Previous research has shown that despite recommendations to limit sugar-sweetened beverages (SSB), 29% of toddlers and 45% of preschool-aged children in the U.S. reportedly consume SSB daily.  It has been suggested that this may be due to parent’s perceptions of beverage’s nutritional quality and perceived healthfulness. The purpose of this study was to 1) identify characteristics that Hispanic and African-Americans parents of young children believe make a beverage healthy, and 2) examine the influence of these characteristics on parents’ perceptions of beverages they provide to their young children. Hispanic and African-American parents with children 5 years or younger residing in the District of Columbia were eligible to participate. Data collection used mixed-methods and occurred in two phases. In the first phase (qualitative) , parents (n=102) were asked to report the characteristics they thought reflected a healthy beverage.  In the second phase(quantitative), other parents (n=96) were asked to indicate the extent to which characteristics reported in the first phase influenced perceptions of beverages they provide to their children using Likert scales. Qualitative data analysis involved merging redundant responses into a set of 50 unique characteristics of a healthy beverage. After completing a thematic analysis, these 50 characteristics were sorted into the following nine distinct categories: 1) sugar and sweeteners, 2) natural, 3) presence of certain nutrients, 4) lack of certain ingredients, 5) appearance, 6) made with plant-derived ingredients, 7) beverage packaging/cost/retail, 8) presence of absence of dairy, and 9) contains water. Using participants’ responses from phase two, mean influence values were calculated for each characteristic and category. The categories with the most influence (median category influence value is greater than or equal to 3.6) were “sugar and sweeteners”, “natural”, and “containing certain nutrients”. Further analysis revealed that Hispanic parents reported the characteristics of being homemade, made with fruit, and containing vitamins as being more influential compared to African-American parents.

Study strengths: This study provided novel insights regarding Hispanic and African-American parents’ perceptions of a healthy beverage. This study also highlighted a need to consider how nutrient-related front-of-package claims may be interpreted by consumers. Lastly, the results call attention to the need to address misperceptions about beverage healthfulness in a way that is culturally relevant.

Study limitations: This study did not assess the beverages parents provided to their children, and therefore perceptions of beverages may not align with provision behaviors. Additionally, data was not collected on intake of SSB or on parents’ nutrition literacy. Finally, the small sample was one of convenience and was limited to the District of Columbia. The results are not generalizable.

What this means for your practice: This study results indicated that drinks that are “natural” or that contain certain nutrients may be perceived as healthy among Hispanic and African-American parents, despite the presence of added sugars. The front-of packaging claims can be misleading because they do not accurately reflect the healthfulness of a beverage. Educating parents/guardians using materials in your Rethink Your Drink Toolkit may help facilitate a productive conversation about healthy beverage choices for families with young children. For more information about the Toolkit, or to request additional materials, visit www.rethinkyourdrinknevada.com/healthpros.

Original citation: Sylvetsky, A. C., Hoang, S. T., Visek, A. J., Halberg, S. E., Smith, M., Salahmand, Y., … & Lora, K. R. (2022). Beverage Characteristics Perceived as Healthy among Hispanic and African-American Parents of Young Children. Journal of the Academy of Nutrition and Dietetics, 122(6), 1158-1167.

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