June 26, 2024

Childhood Obesity Tied to Sugar in Early Diet?

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Manisha B K

MPH (James Lind), MBA, CTAA, 200 RYT Yoga

Childhood Obesity Tied to Sugar in Early Diet?
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Disclaimer: This article is meant for informational purposes only. Livest Health does not provide any diagnostic advice.

“Those little feet won’t be little forever.”

Investing in children is always a capital investment for the country. With urbanization, the proportion of metabolic health disorders has become limitless. Research also inferred that the disrupted metabolic state in adults can be triggered during childhood by their eating habits (knowingly and unknowingly). 

Operant conditioning, maternal conditioning, family, and peer pressure have a huge impact on children and their health. 

Pediatric primary care, nutrition, and mental well-being are crucial in bringing awareness to the changing generations. 

The gut microbiota and childhood obesity

Childhood obesity and non-communicable diseases are the major causes of concern in the world today. While the world is battling with childhood health concerns, researchers found that sugar is one of the culprits that has been rubbing these tiny consumers in the wrong way. 

It has been studied that the gut microbiome that is developed during childhood plays a huge role in developing childhood obesity and non-communicable diseases. (Griebel-Thompson et al., 2023)

What is gut microbiota?

The gut microbiome is responsible for many physiological functions in our bodies. Bacteroidetes, firmicutes, proteobacteria, actinobacteria, bifidobacterium, lactobacilli, etc, are some microorganisms that contribute to a balanced gut microbiome.

This article intends to present the facts about how exposure to added sugars in infant formulas during early childhood can impact the adult’s gut microbiome and potentially hamper their metabolic health in the long run. 

You May Also Like: Understanding the Gut-Brain Axis

How do you develop your gut microbiome?

The gut bacteria or the gut microbiome is absent at birth. However, it can be developed through consistent breastfeeding (transferred by mothers to babies through human milk). HMOs (human milk oligosaccharides) are responsible for developing a healthy gut microbiota. 

The gut bacteria are transferred from a mother to a baby through vaginal birth (vaginal microbiome) and exclusive breastfeeding.

In the absence of breastmilk, it is observed that there can be a heavy gut dysbiosis (imbalance of the gut bacterium).(Wiciński et al., 2020)

Functions of the gut microbiome

  • Nutrient metabolism and absorption of vitamins and minerals (secretes enzymes).
  • Regulate the gut-brain axis communication.
  • Energy balancing and fat storage.
  • Maintains intestinal barrier and mucous membranes. 
  • Regulates inflammatory responses. 
  • Maintains immune functions and inhibits harmful bacterial growth. 

Breastmilk develops the gut microbiome

Breastfeeding is considered liquid gold to infants. Breastmilk acts as immunization for protecting their long-term health needs. 

However, not all mothers are lactating or breastfeeding for various reasons. Hence, many medical companies provide instant feeding formulas to nourish infants, babies, and toddlers. 

Breastmilk is known for its presence of highly dense HMOs (Human milk oligosaccharides), which are complex indigestible sugars that help promote the infant’s gut microbiome. These are natural complex carbohydrates (oligosaccharides) that help release the gut bacterium. (Wiciński et al., 2020)

Note: Complimentary foods are not a substitute for breastfeeding. 

Sugars found in traditional formulas and corn syrup solids

Traditional formula milk consists of cow milk solids like casein, whey, and bovine milk formulations that are rich in protein. They also contain vegetable oils as fat sources. Lactose, maltose, sucrose, maltodextrin, and starch, which are simple carbohydrates and are high in sugars, are present in complementary foods and instant formulas. Formula milk is fortified with iron, vitamins, minerals, and electrolytes. Prebiotic oligosaccharides are a mixture of fructo-oligosaccharides (FOSs) and galacto-oligosaccharides (GOSs) that mimic HMOs (human milk oligosaccharides found in breast milk). 

However, traditional formulas are high in added sugars. 

Formula milk with corn syrup solids generally consists of corn syrup (made of various sugars) for sweetening and texture enhancement. Most formula milk (aged six months and +), breakfast cereals, savory snacks, and purees (soft solids) contain corn syrup and other forms of sugars that can be highly addictive. Sugars have a high potential to be addictive. (Hampson et al., 2022)

It is observed that sugars found in formula milk can hamper the development of the gut microbiome in infants and babies, leading to gut dysbiosis and metabolic disorders in adulthood. 

In a retrospective study, it was confirmed that adults who consumed formula feeds and complementary savory foods as babies had a higher BMI during their childhood, and few of them suffered from childhood obesity. 

Childhood obesity often leads to obesity during adulthood. 

Are baby foods high in sugar?

Recent studies revealed that infant formulas, complementary baby foods, and savory snacks for babies between six and 36 months contain added sugars and fruit sugars at higher than permitted levels. According to WHO, in European countries, formula feeds contribute more than 15% of sugar to total energy consumption, which is dangerously high. 

The nutritional profile on the product label is the primary proof to take up serious retrospective studies by researchers. Many studies were conducted to understand the health consequences of consuming baby formulas with added sugars and flavors. 

Health consequences 

The presence of added sugars in baby foods, cereals, and snacks might lead to: (Garcia et al., 2022)

  • Childhood obesity
  • Type 2 diabetes mellitus
  • Cholesterol and hypertension
  • Addictive eating habits (trait eating and state eating)
  • Dopamine and serotonin dependence behaviors. 

