In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

An unbalanced diet with a high proportion of added sugar jeopardizes our health and increases the risk of overweight, type 2 diabetes, and cardiovascular diseases. Yet sugar alone is not to blame. It comes down to overall eating habits and personal lifestyle. A balance between energy intake and energy consumption yields a normal weight. If the balance of energy is not in equilibrium and is combined with inadequate everyday physical activity, the risk of overweight as well as other diseases increases.

How Is Sugar Addictive?

Eating sweet foods does not need to be learned. We love sugar. The preference for the sweet taste is innate in humans and even breast milk tastes slightly sweet. It is assumed that the imprinting of taste perceptions already takes place in the womb. Abstaining from sugar does not trigger any physical withdrawal symptoms and, unlike drugs, food – and thus the consumption of carbohydrates – is necessary for life. After consuming sugar, a reward system in the brain is activated and it provokes a pleasant feeling via the neurotransmitters serotonin and dopamine. This increases the motivation to repeat this feeling – a useful mechanism from the early days of mankind when the consumption of rare sweet foods was necessary for survival. In overweight persons, the reward area of the brain additionally appears to react more strongly to pictures of sweet foods than in the case of persons of normal weight. The consumption of foods containing sugar causes the blood glucose level to increase rapidly; however, it also quickly decreases once again. Hunger returns. If sugar is then eaten again, a vicious cycle easily begins.

The penchant for sweet foods is not just related to biochemical processes in the body but is also associated with learned behavior. Starting in childhood, sweets are often used as a reward, comfort, or gift. In young children in particular, a restrained, conscious approach to sugary foods should be taken. Many foods promoted and developed especially for children are not particularly tailored to children’s nutritional needs but often contain a lot of sugar and fat. Taste preferences are critically shaped from an early age by eating habits. If children regularly eat too much sugar, they become accustomed to the sweet taste. The stimulus threshold for sweet foods increases. It is recommended to take a look at the list of ingredients and nutrition chart. And it is worth it to set a good example. It may help to initially observe yourself to identify the situations in which you automatically reach for sweet foods. Is it from frustration, stress, sadness, boredom, or as a reward? Are there alternatives? Other experiences perceived as pleasant also lead to a release of serotonin or dopamine.

Photo: Nadja Lenherr

How Much Sugar Is Healthy? The Experts’ Current Nutritional Recommendations

In 2015, the WHO issued guidelines on sugar consumption for adults and children, with the following recommendations: The daily intake of free sugar should be limited to <10% of the total energy intake. This recommendation is based on an analysis of the scientific evidence which shows that adults with a low sugar intake have a lower body weight, that weight increases as sugar intake increases, that the consumption of sugar-sweetened beverages by children is positively correlated with overweight, and that there is a connection between an increased intake of free sugar (>10% of total energy) and the frequency of cavities. It would be advisable to aim for a daily intake of free sugar of a maximum of 5% of total energy.

“Free sugar” refers to monosaccharides (such as glucose and fructose) and disaccharides (such as table sugar = sucrose) which are added to foods by manufacturers, cooks or consumers, as well as sugars inherently present in honey, syrup, fruit juices and fruit juice concentrates. The WHO guideline does not refer to sugars occurring naturally in fresh fruit and vegetables as well as in milk, since there are no indications that their intake leads to adverse health effects.

What Does This Mean in Practical Terms?

For an adult who consumes an average of 2,000 kcal per day, 10% of the total energy would be 200 kcal which may be consumed in the form of free sugar. This corresponds to approximately 50 g sugar = approx. 12.5 sugar cubes per day. For a child aged one to two years who consumes 1,100 kcal per day, 10% of the total energy would be 110 kcal which may be consumed in the form of free sugar. This corresponds to approximately 30 g sugar = 7.5 sugar cubes per day.


  • In everyday life, use sugar consciously and properly measured.
  • Any sweetness should preferably be natural.
  • Visualize the amount of sugar: 1 sugar cube = 4 g sugar (average).
  • Enjoy sugary foods such as desserts or chocolates as a special treat, in moderation.
  • There are endless possibilities for being creative in reducing sugar in recipes.
  • Mix sugary foods with unsweetened foods (such as fruit juice with water or fruit yoghurt with plain yoghurt).
  • Read the list of ingredients and nutritional chart on the product; ingredients are listed in decreasing order by quantity; pay attention to the “of which are sugar” quantity.
  • Sugar has many names and hides in the list of ingredients.
  • Avoid sugar substitutes and artificial sweeteners.
  • When buying sugar and sugar alternatives, consider the origin, cultivation method and social sustainability.


Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:


Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

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