everyone else does.
I have been able to make the most difference when I lead with kindness—when I start by recognizing the care someone is providing my child and then point out that there’s one area, though, where their usual concern doesn’t seem to shine, where there’s a contradiction, even: the junk food. I try to explain that really, it’s not just one treat, and that I don’t think it’s fair to have my child singled out for turning down a group treat. And then I suggest an alternative and offer to help.
Further proof that kids are just as happy with non-junk-food rewards: Halloween. Encouraged by a study that found kids valued toys just as much as candy, Stacey and I stopped handing out the sweet stuff in 2006. At the time, we were living in dense, young suburbia; the streets were thick with little superheroes, pirates, and princesses. As the afternoon of Halloween gave way to dusk, it was eggs, not monsters, that Stacey and I feared as we prepared to hand out something other than candy. But we decided we had to give it a shot. We handed out small Play-Doh containers that we found at Costco; they cost us twenty cents per goblin. Other years, we’ve given out glow wands, and swords purchased in bulk at the dollar store. Our house has yet to be egged or toilet papered.
Schools may be your next objective. There are many battlegrounds here, but it may be easiest to focus on your child’s classroom, especially if treats are used as a reward. There are dozens of non-food ideas that harried teachers can choose from instead: dance parties, pyjama days, sit-wherever-you-want passes—the list goes on. (When one of my daughters was in grade five, her teacher decided the students would get to choose a colour and streak her hair with it as their year-end celebration. She told me that she wanted to motivate the kids to read throughout the year “and what better way than [attempting] to humiliate your teacher!”) Then there’s that school staple: the bake sale, part of a ubiquitous practice of junk-food fundraising (think door-to-door chocolate sales and sports team funding drives). There is no shortage of other fundraising options you can suggest, from rummage sales to selling flower bulbs in place of candy bars.
Larger-scale change is possible as well. Ontario’s Middlesex County, for instance, launched their Healthy Sideline Snacks project in 2016; their goal is to return their sports fields and arenas to the days of water and fruit slices in place of our sugary norms. Through pledge sheets, social-media encouragement, and perseverance, participation grew from sixteen teams in the first year to forty-four in 2017. Middlesex County estimates that over 500 children have benefited.
Over our past decade as nutrition guerillas, my wife and I have learned a great deal about ourselves and our community. Most importantly, we now understand that politicians’ short mandates and the food industry’s unwillingness to curtail its own sales, when coupled with the misguided belief that individuals can easily opt out of our pervasive junk food culture, smothers change. Indeed, like with any health-improvement program, change must begin with our own words and actions—by way of thoughtful nutrition and creative, often collaborative, solutions spreading from one home to another and then another and then to our schools, arenas, camps, and communities. We can work directly with the sugar pushers among us to change our sweetly toxic food culture.