What does Research say?

Many research studies were conducted to examine and understand the concept of sugars and the nutrient profile in complimentary baby foods and snacks for the ages 6 to 36 months.

Most baby food brands have exceeded their sugar limits, while other brands displayed misleading information on their labels. 

WHO recommends not more than 10% of sugars of total energy in a day for a human diet. It is even better to restrict to less than 5% of sugars from their total energy consumption in a day.

In a study published in 2021, it was observed that the UK, Denmark, Malta, and Estonia contribute more than 20% of sugars in their baby products as the most used ingredients. Europe, India, the US, and other countries contribute to more than 15% of permitted sugar levels in their baby food products, which are dangerous levels of sugar exposure in infants, babies, and toddlers. (Hutchinson et al., 2021)

A study published in 2022 found that the gut microbiome of infants who receive formula milk differs from that of infants who are breastfed. A diverse microbial population in human milk and the microbes seed the infant gut microbiome and promote a healthy gut-brain axis. 

In an attempt to encourage the formation of a healthy gut microbiome comparable to that of a breastfed infant, manufacturers often supplement infant formula with prebiotics or probiotics, which are known to have a bifidogenic effect and can modulate the immune system.

The gut microbiome composition in neonates is closely connected with events such as how they are born (full-term or preterm), the mode of delivery (vagina delivery or cesarean section), what neonates are fed (human or formula milk), and how neonates are cared for (mother’s care or at neonatal intensive care unit (NICU)). 

The gut microbiome is also responsible for reducing the risks of childhood obesity, necrotizing enterocolitis, and atopic disorders. (Chong et al., 2022)

Clinical implications

Researchers say that human milk protects the infant’s intestinal cells from oxidative stress and necrotizing enterocolitis. The clinical efficacy of formula milk in preventing diseases such as necrotizing enterocolitis and atopic disorders should be further explored and studied.

The presence of added high sugars in formula milk and complementary foods, snacks, breakfast cereals, and pureed fruits and vegetables is a leading cause of childhood obesity in children who consume them. Childhood obesity and higher BMI during childhood might often lead to obesity during adulthood, along with other metabolic disorders. (Chong et al., 2022)

Conclusion

Policies and reforms for better public health

WHO, The American Heart Association, and other global health reform centers should update their policies and regulations to restrict sugar percentage and usage in formula milk and other complementary baby foods. This helps in avoiding many health concerns, from childhood obesity to metabolic disorders in their growing years. (Ghosh et al., 2019)

Product reformations, transparency of nutrient profiles and labeling, and avoiding misleading marketing are other reforms and policies that can change formula feeds and promote better pediatric health and lifestyles. 

Have any questions for the author? Write to us at [email protected]

References

Chong, H. Y., Tan, L. T. H., Law, J. W. F., Hong, K. W., Ratnasingam, V., Ab Mutalib, N. S., Lee, L. H., & Letchumanan, V. (2022). Exploring the Potential of Human Milk and Formula Milk on Infants’ Gut and Health. Nutrients, 14(17). https://doi.org/10.3390/NU14173554

Garcia, K., Ferreira, G., Reis, F., & Viana, S. (2022). Impact of Dietary Sugars on Gut Microbiota and Metabolic Health. Diabetology 2022, Vol. 3, Pages 549-560, 3(4), 549–560. https://doi.org/10.3390/DIABETOLOGY3040042

Ghosh, S., Raghunath, M., Das, B. C., & Sinha, J. K. (2019). High sugar content in baby food: an Indian perspective. The Lancet Diabetes and Endocrinology, 7(10), 748–749. https://doi.org/10.1016/S2213-8587(19)30291-8

Griebel-Thompson, A. K., Fazzino, T. L., Cramer, E., Paluch, R. A., Morris, K. S., & Kong, K. L. (2023). Early exposure to added sugars via infant formula may explain high intakes of added sugars during complementary feeding beyond maternal modeling. Frontiers in Nutrition, 10, 1188852. https://doi.org/10.3389/FNUT.2023.1188852/BIBTEX

Hampson, H. E., Jones, R. B., Berger, P. K., Plows, J. F., Schmidt, K. A., Alderete, T. L., & Goran, M. I. (2022). Adverse Effects of Infant Formula Made with Corn-Syrup Solids on the Development of Eating Behaviors in Hispanic Children. Nutrients 2022, Vol. 14, Page 1115, 14(5), 1115. https://doi.org/10.3390/NU14051115

Hutchinson, J., Rippin, H., Threapleton, D., Jewell, J., Kanamäe, H., Salupuu, K., Caroli, M., Antignani, A., Pace, L., Vassallo, C., Lande, B., Hildonen, C., Rito, A. I., Santos, M., Gabrijelcic Blenkus, M., Sarkadi-Nagy, E., Erdei, G., Cade, J. E., & Breda, J. (2021). High sugar content of European commercial baby foods and proposed updates to existing recommendations. Maternal & Child Nutrition, 17(1). https://doi.org/10.1111/MCN.13020

Wiciński, M., Sawicka, E., Gębalski, J., Kubiak, K., & Malinowski, B. (2020). Human Milk Oligosaccharides: Health Benefits, Potential Applications in Infant Formulas, and Pharmacology. Nutrients, 12(1). https://doi.org/10.3390/NU12010266

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