Added sugar for kids: what the guidelines say, where they differ, and what studies found

Vos, M. B., Kaar, J. L., Welsh, J. A., Van Horn, L. V., Feig, D. I., Anderson, C. A. M., Patel, M. J., Cruz Munos, J., Krebs, N. F., Xanthakos, S. A., & Johnson, R. K. (2017). Added sugars and cardiovascular disease risk in children: A scientific statement from the American Heart Association. Circulation, 135(19), e1017–e1034. (Published online August 22, 2016.) doi:10.1161/CIR.0000000000000439 · free full text

Who was studied: The American Heart Association, reviewing studies of added sugars and children's heart health: blood pressure, blood fats, insulin resistance and diabetes, fatty liver disease, and obesity.

Design: Scientific statement (graded review of evidence and expert consensus)

What they found: The committee found that links between added sugars and higher cardiovascular risk factors in US children appear at intakes far below what children currently eat; it cites an average of 80 grams a day for ages 2 to 19 in national survey data from 2009–2012. It recommends that children and adolescents eat no more than 25 grams of added sugars a day (about 100 calories, or about 6 teaspoons), avoid added sugars entirely under age 2, and drink no more than one 8-ounce sugar-sweetened beverage a week.

Moynihan, P. J., & Kelly, S. A. M. (2014). Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines. Journal of Dental Research, 93(1), 8–18. doi:10.1177/0022034513508954 · free full text

Who was studied: 55 studies of sugar intake and tooth decay (3 intervention, 8 cohort, 20 population, and 24 cross-sectional studies), 50 of them in children.

Design: Systematic review commissioned to inform the WHO sugars guideline

What they found: Of the 50 studies in children, 42 reported at least one positive link between the amount of sugar eaten and tooth decay. The authors rated the evidence as moderate quality that tooth decay is lower when free sugars make up less than 10% of energy intake. A link was also seen with a cutoff of less than 5%, but that evidence was rated very low quality.

Wolraich, M. L., Wilson, D. B., & White, J. W. (1995). The effect of sugar on behavior or cognition in children: A meta-analysis. JAMA, 274(20), 1617–1621. doi:10.1001/jama.1995.03530200053037

Who was studied: 16 reports describing 23 studies in which children were given a known amount of sugar or a sugar-free placebo, with children, parents, and researchers blinded.

Design: Meta-analysis of double-blind, placebo-controlled studies

What they found: Across 14 measures of behavior and thinking, none of the average effects differed reliably from zero; for all 14, the 95% confidence intervals included zero. The authors concluded that sugar does not affect children's behavior or cognitive performance, suggested that parents' strong belief may come from expectation and the settings where sweets are eaten, and noted that a small effect, or effects in some children, can't be ruled out.

The guidelines rest on different kinds of evidence. The link between sugar and tooth decay is supported by many studies in children, rated moderate quality for the 10% limit. The links with weight and heart-health risk factors come largely from observational studies, supported by some trials in which sugary drinks were replaced; the AHA calls its 25-gram limit a reasonable recommendation and grades the evidence behind that specific number as Level C, its lowest level, based largely on expert opinion. The behavior meta-analysis is based on blinded trials, but it is from 1995, and newer trials of this kind are scarce.

• They don't show that a birthday cake or an occasional treat harms a child. The AHA and WHO limits describe usual intake over time.
• They don't show that 25 grams is a safe threshold and 26 grams is not. The AHA's limit is a practical target, not a threshold identified in a trial.
• They don't show that sugar causes hyperactivity. The trials found no reliable effect on behavior, though a small effect in some children can't be ruled out.
• Most of the evidence on weight and heart risk is observational, so it shows links, not proof that sugar alone caused the outcomes.

Added sugars are sugars and syrups put into foods and drinks during processing or preparation, as opposed to the sugar naturally present in whole fruit or plain milk. Here is what the main sources say about added sugar for kids.

The American Heart Association (2016 statement, published in print in 2017) recommends that children and adolescents eat no more than 25 grams of added sugars a day, about 6 teaspoons or 100 calories. Children under 2 should have no added sugars, and sugar-sweetened drinks should be limited to one 8-ounce serving or less a week.

The Dietary Guidelines for Americans 2025–2030, published by HHS and USDA in January 2026, are stricter for young children. For infancy and early childhood (birth to age 4), they say: "Avoid added sugars during infancy and early childhood." For middle childhood (ages 5 to 10), they say: "No amount of added sugars is recommended." In their general guidance for everyone, they say no amount of added sugars or non-nutritive sweeteners is recommended, and that "one meal should contain no more than 10 grams of added sugars." They also suggest snack limits, such as no more than 5 grams of added sugar per ¾-ounce whole-grain equivalent for grain snacks like crackers, and no more than 2.5 grams per ⅔-cup equivalent for dairy snacks like yogurt.

