Role of soft drinks in childhood obesity

Obesity is one of the biggest threats to child health. Genetics, decreases in physical activity, increases in television watching, and consumption of fast food are factors that have led to an increase of childhood obesity in the United States. Excessive consumption of sugar sweetened drinks may also be a key factor.

A commentary in the May issue of The Journal of Pediatrics reviews prior research to provide perspective about the role of soft drinks in childhood obesity.

Robert Murray, MD and colleagues from Ohio State University, University of Vermont, and University of California San Diego reviewed articles, press releases, statements, and editorials from researchers and from representatives in the soft drink industry. Although no single factor can be cited as the sole cause, many of the articles showed a correlation between soft drink consumption and the risk of childhood obesity.

Dr. Murray points out that "the typical teen consumes approximately two-12 ounce cans of soft drinks per day, containing 300 calories and 20 teaspoons of sugar." Although current guidelines recommend a limit of 10% of daily calories from added sugars, they actually account for 18-20% of children's daily calories. Because even small amounts of sweetened drinks at home or at school can add up, soft drinks and sweetened fruit drinks account for 43% of these total added sugars. American children consume one-third of their daily calories from nutrient-poor, energy-dense snack foods, which makes nutritional deficiencies another area of concern. Children seem to be choosing soft drinks or sweetened fruit drinks instead of milk, which can decrease their levels of protein, calcium, zinc, and vitamins A and C. The American Academy of Pediatrics Committee on School Health has stated that the consumption of soft drinks in schools can lead to obesity. Despite this, one study showed that out of 523 school districts, 50% had a contract with a soft drink company; two-thirds of those districts were given incentives by the soft drink company, and nearly 80% received a percentage of the soft drink sales. Dr. Murray recommends that schools should "strengthen existing programs such as the school breakfast program, the national school lunch program, classroom nutrition instruction, daily physical fitness instruction, intramural sports, and after-school programs," instead of setting up contracts and marketing with soft drink companies.

Children can compensate for the added calories from occasional soft drinks by choosing more nutritious, lower calorie drink options throughout the rest of the day and increasing their amount of physical activity. Schools should concentrate on providing more nutritious lower calorie beverage choices in their vending machines such as milk, water, and 100% fruit and vegetable juices. Dr. Murray has suggested that "altering the energy (calorie) gap by 100 calories a day--which, ironically, is the equivalent of one 8-oz. serving of a sweetened soft drink--would prevent excessive weight gain in most Americans." The prevention of childhood obesity is of great importance. It has been estimated that 25% of obese children are already showing signs of glucose intolerance and "a child who is diagnosed with type II diabetes mellitus at age 10 years may lose between 17 and 26 life-years to the disease." Although no single factor should be designated as the scapegoat for childhood obesity, decreasing soft drink consumption, especially in schools, can help reduce the risk.

The commentary is "Are soft drinks a scapegoat for childhood obesity?" by Robert Murray, MD, Barbara Frankowski, MD, PhD, and Hoard Taras, MD, FAAP. The article appears in The Journal of Pediatrics, Volume 146, Number 5 (May 2005), published by Elsevier.