Hispanic children are more likely to be overweight or obese compared to other racial/ethnic groups, and a major contributor to this is sugar-sweetened beverages (SSB). Understanding parents’ decisions about serving SSB to their children is important for effective interventions. Therefore, the purpose of this exploratory study was to use the Social Ecological Model to evaluate Hispanic parents’ perceptions of SSB and their decisions about serving them to children. This cross-sectional survey used a convenience sample provided by a third-party research company of Hispanic parents with children aged one to five years old living at home (n = 350). The survey included questions about categories (n=7) and brands of drinks they had served to their child(ren) within the past month, as well as their perspective of the drink healthfulness. Other questions about SSB were included such as individual knowledge (i.e., impact on cavities), community setting factors (i.e., access to SSB at home), and socio-cultural norms (SSB consumption by friends/family). Results showed that 98% of parents served a SSB to their child within the past month. The most common SSB served were fruit-flavored drinks and sweetened milk drinks (90% and 71%, respectively). On average, parents reported serving 6.7 categories of SSB within the past month. A linear regression model showed that parents  were more likely to serve SSB if they 1) were born in the US/Puerto Rico, 2) had higher rating of SSB healthfulness, 3) had normative beliefs that others serve SSB to children, 4) had a child between three and five years-old, and 5) enjoyed drinking SSB or their child enjoyed drinking SSB. Language related acculturation, gender, and income were not significant after controlling for other variables.

Study strengths: This is the first study to quantitively examine individual and socio-cultural levels of the social ecological model that are associated with Hispanic parents serving SSB to their children. Offerings of different categories of SSB, along with specific, culturally relevant brands provided a comprehensive overview of the SSB Hispanic parents serve. Additionally, previous studies have mainly focused on mothers, and this study included both mothers and fathers.

Study limitations: This study did not include non-Hispanic parents and therefore cannot compare or make conclusions about the differences across ethnic groups. Additionally, this study assessed prevalence of SSB intake over the past month but did not account for frequency of each item consumed. Finally, convenience samples limit external validity of prevalence estimates, and the cross-sectional study design cannot assess causality.

What this means for your practice: When discussing SSB with parents and guardians of your young patients, impactful strategies to replace sugary drinks with healthful alternatives may include addressing social norms and parent/child enjoyment of SSB. If families enjoy flavored beverages, there are over 40 sugar-free recipes available on our website, that use a variety of fruits, vegetables and herbs to naturally flavor water or milk. In this study, perceptions of SSB healthfulness varied widely.  Education about added sugar in fruit-flavored drinks, flavored milk and nectar juice may be of benefit. Referring families to www.rethinkyourdrinknevada.com, or by using the tear sheet in the Rethink Your Drink Toolkit can help with this education effort.

Original citation: Beckman, M., & Harris, J. (2021). Understanding individual and socio-cultural factors associated with hispanic parents’ provision of sugar-sweetened beverages to young children. Appetite, 161, 105139.

About the Author:  Chenin Treftz, Ph.D., R.D.N., is a member of the research faculty at the University of Nevada, Reno.  Dr. Treftz has expertise in research, community nutrition, and higher education. Dr. Treftz has been a member of the Rethink Your Drink team since 2012.

The goal of Rethink Your Drink Nevada is to promote healthy beverages and reduce sugary drinks. To support this goal, free educational resources are available to eligible medical and dental care practices in Nevada.  For more information, please visit www.rethinkyourdrinknevada.com/healthpros or e-mail rethinkyourdrinknevada@cabnr.unr.edu.

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