In March 2019, the American Academy of Pediatrics (AAP) and the American Heart Association (AHA) released public health policy recommendations designed to reduce children's consumption of sugary drinks. The recommendations targeted at federal, state, and local legislators are broad sweeping and include excise taxes, limits on marketing to children, educational initiatives, and financial incentives for purchasing healthier drink options (AAP, 2019; Muth, Dietz, Magge, & Johnson, 2019).

Although AAP has never recommended taxes on sugary drinks, in their 2004 policy statement on soft drinks in schools they summarized potential health risks of soft drink consumption during childhood and advocated for a clearly defined school district policy that restricts the sale of soft drinks in schools (AAP, 2004). In addition to obesity, calcium deficiency, dental caries, and tooth enamel erosion, further research has found correlations with cardiovascular disease, hypertension, dyslipidemia, insulin resistance, type 2 diabetes, and fatty liver disease (Muth et al., 2019).

Specifically, the AAP 2019 policy statement (Muth et al., 2019) calls for six recommendations:

1) Local, state, and national policy makers should consider raising the price of sugary drinks. This could include an excise tax with revenues contributing to educational campaigns and efforts to reduce health and socioeconomic disparities. Price increases have been associated with a decrease in alcohol and tobacco consumption, especially with teens and those of lower socioeconomic status. Taxes on sugary drinks are associated with significant decreases in sugary drink purchases and a concomitant increase in water and milk purchases.

2) Federal and state governments should support efforts to decrease marketing of sugary drinks to children and adolescents. Since 2007, marketing to teens has significantly increased; almost half of teens surveyed reported daily consumption of sugary drinks (Muth et al., 2019). On average, children consume >30 gallons of sugary drinks every year. State governments should implement the U.S. Department of Agriculture school policy that prohibits school districts from marketing and selling sugary drinks during the school day.

3) Federal nutrition assistance program should aim to ensure access to healthy foods and drinks and discourage consumption of sugary drinks. Sugary drinks are not included in the Women, Infants and Children program or the Child Adult Care Food, and Healthy programs and are prohibited under the Health, Hunger-Free Kids Act of 2010. However, the Supplemental Nutrition Assistance program, the largest federally funded child nutrition program is silent on sugary drinks.

4) Children, adolescents, and their families should have ready access to credible nutrition information, including on nutrition labels, restaurant menus, and advertisements. This includes regulations on labeling and advertisements as well as educational initiatives.

5) Policies that make healthy beverages the default should be widely adopted and followed. Several state legislatures taken the lead here including: California, Hawaii, Vermont, Connecticut, and Rhode Island.

6) Hospitals should serve as a model and implement policies to limit or disincentivize purchase of sugary drinks. A well-defined hospital policy and educational campaign to limit sugary drinks for patients, visitors, and employees is an effective strategy to build a public awareness campaign.

Nurses can play a key role in reducing the consumption of sugary drinks in children and adolescents by counseling children and families on risks of consumption, educating on nutrition label literacy, and advocating for policy change with school and hospital boards, elected officials, and in public health campaigns.

References