Special Report: Added sugar guidance sparks debate across age groups

In episode 6 of this Special Report, Colleen Sloan, PA-C, RDN, joined Catherine McManus, PhD, RDN, LD, and Viet Le, DMSc, MPAS, PA-C, FACC, to discuss updated recommendations on added sugars in the 2025–2030 US Dietary Guidelines and how they apply differently across pediatric and adult populations.

McManus outlined the new pediatric guidance, which recommends avoiding added sugars in early childhood and states that no amount of added sugar is recommended for children aged 5 to 10 years. While she supported the intent of reducing excess sugar intake, she cautioned that overly restrictive messaging may be impractical and counterproductive. Research shows that labeling foods as forbidden can lead to overconsumption when children gain access, particularly given humans’ innate preference for sweet tastes. She suggested that emphasizing avoidance and limitation—rather than absolute prohibition—may be more realistic for families.

Sloan highlighted the need for context-specific interpretation, particularly for adolescent athletes. She noted that quick sources of sugar can serve a functional role in fueling intense physical activity, underscoring that dietary recommendations should be tailored to individual metabolic needs rather than applied uniformly.

Le framed the guidance as population-level guardrails rather than prescriptive rules. In adult and cardiology practice, he emphasized the importance of meeting patients where they are—considering food access, work demands, and socioeconomic constraints. Rather than rigid restriction, he advocated for a “good, better, best” approach that prioritizes incremental improvements and food swaps within realistic circumstances.

Across age groups, the panel agreed that while the guidelines offer an evidence-based framework, clinicians must apply nuance and personalization. Effective counseling requires balancing ideal recommendations with practicality, context, and patient-specific goals to support sustainable dietary change.

Our Experts:
Colleen Sloan, PA-C, RDN, pediatric physician assistant and registered dietitian; host of The Exam Room Nutrition Podcast.
Catherine McManus, PhD, RDN, LD, assistant professor of nutrition, Case Western Reserve University; Cleveland Clinic Foundation.
Viet Le, DMSc, MPAS, PA-C, FACC, preventive cardiology physician assistant and associate professor of research, Intermountain Health.