As much as one-third of all children's fruit drinks have 16 grams or more of sugar per serving - equivalent to four teaspoons - which is more than half of the maximum amount of added sugars experts recommend for children per day.
The findings - according to Children's Drink FACTS 2019, a new report from the Rudd Center for Food Policy & Obesity at the University of Connecticut - are based on an analysis of drinks that companies marketed as intended for children in 2018. The report states that sweetened drinks for children - such as fruit drinks and flavored waters that contain added sugars and/or low-calorie (diet) sweeteners - made up for 62% of children's drink sales in 2018.
Overall, children's drink sales amounted to $2.2 billion in 2018. Due to the added sugars and low-calorie sweeteners in these products, none of them met expert recommendations for drinks that should be served to children under 14 years old. In contrast, healthier drinks such as 100% juice represented 38% of children's drink sales last year, says the report.
"The American Academy of Pediatrics and the American Heart Association warn that sugary drink consumption threatens children's health and policy strategies to reduce sugary drink consumption are "urgently needed." Sugary drinks contribute almost one-half of added sugars consumed by children, and fruit drinks (fruit-flavored beverages with added sugars) are the most common type of sugary drink for young children. Overconsumption of 100% juice by children also raises concerns", says the report.
The report, according to the researchers, follows a consensus statement released in September by health and nutrition experts, which recommended that children under five should not consume any drinks with added sugars or low-calorie sweeteners and that they should consume limited amounts of 100% juice.
It adds, "Health and nutrition experts recommend that children should not consume any drinks with added sugars or low-calorie sweeteners and that caregivers limit children's consumption of 100% juice."
Researchers from the Rudd Center examined the sales, nutrition, and marketing of children's drinks, defined as drinks that companies market as intended for children to consume (in marketing to parents and/or directly to children).
The team identified and analyzed children's drinks offered by 23 drink brands that had at least $10 million in sales in 2018. The analysis included 34 sweetened children's drinks (fruit drinks, flavored waters, and drink mixes) and 33 drinks without added sweeteners (100% juice, juice/water blends, and one sparkling water).
According to their analysis, among the sweetened fruit drinks and flavored waters for children assesses, 65% contained added sugars, and 74% contained low-calorie sweeteners, whereas 38% contained both types of sweeteners. Two-thirds did not contain any juice, and the majority of products with juice contained just 5%.
"One serving of many of the highest-selling fruit drink brands (such as Capri Sun Juice Drink, Hawaiian Punch, Sunny D, and Minute Maid Lemonade) had more than 50% of the recommended amount of daily added sugars for children, which is greater than 12.5 kg", the findings state.
Companies promote sweetened drinks
The team also found that companies spent $20.7 million to advertise children's drinks with added sugars in 2018, primarily to kids under age 12. "Beverage companies continue to market sugar-sweetened drinks directly to young children on TV and through packages designed to get their attention in the store", says Dr. Jennifer Harris, the lead study author.
"Beverage companies have said they want to be part of the solution to childhood obesity, but they continue to market sugar-sweetened children's drinks directly to young children on TV and through packages designed to get their attention in the store. Parents may be surprised to know that pediatricians, dentists, and other nutrition experts recommend against serving any of these drinks to children", says Dr. Harris.
Analysis of exposure to TV ads reveals that children (ages 2 to 11) saw more than twice as many advertisements for sweetened drinks than for drinks without added sweeteners. Similarly, children saw more than four times as many ads for sweetened children's drinks than adults, it says.
"Sweetened children's drink brands continue to advertise directly to children. Sweetened children's drinks spent more to advertise on TV than children's drinks without added sweeteners ($18.5 vs. $13.6 million)", says the report.
The research team says that package claims on sweetened children's drinks and similarities between claims on sweetened and unsweetened drinks can confuse parents about their nutritional content.
Sugar-sweetened children's fruit drinks typically contained just 5% juice or less, but according to the report, 80% of those packages included images of fruit, and 60% claimed to have "less" or "low" sugar or "no high fructose corn syrup." Children's drinks with and without added sweeteners also had similar package sizes and types, flavor names, use of fruit imagery, and front-of-package claims for products.
“Brands that offered both sweetened drinks and drinks without added sweeteners (including Apple & Eve, Capri Sun, and Mott’s) used similar-looking packages, flavor names, fruit images, and claims for all their products”, the findings state.
Besides, low-calorie sweeteners, such as sucralose and stevia, were found in 74% of children's sweetened drinks, including drinks that also contained added sugars, but there was no mention of low-calorie sweeteners on the front of packages.
"Information about percent juice (except for 100% juice) and types of sweeteners contained in children's drink products were only available on the nutrition facts panel on the back of the package. Consumers would need to know the chemical names of low-calorie sweeteners (that is, sucralose, acesulfame potassium, neotame, and stevia) to determine that their child's drink contained these ingredients", says the report.
The researchers recommend that improvements in the marketing of children's drinks would help parents identify healthier children's drinks and reduce sugary drink consumption by children. They say beverage manufacturers should clearly indicate on the front of children's drink packages that a product contains added sugars and/or low-calorie sweeteners and the percent juice content.
"You should not have to be a nutritionist to figure out whether or not a product is healthy for your child", says Dr. Maria Romo-Palafox, study author and assistant professor of nutrition and dietetics at Saint Louis University.
She says, "The fronts of the packages make children's drinks look healthy, but there is no way to know which ones have added sugars or low-calorie sweeteners reading the front. You have to read the nutrition facts panel on the back, and you have to know the names of low-calorie sweeteners, such as acesulfame potassium and sucralose, to realize they are in the product."
The team suggests that the US Food and Drug Administration could require that products with nutrition-related claims on packages meet minimum nutrition standards and prohibit the use of fruit and vegetable images on drink product packages that contain little or no juice.
"The Children's Food and Beverage Advertising Initiative should establish nutrition standards that align with health expert recommendations. Specifically, drinks with added sugars and/or low-calorie sweeteners should not be advertised directly to children", they recommend.