Soft Drink and Beverage
Consumption in Children and Youth

Why are Sweetened Drinks a Concern for Health?

• Excessive use of carbonated soft drinks, sports drinks, and sweetened fruit drinks can influence bone health and may promote the development of obesity.

What Changes are Occurring in Children and Youth Beverage Consumption?

• The highest average consumption of fluid milk peaks at 2 cups per day at age 1 and declines to only ¾ cup per day at age 18.1 (USDA data CSFII 1994-96, 1998)
• A rapid rate of increase of carbonated soft drinks begins at age 8. The average intake of carbonated soft drinks is 4.5 ounces per day for 4-8 year olds. That amount increases to 18 ounces per day for 14-18 year olds. 1(USDA data CSFII 1994-96, 1998)
• Compared to 1965, U.S. adolescents (ages 11-18) were drinking less milk and more soft drinks and other sweetened beverages in 1996.2 (USDA)
  • Total milk consumption has been reduced by 37% for males and 43% for females [from 5 cups to 3 cups/day for males and from 3 ½ to 2 cups per day for females].
  • Per capita caloric soft drink intake has increased more than 2 times [from 364 ml to 1046ml/day for males and from 303ml to 678 ml/day for females].

Health Consequences of Reduced Calcium Intakes

• Youth with calcium intakes below recommended amounts may not achieve peak bone mass, thus increasing the risk of osteoporosis later in life. 3,4
• Adequate calcium intake may help to regulate fat balance and body weight. 5,6

Nutrient and Caloric Contribution of Soft Drinks versus Milk

• Children* consuming 9 ounces of more of soft drinks per day had significantly higher calorie intakes and significantly lower intakes of calcium, phosphorus, riboflavin, folate, and vitamins A and C compared to non-consumers of soft drinks. [*pre-school(2-5 years) and school-age(6-12 years)]7 (USDA CSFII 1994-96)
  • Approximately 12% of preschool age children consume 9 oz or more of soft drinks compared to approximately 32% of school age children. (USDA 1994 CSFII,).
  • Among school-aged children, those consuming 9 oz or more per day of soft drinks had a daily energy intake of 2,018 kcal compared to 1,830 for non-consumers.
• Total beverage intake contributed 20-24% of total energy for all ages of children and adolescents.8 (NHANES) For adolescents:
  • Sweetened soft drinks and fruit drinks provided approximately 10% of energy.
  • Milk provided approximately 6% of energy.
• Adolescent males and females consumed 20% of energy from added sweeteners. The largest source of added sweeteners was regular soft drinks which contributed one third of the intake.9 (USDA CSFII 1994-96)
• When excess calories are consumed as sweetened beverages there is a reduced ability to compensate (or reduce other food intake and energy intake) as compared to eating carbohydrate in the solid form.10
• Sweetened soft drinks and beverages with a higher Glycemic Index rating may contribute to increased hunger and increased body weight.11,12

^{How Does North Dakota Youth Milk Consumption and Overweight Risk Compare to National Youth?}

Health Concerns with the Development of Obesity

• The prevalence of over weight (BMI > 95th percentile) among children has increased more than three times in the past three decades reaching a level of 15% of youth ages 6-19.13 (1999-2000 HNANES)
• Each additional serving of sugar-sweetened drink has been found to be associated with an increased frequency of obesity in children (grades 6 and 7).12
• Obesity, resulting in insulin resistance, may lead to pre-diabetes and ultimately to type 2 diabetes in children.14,15
• Obese children have about 3 times the risk of developing hypertension compared to non-obese children.16-17 · Cardiovascular risk factors were increased (2.4-12.6 times) for obese children (5-17 years old) in the Bogalusa Heart Study.18,19

References

1. Rampersaud GC et al. National survey beverage consumption data for children and adolescents indicate the need to encourage a shift toward more nutritive beverages. J Am Diet Assoc. 2003;103:97-100.

2. Cavadini C et al. US adolescent food intake trends from 1965 to 1996. Arch Dis Child 2000;83:18-24.

3. Sandler , R et al. Post menopausal bone density and milk consumption in childhood and adolescence . Am J Clin Nutr 1985;42:270-274.

4. Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab 2001:12(1):22-28.

5. Carruth BR and JD Skinner. The role of dietary calcium and other nutrients in moderating body fat in preschool children. Internat J Obesity 2001;25:559-566.

6. Zemel MB. Regulation of adiposity and obesity risk by dietary calcium: Mechanisms and implications. J Am Coll Nutr 2002;21(2):146S-151S.

7. Harnack L et al. Soft drink consumption among US children and adolescents: Nutritional consequences. J Am Diet Assoc 1999;99:436-441.

8. Troiano RP et al. Energy and fat intakes of children and adolescents in the United States: data from the National Health and Nutrition Examination Surveys. Am J Clin Nutr 2000;72(suppl):1343S-1353S.

9. Guthrie JF & Morton JF. Food sources of added sweeteners in the diets of Americans. J Am Diet Assoc 2000;100:43-48,51.

10. DiMeglio DP and RD Mattes. Liquid versus solid carbohydrate: effects on food intake and body weight. Internat J Obesity 2000;24:794-800.

11. Roberts SB. High-glycemic index foods, hunger and obesity: Is there a connection? Nutr Rev 2000;58(6):163-168.

12. Ludwig DS et al. Relation between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis. Lancet 2001;357:505-508.

13. Ogden CL et al. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002;288(14):1728-1732.

14. Kaufman FR. Type 2 diabetes in children and youth. Rev Endocr Metab Disord 2003;4:33-42.

15. Libman I & Arslanian S. Type 2 diabetes in childhood: the American perspective. Horm Res 2003;59 (Suppl1):69-76.

16. Sorof J & Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002;40(4):441-447.

17. Rocchini AP. Pediatric hypertension 2001. Curr Opin Cardiol 2002; 17(4):385-389.

18. Freedman Ds, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatr. 1999;103:1175-1182.

19. Nicklas TA et al. Tracking of serum lipids and lipoproteins from childhood to dyslipidemia in adults: the Bogalusa Heart Study. Int J Sports Med 2002;22(suppl 1):S39-S43.