Is sugar the only threat to children’s health?

A generation of children is growing up in a dietary and lifestyle environment that is stacked against their health. Fixing this requires a collective effort - from parents, teachers, policymakers, food companies, and, yes, children themselves. Dr Subramanian Kannan, Senior Consultant and Director - Endocrinology and Diabetology, Narayana Health City, Bengaluru, explains the challenges and how they can be tackled

When the CBSE mandated ‘Sugar Boards’ across all affiliated schools by July 2025, it touched anerve in India’s health and education sectors. The directive, which aims to alert students about hidden sugars and their harmful effects, has received wide praise, and deservedly so. It brings along-overdue focus to the relationship between diet and disease in childhood. But here’s the critical question - is sugar the only problem we need to worry about? And more importantly, are we equipped to offer children real alternatives they won’t reject?

Metabolic crisis isn’t just about sugar

The obsession with sugar risks oversimplifying a complex and growing crisis in India’s child health landscape. Urban pediatric clinics, including ours, are increasingly seeing cases of insulin resistance, childhood obesity and fatty liver disease, often in children who may not even consume excessive sugar. The real culprits? A cocktail of factors including sedentary routines, ultra-processed foods, inadequate sleep, and a lack of vegetables and fibre in everyday meals. Children today are living in what the WHO calls an ‘obesogenic environment’, one that actively promotes weight gain and discourages physical activity. This cannot be solved with a single board, no matter how well-intentioned.

Tiffin troubles: What children eat at school

Even as we scrutinise sugar, it is time to examine another space - the school tiffin box. In far too many homes, hurried mornings result in children heading to school with white bread sandwiches, instant noodles, biscuits or processed snacks - food that is quick to make but poor in long-term nutrition. This results in cravings, fatigue and food trade-offs where children routinely swap home-cooked food for chocolates and fast food items brought by peers. For schools that offer in-house meals, there’s an opportunity to do better. Are vegetables being served in appealing forms? Are fried items the norm? Is fruit part of the daily menu? These aren’t minor questions. What’s eaten during school hours constitutes over 30 per cent of a child’s daily nutritional intake. This can either reinforce or undo what’s taught in the classroom.

Packing nutrition into busy mornings

Acknowledging the reality of working parents and rushed mornings, dieticians suggest simple, creative interventions that can transform the daily tiffin box without adding to a parent’s burden.

Here’s how you do it:

Roll it up: Whole wheat chapatis with paneer, spinach or egg fillings are fuss-free and portable.

Sneak in veggies: Puree spinach or beetroot into dosa or idli batter, mix grated carrots or bottle gourd into parathas.

Mini portions, big wins: Small servings of cucumber sticks, boiled corn or fruit slices make a difference - children eat what’s familiar and bite-sized.

Swap sweet for spice: Replace chocolate spreads with homemade hummus, chutneys or peanut butter with a pinch of jaggery.

Plan the night before: Prepping dry components the night before (cutting veggies, grating cheese, soaking dals) can cut down morning stress significantly. The idea is to balance appeal with nutrition and make vegetables, pulses and whole grains a natural part of the meal, not a punishment.

Broader approach to wellness in schools

While the CBSE’s ‘Sugar Board’ may be a useful prompt, real change demands a broader school-based wellness agenda.

It should include:

● Mandatory physical activity, with daily exercise and outdoor time.

● Strict canteen guidelines banning foods high in fats, sugar and salt.

● Regular engagement with parents on meal planning and food literacy.

● Inclusion of mental health, screen-time regulation, and sleep hygiene in curricula.

If our only intervention is an educational board warning about sugar then we risk creating panic, guilt, or worse, apathy. But if we use this as a springboard to a wider shift in school health culture, we may finally start turning the tide towards better health.

Let’s start with sugar, not stop there

The CBSE mandate is a commendable beginning, a wake-up call. But it must not become a token gesture. A generation of children is growing up in a dietary and lifestyle environment that is stacked against their health. Fixing that requires a collective effort - from parents, teachers, policymakers, food companies, and, yes, children themselves. Sugar isn’t the only threat. But it is just the starting point we need.