An initiative of the Robert Wood Johnson Foundation

Sugary Drinks Harm Kids’ Health

Reducing or eliminating consumption of sugary drinks is critical for helping kids grow up healthy.


September 3rd, 2020


Sugary drinks—any beverages that contain added caloric sweeteners—are the single largest source of calories in children’s diets and provide nearly half of kids’ added sugar intake. On average, kids are drinking more than 30 gallons of sugary drinks per year. These drinks, sometimes also called sugar-sweetened beverages or SSBs, include sports drinks, energy drinks, sodas, fruit-ades, sweetened waters, sweetened coffee and tea.

What can you expect to learn here?

This special feature highlights the latest data and trends on sugary drink consumption and facts about how sugary drinks impact kids’ health. It summarizes efforts and recommendations for reducing consumption, recent research, and stories of communities taking action.

What is the impact of consuming sugary drinks?

Consuming sugary drinks poses a real health risk to kids—and adults. It increases children’s risk of excess weight gain and tooth decay and preventable diseases such as obesity. For adults, consuming sugary drinks also increases risk of type 2 diabetes and heart disease. Latinx and Black populations have higher rates of these diseases, which is in part due to consuming sugary drinks.

Who’s consuming sugary drinks and how much are they drinking?

Sugary drinks are the top source6 of added sugar in kids’ diets. Nearly two thirds7 (61%) of U.S. children and youth consume sugary drinks each day; among children ages 2 to 4, nearly half8 (46%) do. Learn more about the different patterns of consumption by age, race and ethnicity.

The 2010 Dietary Guidelines for Americans recommend limiting added sugars to less than 10% of daily calories. How many children do?

Source: NHANES, Added Sugars in American’s Children’s Diets, 2015-16

What types of drinks do children consume on any given day?

Source: NHANES, Beverage Choices Among US Children, 2015-16

What types of drinks do children consume on any given day (by race and ethnicity)?

Source: NHANES, What We Eat in America, 2015-16

Sugary drinks are the leading source of added sugars in children’s diets across, all age groups.

Source: NHANES, Added Sugars in American’s Children’s Diets, 2015-16. Note: The other sources of added sugar in children’s diets that were studied include sweet bakery products (e.g., cakes, cookies, pies), candy, other desserts, ready-to-eat cereals, and flavored milk.

How many young people are heavy consumers of sugary drinks?

Over roughly the last decade, the percentage of young people who are heavy consumers of sugary drinks—drinking about 3.5 12-ounce cans of soda each day—has dropped significantly. These declines were significant across family income level, sex, and for white, Black, Mexican-American and non-Mexican Hispanic youth.

How are companies marketing sugary drinks?

In 2018 alone, companies spent more than $1 billion on advertising sugary drinks.

A UConn Rudd Center Sugary Drink FACTS report9, released in June 2020, also found that:

  • More than one-half of the $1.04 billion in sugary drink ad expenditures promoted regular soda and soda brands ($586 million), a 41% increase over 2013.
  • Sports drink advertising increased by 24%, totaling $159 million in 2018, and advertising for sweetened iced tea almost tripled, from $38 million in 2013 to $111 million in 2018.
  • In contrast, total advertising spending for diet and unsweetened drink categories (including plain water and 100% juice) totaled $573 million in 2018 – less than the amount spent to advertise regular soda and soda brands alone.

Deceptive marketing practices shape kids’ preferences and purchases, and therefore, their diets, overall health and life trajectory. These practices are particularly targeted toward communities of color10 through place-based marketing, prices designed to appeal to specific income groups, promotions that exploit cultural images and language, and products that are developed specifically for their communities.

Kids are particularly vulnerable to unfair advertising and marketing practices. Research shows companies spend more money directing sugary drink ads at Black and Latinx youth – and companies target kids as young as age 2  with TV ads for sugary drinks. For example, spending on sports drink advertising increased 745% from 2013 to 2018 and exposure to these ads among Latinx kids increased 10-fold or more during that period. In 2018, Black children and teens saw twice as many ads for sugary drinks as their white peers.

The majority of children’s drinks sold in 201811 were sweetened fruit drinks and flavored waters with added sugars and/or low-calorie sweeteners. Looking at the front of the packages, many sugary children’s drinks appear to be healthy choices, with images of fruit and nutrition-related claims, but none meet expert recommendations for drinks that should be served to children under age 14.

What policy efforts are underway to reduce sugary drink consumption?

At the federal, state and local levels, community members and decision-makers are creating and implementing policies to promote healthy beverages and curb kids’ consumption of sugary drinks.