The World Health Organization's 2015 guideline on sugars, for adults and children, strongly recommends keeping free sugars below 10% of total energy intake, and conditionally recommends a further reduction to below 5%. WHO's "free sugars" include sugars added to foods and drinks plus the sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates.

The sources agree on the direction: less added sugar, none for babies, and, in the AHA statement and the Dietary Guidelines, sugary drinks as a target. They differ in three ways.

First, the number. The AHA gives a daily ceiling of 25 grams that applies from age 2 through the teen years. The 2025–2030 Dietary Guidelines don't give a daily amount for ages 5 to 10; they recommend no added sugar, while their general guidance caps a single meal at 10 grams. WHO uses a share of calories rather than grams, so its limit depends on how much a child eats.

Second, the age bands. The AHA's "none" applies under age 2. The Dietary Guidelines' "avoid" covers birth through age 4, and their "no amount is recommended" covers ages 5 to 10.

Third, what counts. The Dietary Guidelines list honey and fruit juice concentrate among the names of added sugars, and say 100% fruit or vegetable juice should be consumed in limited portions or diluted with water. WHO counts the sugars in fruit juice itself as free sugars. So a glass of 100% juice counts toward WHO's limit but is handled separately in the US guidelines.

In practice the gap is real for ages 5 to 10: the AHA and WHO allow a limited amount, while the Dietary Guidelines say no amount of added sugar is recommended.

According to the AHA statement, US children ages 2 to 19 ate an average of 80 grams of added sugar a day in national survey data from 2009–2012, more than three times the AHA's 25-gram limit, and added sugars made up nearly 16% of their calories. That's an average; some children eat much less and some much more.

The AHA concluded that links between added sugars and higher cardiovascular risk factors in children appear at levels far below that average. Strong evidence, in the committee's grading, supports the association of added sugars with higher energy intake, more body fat, and unhealthy blood fat levels in children. The committee also noted that added sugars can most likely be eaten safely in low amounts as part of a healthy diet.

Many parents are sure it does. In blinded trials, sugar did not change behavior on average. In the 1995 meta-analysis by Mark Wolraich and colleagues, children in 23 blinded studies were given either sugar or a sugar-free sweetener, without the children, parents, or researchers knowing which. Across 14 measures, sugar had no reliable effect on behavior or thinking.

The authors suggested the belief may come from expectation and from the settings where children eat a lot of sugar, such as parties and holidays, which are exciting on their own. They also said a small effect, or an effect in some children, couldn't be ruled out. The reasons to limit added sugar are about teeth, weight, and long-term health, not about behavior.

Tooth decay is the link with the most studies in children. The systematic review by Paula Moynihan and Sonia Kelly, which informed the WHO guideline, found that 42 of 50 studies in children reported at least one positive link between sugar intake and tooth decay. The same review found moderate-quality evidence that tooth decay is lower when free sugars stay under 10% of energy, the threshold behind WHO's strong recommendation. For snack ideas without much added sugar, see our guide to healthy snacks for kids.

How much added sugar should kids have a day?

It depends on the source. The American Heart Association suggests no more than 25 grams (about 6 teaspoons) a day for children and adolescents, and none under age 2. The 2025–2030 Dietary Guidelines say no amount of added sugar is recommended for ages 5 to 10, with no more than 10 grams in any one meal.

Does sugar make kids hyper?

On average, no. In a 1995 meta-analysis of 23 blinded studies, children given sugar or a sugar-free placebo, without anyone knowing which, showed no reliable difference in behavior or thinking. The authors noted that a small effect, or an effect in some children, couldn't be ruled out. The reasons to limit added sugar are teeth, weight, and long-term health.

Is fruit juice added sugar?

Not on a US Nutrition Facts label: under FDA labeling rules, the sugar naturally in 100% juice isn't counted as added sugar, though juice concentrate used to sweeten other foods can be. The Dietary Guidelines say 100% juice should be consumed in limited portions or diluted with water. WHO counts the sugar in fruit juice as free sugar, which falls under its limit.

Is honey added sugar?

Yes. The 2025–2030 Dietary Guidelines list honey among the names of added sugars, and WHO counts it as a free sugar. Separately, US health authorities, including the CDC and AAP, advise against giving honey to babies under 12 months because of the risk of infant botulism.

Are sugar substitutes better for kids?

The 2025–2030 Dietary Guidelines don't recommend them either: they advise limiting foods and drinks with low-calorie non-nutritive sweeteners, and say no amount of added sugars or non-nutritive sweeteners is recommended as part of a healthy diet.

Boss of My Want (lesson 13) practices "I want it now" and learning to wait. Waiting for the sweet that comes after dinner, or deciding it can wait until tomorrow, is a natural place for children to try it.

See the program

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