Volume 1  Number 4  August 6, 2004
Second Opinions

Foods of Mass Destruction: Sugar Highs and Caffeine Conniptions

It is a truth widely acknowledged among postmodern American moms that ingestion of high sugar foods makes kids crazy. Mothers will tell you a sugar "high," can result from ingesting sweets, like ice cream, cakes, soda, and candy. If a child becomes jumpy, irritable, unmanageable or otherwise acts strangely minutes after eating candy, it's obviously not the kid, it's the candy. This nasty syndrome supposedly is not limited to youngsters, but may also be manifested in adults by loopy behavior often with nervousness and the shakes.

Do sweet foods really pack a high or even a buzz? Sorry to inform you, this is a magisterial myth. If high blood sugar really pushed people "off the mainland", what of those millions of diabetics who generally behave normally even when they occasionally suffer with wildly fluctuating blood sugars in the 150-350 (mg/dl) range? How about patients receiving glucose infusions, most of whom run sky high blood sugars for hours? I've never seen such patients jumping off a hospital bed. Recent studies conducted at Vanderbilt University and the University of Iowa found no evidence that sugar has any adverse effects on children's behavior.

Richard S. Surwit, a medical researcher at Duke University, recently studied sugar's effects on volunteers in a weight-loss program. Not only did subjects lose equal weight on calorie-controlled high-sugar and no-sugar diets, he found no negative side effects. "Nobody reported any behavioral problems, any mood swings, any anxiety, any hyper-kinetic kind of behavior," He adds, "Sugar has gotten a really bad rap...Most simple carbohydrates, like potatoes and rice, have the same metabolic effect as granulated sugar." Yet who ever heard of a potato buzz? A rice high?

Surwit thinks the myth about sugar might have originated during World War II when, in an effort to ease the burden of sugar shortages, health officials spread a rumor that sweets promoted hyperactivity. My own theory is that the effects of low blood sugar, which can indeed cause nervousness, shakiness, and even mental changes, has been the source of confusion in the public mind. Recurrent diagnostic infatuations with "low blood sugar" as a widespread cause of depression, fatigue, and a host of other symptoms - not hyperactivity - has been a hot medical fad on and off for 60 years. (More about low blood sugar in a future newsletter.)

Despite studies to the contrary, misinformation about sugar effects persists. Candy, cookies and cakes fill the menus of birthday parties and social occasions, where people, and especially children and parents are keyed up to begin with. Is this guilt by association? "There are things in sweets that might give you a buzz, but it isn't sugar," Surwit said.

Perhaps he was referring to chocolate or another suspect candidate for hyperactivity. This brings us to a related series of compounds called methyl xanthines. These include caffeine, found widely in various drinks, such as coffee, tea, and soft drinks, and theobromine, found in chocolate. But where's the beef? A good cup of drip coffee indeed carries a nice jolt, the equivalent of a therapeutic dose of caffeine, varying from 90-175 mg per 8 oz. cup, whereas tea contains considerably less caffeine, between 20-60 mg...But, despite the fact that many 3-10 cups a day coffee lovers maintain a nice caffeine level throughout the day, the Government has not yet put caffeine on the list of illegal drugs.

What about caffeine in soft drinks? The U.S. Food and Drug Administration limit the maximum amount of caffeine in soft drinks to 6 mg/oz. Therefore the most caffeine allowed in a 12 oz can of soft drinks is 72 mg. According to the National Soft Drink Association caffeine levels in almost all soft drinks are well below this, in the 20-40 mg range (drinks such as, Sunkist Orange, Pepsi-Cola, Diet Pepsi, Coca-Cola Classic, Cherry Coke, Barq's Root Beer, and Canada Dry). There is no caffeine at all in Sprite, 7-Up, Slice, Fresca, among other drinks. See this page.

Chocolate does contain theobromine, a chemical relative of caffeine, but virtually no caffeine. According to the Hershey Chocolate Company, theobromine occurs naturally in cocoa beans and is present-but never added-in all chocolate products. "Milk chocolate contains less theobromine than dark chocolate...but does not stimulate the central nervous system" Others cite evidence that theobromine is in fact a gentle stimulant and perhaps even a mild antidepressant. See this page. Perhaps we have to give mom a nod when it comes to too many chocolate bars for junior, but the jury is still out. Certainly in domestic animals, especially dogs, chocolate may cause severe organ damage, even death. But for children and adults, I would suggest that sweets, chocolate, and soft drinks, though not a caloric nirvana, are there to be enjoyed by young and old. But as the philosopher observes, "Everything in moderation." If you want Real stimulation, stick with coffee, but "play it as it lies."

Martin F. Sturman, MD, FACP

Copyright 2004, Mathemedics, Inc.

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