Taxing Sugary Drinks

  • Raise the price of sugary drinks, such as via an excise tax, along with an accompanying educational campaign. Tax revenues should go in part toward reducing health and socioeconomic disparities. Learn more about how different places are taxing sugary drinks and using the revenue to promote health. (state and local)

Labeling Sugary Drinks & Providing Guidance for Consumption

  • An updated Nutrition Facts12 label, which took effect in January 2020, now includes the amount and percent daily value of added sugars in addition to total sugars. Beverages that could be consumed in one or multiple servings (like a 24 ounce soda) will have a dual label to show the amount of sugar and calories in the entire bottle, as well as per serving.  (federal) 
  • National menu labeling guidelines, a provision of the Affordable Care Act, require chain restaurants and other similar food retail establishments to provide nutrition information (including added sugars) to consumers upon request.  (federal) 
  • The Dietary Guidelines for Americans13, which sets nutrition standards utilized by a number of federal nutrition programs such as school meals and WIC, recommends that children and adults consume less than 10 percent of their daily calories from added sugars. (federal) 
  • Head Start14, which serves more than 1 million low-income children15 under age 5, requires its programs to make drinking water easily accessible throughout the day. (federal) 
  • The Child and Adult Care Food Program16, which provides meals and snacks to 4.2 million participants each day, updated its nutrition standards in 2017. This includes new limits on juice and allowing only non-flavored milk for kids under age 5. (federal) 
  • The U.S. Department of Agriculture’s current school nutrition rules17 prohibit serving sugary drinks with school meals, limit sugar included in “Smart Snacks in School,”  and call on schools to feature only advertising for foods and drinks that meet “Smart Snacks”18 nutrition guidelines. In elementary and middle schools, this includes water, milk and juice. Schools are also required to provide free, potable water to kids during lunch at the locations where meals are served. (federal) 
  • Allowing just water and non-flavored milk to be served in early care and education19 programs. (state and local) 

Limiting Marketing of Sugary Drinks

  • Allowing only healthier drinks like water and milk, as opposed to unhealthy drinks like sodas, as the default options on kids’ meals20 at restaurants. (state and local) 
  • Some states also have introduced bills requiring warning labels for sugary drinks, though none have yet passed. Surveys of teens21 and parents22 find warning labels show promise for deterring people from buying sugary drinks. (state and local) 

Sugary drinks harm our health and contribute to serious diseases, like obesity and diabetes, that disproportionately affect Black and Latinx communities and increase risk for more severe cases of COVID-19. We should be doing everything we can to help all kids and families avoid sugary drinks—it’s more important than ever.

RWJF Senior Program Officer, Jamie B. Bussel

What has been the impact of taxing sugary drinks?

Seven U.S. cities and the Navajo Nation have passed taxes on sugary drinks, ranging in value from one to two cents per ounce. Research has generally found that the taxes result in people buying significantly fewer sugary drinks. Some studies show people are consuming fewer sugary drinks overall after the taxes pass. And, revenue programs are helping to address health and socioeconomic disparities in some communities.

What other strategies are places using to reduce consumption?

Limiting Marketing of Sugary Drinks

  • Generating Grassroots Change in Washington, DC. With support from Voices for Healthy Kids and DC Greens, Te Speight, a resident and local artist of Washington, DC, released a spoken word piece to elevate how companies deceptively market sugary drinks to communities of color, including his own. It laid the groundwork for the eventual introduction of DC’s sugary drink tax bill. Watch the video: #DontMuteMyHealth
  • Changing Kids Meals in Local Restaurants across the U.S. New York City and several cities in California, Maryland, and Colorado have adopted local ordinances requiring restaurants to provide healthy beverages such as milk or water as the default choice in children’s meals. In 2018, California became the first U.S. state to pass a state law that made water or milk the default option for all kids combo meals that restaurants offered. Hawaii and Delaware followed suit. Read how public health advocates made it happen in California.
  • Expanding Vending Offerings to Include Healthy Options. Vending machines in public facilities across Baltimore have calorie limits on beverages and water is required to be stocked and placed “in the position with the highest selling potential.” Read about the campaign that led to policy change.

Labeling Sugary Drinks & Providing Guidance for Consumption

  • Requiring Warning Labels in Chile. In 2016, Chile started putting warning labels on the packaging of soda, juice, and other sugary drinks and sugar-laden food. Country-wide, consumption of sugary drinks plummeted 25 percent in 18 months. Other countries in Latin America are now expected to follow in Chile’s footsteps. Read more about the labels’ impact. 

What can we learn from other research?

Joint Recommendations for Action

The American Academy of Pediatrics and American Heart Association have jointly endorsed a suite of policies to reduce kids’ consumption of sugary drinks. Citing strong evidence linking consumption of added sugar to long-term health challenges, the organizations endorsed several options to reduce health harms. See the recommendations.

