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March 13, 1996

Effects of Sugar on Behavior in Children-Reply

Author Affiliations

Vanderbilt University Nashville, Tenn
Yokosuka, Japan

JAMA. 1996;275(10):757. doi:10.1001/jama.1996.03530340020016

In Reply.  —We feel that our interpretations were appropriately qualified. Although meta-analysis does examine mean scores, it is important to point out that six of the 23 studies we analyzed included children most likely to demonstrate effects, namely, those children who were reported to respond adversely to sugar. In addition, the dietary intervention studies1 performed additional analyses of their results to detect individual effects and found none. As we stated in our article, we could not exclude the possibility of a small number of children responding adversely, but if so, the number is likely to be very small and the distinguishing characteristics of these children are yet to be determined.Dr Jacobson cites a study of 21 boys (the data were included in our analysis, as the cohort had been reported2) as evidence of the differential effects of sugar on behavior. However, we cannot conclude that sugar was