This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Meta-analysis

Mark L. Wolraich, MD; David B. Wilson, PhD; J. Wade White, MD

JAMA. 1995;274(20):1617-1621.

Abstract
Objective.
—To examine the effects of sugar on the behavior or cognition of children by using meta-analytic techniques on reported studies.

Data Sources.
—Studies were identified through a literature search of the MEDLINE and PsychINFO databases and the authors' files using sugar, sucrose, and attention deficit disorder as the search terms.

Study Selection.
—Studies were required to (1) intervene by having the subjects consume a known quantity of sugar; (2) use a placebo (artificial sweetener) condition; (3) blind the subjects, parents, and research staff to the conditions; and (4) report statistics that could be used to compute the dependent measures effect sizes.

Data Extraction.
—Variables included publication year, study setting, subject type and number, gender, age, sugar and placebo type and dose, prior dietary condition, measurement construct, means and SDs for the sugar and placebo conditions, and direction of effect.

Data Synthesis.
—Sixteen reports met the inclusion criteria for a total of 23 within-subject design studies. The weighted mean effect size and related statistics for each of the 14 measurement constructs revealed that although the range for these means was from -0.14 for direct observations and up to +0.30 for academic tests, the 95% confidence interval for all 14 mean effect sizes included 0.

Conclusion.
—The meta-analytic synthesis of the studies to date found that sugar does not affect the behavior or cognitive performance of children. The strong belief of parents may be due to expectancy and common association. However, a small effect of sugar or effects on subsets of children cannot be ruled out.

(JAMA. 1995;274:1617-1621)

Author Affiliations
From the Department of Pediatrics, Vanderbilt University Child Development Center (Dr Wolraich), and the Institute for Public Policy Studies (Dr Wilson), Vanderbilt University, Nashville, Tenn; and US Naval Hospital, Yokosuka, Japan (Dr White).

Footnotes
Reprint requests to Department of Pediatrics, Vanderbilt University, Child Development Center, 2100 Pierce Ave, 426 MCS, Nashville, TN 37232-3573 (Dr Wolraich).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cultural Variations in Parental Health Beliefs, Knowledge, and Information Sources Related to Attention-Deficit/Hyperactivity Disorder
Bussing et al.
Journal of Family Issues 2007;28:291-318.
ABSTRACT  

Consumption of Soft Drinks and Hyperactivity, Mental Distress, and Conduct Problems Among Adolescents in Oslo, Norway
Lien et al.
Am. J. Public Health 2006;96:1815-1820.
ABSTRACT | FULL TEXT  

Attention Deficit-Hyperactivity Disorder
Rappley
NEJM 2005;352:165-173.
FULL TEXT  

The scientific basis of recent US guidance on sugars intake
Murphy and Johnson
Am. J. Clin. Nutr. 2003;78:827S-833.
ABSTRACT | FULL TEXT  

Sugar and Cardiovascular Disease: A Statement for Healthcare Professionals From the Committee on Nutrition of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association
Howard and Wylie-Rosett
Circulation 2002;106:523-527.
FULL TEXT  

Clinical nutrition: 3. The fuzzy boundary between nutrition and psychopharmacology
Young
CMAJ 2002;166:205-209.
FULL TEXT  

Nutritional and other natural medical treatments for attention-deficit/hyperactivity disorder - AD(H)D
Dommisse
Social Science Information 2000;39:489-504.
ABSTRACT  

Breast-feeding and cognitive development: a meta-analysis
Anderson et al.
Am. J. Clin. Nutr. 1999;70:525-535.
ABSTRACT | FULL TEXT  

Treatment alternatives for Attention-Deficit! Hyperactivity Disorder (ADHD)
Arnold
J Atten Disord 1999;3:30-48.
ABSTRACT  

Guides for Reading and Interpreting Systematic Reviews: I. Getting Started
Klassen et al.
Arch Pediatr Adolesc Med 1998;152:700-704.
FULL TEXT  

The Practical Aspects of Diagnosing and Managing Children with Attention Deficit Hyperactivity Disorder
Wolraich and Baumgaertel
CLIN PEDIATR 1997;36:497-504.
ABSTRACT  

Effects of Sugar on Behavior in Children
Jacobson
JAMA 1996;275:756-757.
ABSTRACT  

Sugar Does Not Affect the Behavior of Children
JWatch Psychiatry 1996;1996:13-13.
FULL TEXT  

MORE ON SUGAR AND CHILDREN'S BEHAVIOR
JWatch General 1995;1995:6-6.
FULL TEXT