A study recently published in the Journal of Obesity, provides additional evidence that there is a need to reinforce the importance of limiting sugar-sweetened beverages (SSB) and encouraging water intake among parents of young children.

The purpose of the cross-sectional study was to examine the relationship between types of beverages consumed and body weight status among low-income preschool-age children that were participants of the Women, Infants, and Children (WIC) Supplemental Nutrition Program.

The study included a total of 197 children between the ages of 3 and 4.9 years old, who were currently enrolled in the WIC program in Broward County, Florida. The researchers utilized the WIC data system to obtain anthropometric data. Interviews were conducted with authorized representatives of the children at WIC clinics to obtain the amount and types of drinks consumed. It is noteworthy that about 94% of the participants were either Hispanics/Latinos or non-Hispanic Blacks/African Americans.

Findings from the study showed that, on average, children consumed 17.8 oz of milk, 11.6 oz of 100% fruit juice, 5.5 oz of SSB and 18.2 oz of water per day. There were no differences by gender or age. However, children who were overweight or obese consumed significantly more SSB compared to normal/underweight children. A closer examination of the data revealed that this was largely due to fruit drinks or fruit-flavored beverages. Interestingly, there were no significant differences in 100% fruit juice or milk intakes by weight category. Approximately 65% of children consumed fat-free or 1% milk more often than any other milk. Lastly, SSB intake was positively associated with milk and 100% fruit juice, but negatively correlated with water intake.

The findings from this study support the importance of promoting healthful beverage choices and appropriate beverage amounts among parents/guardians of preschool-age children. The positive association between SSB and obesity is similar to a number of other studies. In addition, the study revealed that preschool-age children were consuming more than twice the recommended daily maximum intake of 100% fruit juice according to the American Academy of Pediatrics. They recommend a maximum of 4 ounces for ages 1-3 years and 4 – 6 ounces for children ages 4-6 years. This is particularly important in light of the recent recommendations released by Healthy Eating Research in partnership with the Academy of Nutrition and Dietetics, the American Academy of Pediatrics, the American Academy of Pediatric Dentistry, and the American Heart Association. Lastly, about one-third of children were consuming whole-fat milk. Promoting water as healthy beverage choice for pre-school children and discouraging SSB and excessive amounts of 100% juice has the potential to reduce the risk of overweight/obesity and dental caries.

Study Strengths: This study included a racially, ethnically, and socioeconomically diverse sample of mainly Hispanic and African American children participating in WIC that are at a higher risk for childhood obesity but are rarely included in childhood obesity related research. The researchers used both existing anthropometric data, in addition to beverage intake data from questionnaires.

Study Limitations: This study lacked data on the energy (kilocalories) and nutrient intake of the preschool-age children. These factors could possibly contribute to the relationship between the consumption of SSB and the prevalence of overweight/obesity. Other limitations of the study include the cross-sectional design and the potential for bias within the self-reported data. Lastly, the results of the study are not generalizable and only represent the preschool-aged WIC population in South Florida.

What this means for your practice: This study provides more evidence that parents and other caregivers may benefit from recurrent instruction on the importance of providing healthful beverages to their young children. The messages can be quite simple: 1) Avoid serving young children sugary drinks, including fruit-flavored drinks. 2) Serve 100% fruit juice in very small quantities (The American Academy of Pediatrics recommends a maximum of 4 ounces for ages 1-3 years and 4 – 6 ounces for children ages 4-6 years). 3) Routinely offer children water to drink. Having a medical or dental care professional reinforce the nutrition education provided by WIC has the potential to have a lasting impact.

Original article: Charvet A. and Huffman F.G. “Beverage Intake and Its Effect on Body Weight Status among WIC Preschool-Age Children,” Journal of Obesity, vol. 2019, Article ID 3032457, 8 pages, 2019.

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