Sugar and hyperactivity


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Sugar does not cause children’s hyperactivity – the evidence

1) The best ever study

A definitive multimillion dollar study of sugar and behaviour was carried out in 1994 in Tennessee. In the trial, 48 children – half of whom were identified by their parents as sugar-sensitive – ate disguised diets for 9 weeks. All foods were provided by a mobile van that delivered new foods and removed old foods at the end of every week. Although the diet appeared to change every week e.g. predominantly yellow or green vegetables, families and researchers were unaware of the experimental diet changes: every three weeks the sweetener was changed to sugar, aspartame or saccharin (placebo). There was essentially no change in the children’s behaviour or learning ability throughout the 9 week period.

But here’s the important part: all of the diets were kept mostly additive-free. They avoided artificial colours, artificial flavours, preservatives and MSG as well as chocolate and coffee. Spreads and oils used in the diets were free of synthetic antioxidants BHA (320) and BHT (321) and the use of products treated with these antioxidants was kept to a minimum. Guess what? The children improved on all the experimental diets. That’s right. The children’s behaviour ratings and test scores generally improved during the trial compared with their pre-diet base-line values. This finding wasn’t mentioned in the press release at the time and the baseline figures weren’t included in the article because the study was set up to look at the effects of sugar. But these findings show that sugar isn’t the culprit – it’s the additives.

Further reading: Wolraich ML and others, Effects of diets high in sucrose or aspartame on the behavior and cognitive performance of children, N Engl J Med. 1994;330(5):301-7. FULL TEXT at

2) A 2008 meta-analysis of well designed studies

This paper reviews 109 studies and reviews regarding the impact of sucrose on the behavior of children and concluded that well designed studies produced no evidence that it has an adverse influence.

Benton D, Sucrose and behavioral problems. Crit Rev Food Sci Nutr. 2008 ;48(5):385-401

ABSTRACT: Various mechanisms by which sucrose could influence behavior are reviewed. Firstly there is food intolerance. There are dozens of foods to which an adverse reaction has been demonstrated, although a reaction to sucrose is less frequent than many other foods. A second possible mechanism is hypoglycemia. There is evidence that a tendency to develop low blood glucose levels, but higher than those that can be described clinically as hypoglycemic, is associated with irritability and violence. However, sucrose is not the predominant cause of swings in blood glucose levels. Thirdly, the role of sucrose intake on micro-nutrient status has been considered as studies have found that micro-nutrient supplementation decreased anti-social behavior. Micro-nutrient intake is more closely associated with the total energy rather than sucrose intake; typically the amount of sucrose in the diet does not lead to micro-nutrient deficiency. In fact meta-analysis of well designed studies that have examined the impact of sucrose on the behavior of children produced no evidence that it has an adverse influence.

When children’s behaviour appears to be affected by sugary products, they are generally reacting to other ingredients such as additives or salicylates

1) Concerns about the effects of artificial colours, flavours and salicylates on children’s behaviour and learning ability were first reported in 1970s

Feingold BF, Hyperkinesis and learning disabilities linked to artificial food flavors and colors, Am J Nurs, 1975;75(5):797-803 full article at

2) In 2005 a study at the University of Liverpool found that combinations of certain food additives are potentially more toxic than might be predicted from the sum of their individual compounds.

After combining the food colouring brilliant blue (133) with monosodium glutamate (MSG 621) and the colouring quinoline yellow (104) with the artificial sweetener aspartame (951) at levels similar to those consumed in a typical children's snack and drink, researchers found the additive mixtures stunted the growth of nerve cells in mice, interfering with proper signalling functions. Lau K and others, Synergistic Interactions between Commonly Used Food Additives in a Developmental Neurotoxicity Test

3) In December 2007 a multimillion dollar landmark study funded by the UK government was published in the prestigious Lancet medical journal. Dubbed the Southampton study, it found that not just children with hyperactivity but the general population can be affected – colours can reduce the ability of normal children to benefit from schooling.

McCann D et al, Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007 Nov 3;370(9598):1560-7, full article at

Changes in children’s behaviour are NOT all in the mind as claimed by BBC about the Christmas 2008 edition of the British Medical Journal. The Journal said the opposite!

The Festive Medical Myths article in the Christmas 2008 BMJ reviewed 12 studies on sugar and behaviour and concluded that regardless of what parents may believe, sugar is not to blame for out of control children. So far so good. We agree. However this study has been widely reported all over the world as saying that “when parents think their child has had a sugary drink they rate their behaviour as more hyperactive - so it is all in the mind.” (BBC) with dozens of articles telling parents their children can eat Christmas lollies without fear of behavioural change.

These scientists appear to have overlooked the other ingredients in sugary foods and drinks – such as artificial colours, sodium benzoate (211), artificial flavours and/or salicylates – all of which have been shown to cause changes in children’s behaviour.

The researchers themselves were bemused by the finding. "I have three kids... I was sure that sugar made kids hyperactive," said Carroll, director of Indiana University's centre for health policy and professionalism research. "No one seems to want to believe us on this one," said Vreeman, an assistant professor of pediatrics.

Q. I have observed that small amounts of salicylates seem to disrupt my child's ability to regulate his blood sugar. Is this possible?

A. Yes, there is a condition called salicylate-induced hypoglycemia or ketonic hypoglycemia which was relatively common in children 40-50 years ago, when children were often given aspirin (salicylates) and became rare when aspirin was no longer recommended for children. One of the children in our network was diagnosed with it - the recommended treatment of a caloric supplement such as Poly Joule powder (which is failsafe) throughout the day as well as failsafe foods made a huge difference to him.


Sugar and hyperactivity

Vreeman RC and Carroll AE, Festive medical myths, British Medical Journal 2008;337:a2769.  

Where can I find more information?

Fed Up by Sue Dengate, Random House 2008

Introduction to food intolerance

Candida, yeast, sugar, hypoglycemia factsheet

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians 

© Sue Dengate update March 2022