Guidelines for Babies and Toddlers

In 2019, four national public health organizations released guidelines for what babies and kids ages 0-5 should drink, recommending water and plain milk as the go-to drinks for young kids. Drinks with added sugars or low-calorie sweeteners are not recommended for children under the age of 5. Unfortunately, a 2019 Rudd Center report showed that not one of the 34 top-selling sweetened children’s drinks met expert recommendations for healthier drinks. Read the guidelines.

Cost-Effective Interventions 

Researchers identified three obesity-related interventions that would save more in healthcare costs than they would cost to implement: sugary drink taxes; elimination of the tax subsidy for advertising unhealthy food to children; and nutrition standards for food and drinks sold in schools outside of school meals. Read the study.

Community Strategies 

ChangeLab Solutions produced a 10-strategy guidebook to help communities reduce consumption of sugary drinks, including considerations for health equity and collaboration across sectors. See the playbook. 

National Research Agenda

Healthy Eating Research developed a national research agenda that outlines research gaps and opportunities for practitioners, researchers and foundations to pursue in order to reduce sugary drink consumption and increase safe water access and consumption among kids age 5 and younger.  Read the agenda.

Footnotes: [1] Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents, [2] The negative impact of sugar-sweetened beverages on children's health: an update of the literature, [3] Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents, [4] Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association, [5] Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association, [6] Sources of Added Sugars In American Children's Diet, [7] Sugar-sweetened Beverage Consumption Among U.S. Youth, 2011–2014, [8] Beverage Consumption Patterns among Infants and Young Children (0⁻47.9 Months): Data from the Feeding Infants and Toddlers Study, 2016, [9] Sugary Drink Facts Report, [10] the 4 ps of marketing: selling junk food to communities of color, [11] Unhealthy Drinks Dominate Children’s Drink Sales, [12] New Year, New Nutrition Facts Label, [13] Dietary Guidelines, [14] Head Start and Early Head Start, [15] Head Start Program Facts Fiscal Year 2017, [16] Child and Adult Food Care Program (CACFP), [17] School Meals & Snacks, [18] Smart Snacks in School, [19] Early Care and Education Policies and Programs to Support Healthy Eating and Physical Activity: Best Practices and Changes Over Time, [20] Food Marketing to Children, [21] The Influence of Sugar-Sweetened Beverage Warnings, [22] The Influence of Sugar-Sweetened Beverage Health Warning Labels on Parents’ Choices

Fast Facts

Child Food Insecurity
Cases of type 2 diabetes are attributable to consuming sugary drinks in the U.S. over 10 years
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Child Food Insecurity
deaths were linked with consuming too many sugary drinks in 2012
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Child Food Insecurity
cost of treating obesity in the U.S. each year
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Child Food Insecurity
of added sugars come from sugary drinks (among men)
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Child Food Insecurity
of added sugars come from sugary drinks (among women)
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Child Food Insecurity
of total beverage calories come from sugary drinks (among women and men)
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What policy efforts does RWJF recommend for reducing kids’ consumption of sugary drinks?

The Robert Wood Johnson Foundation offers the following recommendations for federal, state and local leaders working to help prevent kids from consuming sugary drinks and encourage water and plain milk as the go-to drinks for young kids.
Labeling Sugary Drinks & Providing Guidance for Consumption
U.S. Department of Agriculture (USDA) and Department of Health and Human Services should work with the Dietary Guidelines Advisory Committee to extend the Dietary Guidelines (currently under revision) to children under age 2, taking into account the most recent science including: Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach and Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations. USDA should maintain the strength of nutrition standards for school meals resulting from the 2010 Healthy, Hunger Free Kids Act, and reconsider its proposal from January 2020 to weaken them. States and local education agencies should support and implement the provision that all food and beverage advertisements on school campuses meet Smart Snacks nutrition guidelines during the school day. It should be expanded to include all forms of marketing, such as products featured on bulletin boards and vending machines and in incentive programs and fundraisers.
Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach
Limiting Marketing of Sugary Drinks
Restaurants should take soda and other sugary drinks off of kids menus and menu boards. The Federal Trade Commission should resume issuing reports examining food marketing to children.
Healthy Beverage Consumption in Early Childhood
State policymakers should oppose legislation limiting the ability of cities and counties to regulate, tax or otherwise enact legislation stronger than state laws related to children’s health and healthy communities. State policymakers should support the repeal of existing state laws limiting the ability of cities and counties to regulate, tax or otherwise enact legislation stronger than state law related to children’s health and healthy communities.

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