To Lower Childhood Obesity, Don’t Sugarcoat the Facts about Sweet Drinks

Columbia pediatricians found that mothers of infants prefer facts, not criticism, about the health risks of sugary drinks.

A new study at Columbia University suggests that giving mothers plain facts about the health risks of consuming sugary drinks during pregnancy and early childhood may offer a new strategy to reduce childhood obesity.

The study was published in the journal Academic Pediatrics.

Why It’s Important

Obesity affects approximately 18% of children in the United States. Recent studies show that obesity is growing fastest among young children between the ages of 2 and 5 years. 

“Emerging evidence suggests that regular consumption of sugary beverages, either by the mother during pregnancy or by the child before age 2, may increase a child’s risk of obesity later in childhood,” says the study’s lead author, Jennifer Woo Baidal, MD, MPH, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons. 

A recent study found that sugary drinks may be marketed more heavily toward low-income children and teens.

Link between Attitudes and Behavior

In a previous study, Woo Baidal and her team found that nearly 90 percent of parents and 66 percent of toddlers between 1 and 2 years old who were enrolled in a local Women, Infants, and Children (WIC) program, a nutritional program for low-income families, regularly consumed sweetened beverages. Families with more negative attitudes toward sugary beverages were less likely to drink them or give them to their infants. 

“We were surprised at how many parents and infants were regularly consuming drinks with added sugar. In order to influence behavior, we needed a better understanding of the factors that influence parents’ attitudes,” Woo Baidal explains.

Clearing Up Confusion about “Healthy” Drinks

In the current study, the researchers conducted in-depth interviews with 25 of the WIC-enrolled families from the previous study. Families were asked to respond to a variety of materials from public health campaigns and other interventions, including written messages and visual aids, about the sugar content and associated health risks of sugar-sweetened drinks. 

Many families were confused about which beverages are healthy, the researchers found, and were surprised to learn that many juices and flavored milks contain large amounts of sugar. 

Families were more receptive toward materials—especially images and graphic warning labels—explaining the sugar content of different beverages and the health risks they pose for children. They indicated the need to include information about culturally relevant drinks and other alternatives to plain water. In contrast, families were less responsive toward materials that advised parents what to consume without giving them facts so they could make their own informed decisions. 

Jennifer Woo Baidal, MD, MPH (CUIMC)

“Parents were unreceptive to finger-wagging messages about what they should buy or drink, but most welcomed information that would help them make healthy choices for themselves and their families,” Woo Baidal says. “Although our study was small, our findings could inform broader strategies to counter the mixed messages that many low-income families get about what’s healthy and what’s not.” 

What’s Next

The researchers plan to conduct a larger, randomized study to learn how different ways of presenting information about the health risks of sugary drinks affect families’ purchasing habits and consumption. 


Jennifer Woo Baidal, MD, MPH, is director of pediatric weight management at Columbia University Irving Medical Center.

The paper is titled “Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1,000 Days: A Qualitative Study.”

Additional authors: Kayla Morel (CUIMC), Kelsey Nichols (CUIMC), Yvonne Nong (CUIMC), Nalini Charles (NewYork-Presbyterian Hospital Special Supplemental Nutrition Program for Women, Infants, and Children), Sarah Price (MassGeneral Hospital for Children, Boston, MA), Elsie Taveras (MassGeneral Hospital for Children), and Roberta Goldman (Warren Alpert Medical School, Brown University, Pawtucket, RI). 

The study was funded by the Robert Wood Johnson Foundation New Connections Grants Through Healthy Eating Research Program (74198), the National Center for Advancing Translational Sciences, and the National Institutes of Health (UL1TR001873).

The authors report no financial or other conflicts of interest.