A reader introduces a new factor:
The original post was correct: sugar does not make kids hyper. It is generally other things in the candy that does so. One reader mentioned food dyes, but the biggest culprit is chocolate, which contains caffiene. And since I would guess that the majority of candy eaten by kids contains chocolate, parents have just been making wrong assumptions.
Another writes:
I’m glad that you added an email regarding food dyes. Reading the stories of hyperactivity (including hallucinations), it’s evident that these kids were all eating things with tons of artificial colors and flavors in them (Easter basket, sherbert, etc).
When they eat sugar without the dyes (pasta and orange juice), the kid is the opposite of hyper and passes out. From the age of two, my nephew was a totally hyper kid and had a very short attention span. Through a lot of trial and error and research, his mother figured out that he was allergic to salicylates, and put him on the Feingold diet. He IMMEDIATELY became a completely different kid – calm, able to be reasoned with, and with an unusually long attention span.
A friend had a young kid who reminded me of my nephew – I didn’t know it at the time, but when he was about four years old she was about to put him on Ritalin when she independently found out about sensitivity to food dyes and put her son on Feingold as well. Within days she had a completely different kid. In both instances, any time the kids eat salicylates (which aren’t just in artificial colors and flavors), they become their old hyperactive ADHD-like selves.
This allergy doesn’t affect every child, and the effect seems to wear off as one goes through puberty. Nonetheless, how many kids who are eating tons of salicylates do you think are put on Ritalin to deal with their hyperactivity/ADHD, instead of just changing their diets?
In an email, Aaron Carroll counters the food dye theory, etc:
I read with interest some of your readers’ responses to your post on my post. I’ve been getting similar comments at The Incidental Economist as well. Here’s the thing. Anecdotes are not the same as studies. Not even a collection of them.
I will concede that you can’t prove a negative. Therefore, I cannot prove that there isn’t a single child out there who is sensitive to sugar. The question is, rather, whether this is a widespread phenomenon or whether parents can identify if they have such as a child.
As to the former, it doesn’t appear to be so. As I said in my post, there have been many randomized controlled trials on this topic. RCTs are the most powerful types of studies, and the only ones that can prove causation. They don’t find a relationship. Yes, one individual author may hedge and say it’s not enough, but the whole sum of them are rather convincing.
Let me give you an example of how they work. We divide kids into two groups. One gets sugar, the other gets a sugar-free substitute. Then we measure hyperactivity. There will be kids in both groups who are hyper and kids who are not. The important question is whether there are more kids in the sugar group than the non-sugar who are hyper. There aren’t. This means that the hyperactivity, while present in some kids after sugar, isn’t caused by the sugar. Some parents who see hyperactivity in the sugar group will believe so, but there will be just as many in the non-sugar group.
As to the second idea, whether parents can accurately identify those kids who are sensitive to sugar, I point you to the study I summarized:
[C]hildren were divided into two groups. All of them were given a sugar-free beverage to drink. But half the parents were told that their child had just had a drink with sugar. Then, all of the parents were told to grade their children’s behavior. Not surprisingly, the parents of children who thought their children had drunk a ton of sugar rated their children as significantly more hyperactive. This myth is entirely in parents’ heads. We see it because we believe it.
Parents who believe their children are hyper when they get sugar are conditioned to see it, even when their kids aren’t given real sugar. They’re not reliable.
As to the red dyes, the evidence there is not compelling either (emphasis mine):
Adverse behavioral responses to ingestion of any kind of candy have been reported repeatedly in the lay press. Parents and teachers alike attribute excessive motor activity and other disruptive behaviors to candy consumption. However, anecdotal observations of this kind need to be tested scientifically before conclusions can be drawn, and criteria for interpreting diet behavior studies must be rigorous. Ingredients in nonchocolate candy (sugar, artificial food colors), components in chocolate candy (sugar, artificial food colors in coatings, caffeine), and chocolate itself have been investigated for any adverse effects on behavior.
Feingold theorized that food additives (artificial colors and flavors) and natural salicylates caused hyperactivity in children and elimination of these components would result in dramatic improvement in behavior. Numerous double-blind studies of the Feingold hypothesis have led to the rejection of the idea that this elimination diet has any benefit beyond the normal placebo effect. Although sugar is widely believed by the public to cause hyperactive behavior, this has not been scientifically substantiated. Twelve double-blind, placebo-controlled studies of sugar challenges failed to provide any evidence that sugar ingestion leads to untoward behavior in children with Attention-Deficit Hyperactivity Disorder or in normal children. Likewise, none of the studies testing candy or chocolate found any negative effect of these foods on behavior. For children with behavioral problems, diet-oriented treatment does not appear to be appropriate. Rather, clinicians treating these children recommend a multidisciplinary approach. The goal of diet treatment is to ensure a balanced diet with adequate energy and nutrients for optimal growth.
Not that I expect this will settle the debate. I’m becoming convinced I will never win this one.
The Dish 