Bottom Line:

• Be aware of added sugar's harmful effects on you and your kids
• Aim for less than 25g of added sugar daily for children
• When we notice our habitual thought patterns instead of running on autopilot, we gain the power to reshape our stories—and dramatically increase our energy and engagement with life

Keep reading for how these two seemingly different topics came together…

There's a consistent theme among physicians: we start medicine with enormous energy, determined to help others. Then each step of training and our careers chips away at that well-intentioned kid trying to do right by people. As medical systems churn and we struggle to keep pace, compassion can turn to callousness.  It’s not something I’m here to justify or analyze—it’s just something you feel, especially on long, demanding days.

And oddly enough, those same days often mimic that journey in miniature…

Last Thursday, I was working at a surgery center my group covers that's exclusively for ENT surgery. The pediatric ENT doctor was scheduled to run the latest with 15 planned cases. He's a fantastic surgeon, and I enjoy these busy days because it's such a good team and my pediatric skills are well-utilized. Other surgeons were there too, so it was the usual busy morning. Sometimes afternoons slow down enough to sit for a bit. But not last Thursday.

After thirteen cases on young kids and babies (down to 6 months old), we had two older kids to wrap up: ages 10 and 11. The 10-year-old was severely autistic and weighed more than me. True, I'm not the biggest, but a 170-pound 10-year-old is no joke—especially when they're non-verbal and don't follow instructions. The 11-year-old was almost 200 pounds. It's hard to explain to non-medical people how much more challenging these cases are for anesthesia teams than kids with the same issues who aren't obese.

Each case presented unique challenges directly related to the child's obesity and poor metabolic health. One child had a difficult airway requiring special equipment and planning to place the breathing tube—a requirement for his surgery type. In the other case, we discovered significant gastric contents in the child's stomach before waking up. This meant either the child hadn't followed pre-surgery fasting instructions, or he had gastroparesis—where the stomach doesn't empty normally, usually indicating significant metabolic dysfunction (often severe diabetes). My team handled both situations well and prevented complications.

There I was around 6 PM, my last two patients finally waking up in recovery after working hard for over 12 hours. I felt worn down, and my habitual thoughts led me to: A) just wanting to leave because I was exhausted, B) annoyance that I'd be late to my boys' swim meet due to these complex cases, and C) relief that my patients were safe and I probably wouldn't see them again soon.

But then I paused.

I thought about my own two boys and how we're all connected—that the obese 10- and 11-year-olds I'd just cared for exist in the same web of interconnectedness as my sons. I thought about how difficult it must be to exist as those boys... the disconnect they seemed to have from their bodies, their high levels of fear and anxiety. Despite all the physical exertion involved in caring for them, I felt energy inside—a real desire to give them a hug and let them know I cared about their suffering.

Hugging patients in recovery might raise eyebrows, so I chose something else. I decided to speak with their parents about more than just anesthesia. I picked one issue I felt confident could make a difference: sugar. I spoke kindly but without my usual timidity when I break through the role of "just the anesthesiologist." I spoke because I remembered why I went into medicine and why I'd dedicated extra time to becoming an expert in pediatric anesthesia. I drew on my full experience as a doctor, parent, and someone who's been through health struggles myself.

Here are the key facts about sugar I shared that I think all parents should know:

Excess sugar harms our gut, immune system, and brain. Focusing on the brain and nervous system, excess consumption puts kids at greater risk for mood disorders like depression and anxiety, ADHD, and cognitive dysfunction. It also worsens our ability to handle normal life stressors.

How much is too much? Two hundred years ago, most people ate just over ½ teaspoon of sugar daily. Today, American children average 19 teaspoons daily—65 pounds per year. Kids don't need added sugar to meet energy needs. A good goal for children ages 2-18 is less than 25g (6 teaspoons) daily. Kids under 2 should have no added sugar.

Start reading food labels. If you only look at one thing, check the added sugar content. Know that there are at least 61 code words for sugar: agave nectar, golden syrup, high-fructose corn syrup, honey, fruit juice, date sugar, beet sugar, and more. Don't be fooled by food company marketing—they're not watching out for your kid. You're the parent, and you must take responsibility for this aspect of your child's health.

About 50% of American sugar consumption comes from liquids. If you do just one thing, stop giving your kids sodas, juices with added sugar, and other sugar-sweetened beverages. Model this behavior yourself—you'll likely feel better and won't have to argue with your kids since they'll follow your lead (or at least the drinks won't be easily available at home).

I advised each set of parents to consider seeing their primary care physician or finding a nutritionist for more information. I made sure they knew I understood how difficult parenting is and wasn't speaking with them because they'd done something wrong. We all parent within different contexts and cultural influences, but I fundamentally believe all parents are doing their best with where they are right now. Now I hoped they knew more. Maybe that will make some small difference for their kids.

I wish I could control the nutrition offered to kids by so many parents, schools, and restaurants. But that's not realistic and perhaps not any one person's place. What I know is that it felt right to change the story for myself and not play it small like I usually do by staying safely in my lane of anesthesia. We all owe it to ourselves and our communities to step beyond our limited, outward-facing roles and see each other in the full human context of who we are. From that place, we can more readily share all the gifts that life has given us.  And only in this sharing, that leads to greater connection and abundance and is rooted in broadening our perspective and letting go of constrained self-identities, can we move towards a healthier society.

Thanks for reading!