A mother and her 2 sons (10 and 13) presented for a regular check-up visit. None of them had any health issues, both her sons had normal weight, height, BMI, as well as were psychologically and intellectually well developed with very satisfactory school performance. The only complain the mother of those 2 boys had was that the younger one was on the skinny side and would rarely eat regular food, instead he would be on go all the time, grabbing a couple of spoons of white sugar while running outside to play with his pears. We did not pay much attention to her last sentence, knowing that from clinical and laboratory point of view the boy was perfectly healthy, reassured her that that was a normal behavior for his age. Then while living the room, in between thanking the doctor for his time and the care provided she asked one last question and looked really concerned: “Doctor, is there any danger in the fact that my younger son instead of regular meals eats white refined sugar with a spoon?” The answer she received in a very kind, reassuring and warm manner was again: “Your boy is healthy, he is growing, and he simply needs some fast energy to be able to run and play with his friends.”

amily Medicine rotation in my third year was scheduled to be the first one.

Every day was overflowing with a huge amount of learning opportunities. Walk-in clinics, then palliative care unit rounds, which reminded me of the days when as a clinical research coordinator I had to follow up on inoperable pancreatic cancer patients, in afternoon elderly people care, a lot of chronic disease follow up scheduled visits, emergency medicine shifts and so on, regular pregnancy and newborn visits, all done and taught by very knowledgeable staff members whose enthusiasm and love for what they are doing professionally and my joy of being part of it confirmed my desire to apply to family medicine residency program, then there were days when I would participate in well-child examinations … and there happened an incident that I did not expect and would remember for a longer than usual time.

A mother with her 2 sons (8 and 11) presented for a regular check-up visit. None of them had any health issues, both her sons had normal weight, height, BMI, as well as were psychologically and intellectually well developed with very satisfactory school performance. The only complain the mother of those 2 boys had was that the younger one was on the skinny side and would rarely eat regular food, instead he would be on go all the time, grabbing a couple of spoons of white sugar while running outside to play with his pears. We did not pay much attention to her last sentence, knowing that from clinical and laboratory point of view the boy was perfectly healthy, reassured her that that was a normal behavior for his age. Then while living the room, in between thanking the doctor for his time and the care provided she asked one last question and looked really concerned: “Doctor, is there any danger in the fact that my younger son instead of regular meals eats white refined sugar with a spoon?” The answer she received in a very kind, reassuring and warm manner was again: “Your boy is healthy, he is growing, and he simply needs some fast energy to be able to run and play with his friends.”

On reflecting on this case while preparing for my PICO presentation, the first explanation to “on the go” child behaviour was that sugar provoked hyperactivity, might also cause dental decay, eventually obesity and diabetes in the future… then by curiosity I also did a quick research on the effect of sugar increased intake in healthy, non-obese children. What I found gave a new meaning to my desire to practice family medicine. The meaning is adult chronic disease prevention by paying particular attention to the diet of a clinically healthy child. The evidence found showed that healthy non obese children with increased refined sugar intake are at increased risk of