How to limit children’s consumption of sugary drinks

Schools across the country have taken steps to limit students’ access to sugary drinks due to health concerns. But new research from the Center for Social Dynamics and Policy (CSDP) shows that the most effective approach to reducing sugar-sweetened beverage consumption is to shift the focus from school withdrawal to home withdrawal.

Sugar-sweetened beverages (SSB), which include sodas, fruit drinks and sports drinks, are the largest source of added sugar in the American diet and make up about 7% of children’s daily calorie intake. These data, along with a strong body of evidence linking sugar-sweetened beverage consumption by young children to a myriad of negative health outcomes, have motivated several recent CSDP studies that have modeled the causes and consequences of consumption of sugary drinks.

The new report, published in the American Journal of Clinical Nutrition, found that removing access to SSB at home was more effective than removing it from school in reducing children’s SSB intake. Eliminating sugary drinks altogether at home resulted in 1.23 fewer servings of sugary drinks consumed per week on average between the ages of two and seven, a reduction of about 60%. By comparison, removing all SSB availability outside the home (ie schools and daycares) had less of an impact: a reduction of around 40%.

In addition, the study results indicated that the impact of removing sugar-sweetened beverages at home on consumption was linear, meaning that as the availability of sugar-sweetened beverages at home decreased, beverage consumption sugar was also decreasing, with no distinct tipping points or drops. Thus, there is no threshold to reach for the success of the intervention or diminishing returns beyond which the effort produces less impact.

To compare several intervention strategies in different combinations, the research team constructed an agent-based model using longitudinal data from children aged two to seven. By comparing the model results with data from actual children in the study, we were able to ensure a high level of precision in the model results. We then used the model as a “virtual laboratory” to test the interventions and ultimately provide guidance to decision makers and intervention experts. This innovative effort is one of the latest in a series of models created by CSDP researchers to inform policy makers on public health issues, from COVID-19 to the relationship between incarceration rates and the prevalence of HIV.

Addressing the challenges of reducing SSB consumption will likely require actions that encompass policy areas such as infrastructure, food systems, and environmental regulations.

To date, sugar-sweetened beverage reduction interventions targeting daycare and school settings have had greater observable success than those attempting to affect the home environment or parental behavior. But as we argue in the new study, our findings “suggest a tantalizing opportunity for future action.”

“Our research indicates that finding ways to intervene effectively in the family setting, optimally complemented by action targeting other parameters, could have a much greater impact,” we write in the journal publication. “Thus, the investment of resources in identifying such strategies is deserved.”

The responsibility for adopting solutions should not rest solely with individual families. Instead, we recommend taking a systems perspective to identify viable policy and practice changes that address barriers to reducing children’s consumption of sugar-sweetened beverages at home. For example, as we have pointed out in previous work, many American families do not have access to running drinking water, and even more have encountered unsafe or unpleasant-tasting water. If it is easier or cheaper for families to obtain sugary drinks than bottled water, this will affect what is consumed at home by children. A recent Lancet special report, to which the authors of this study contributed, highlights how policy and societal solutions are needed to significantly and sustainably change food availability and consumption. Addressing the challenges of reducing SSB consumption will likely be no exception, requiring actions that encompass policy areas such as infrastructure, food systems and environmental regulations.

The Brookings Institution is funded through support from a wide range of foundations, corporations, governments, individuals, as well as an endowment. The list of donors can be found in our annual reports published online here. The findings, interpretations and conclusions of this report are solely those of its author(s) and are not influenced by any donation.

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