Sugar occurs naturally in many foods and there is no evidence to suggest it does any harm to a healthy person. Added sugar — introduced at the production stage — is a different story. Increasingly found in processed food and drink, added sugar has a significant negative impact on public health. A new study led by the Perelman School of Medicine at the University of Pennsylvania argues that health warning labels similar to those found on tobacco products could have a significant effect on whether parents purchase sugar-sweetened beverages (SSBs) for their children.
The researchers say their study is the first to examine the influence of so called "SSB warning labels" — those reminding consumers that beverages with added sugar can contribute to obesity, diabetes and tooth decay. These health warnings, it is proposed, improve parents' understanding of the health dangers associated with such products. The results suggest that parents, regardless of their level of education, may be significantly less likely to buy beverages that carry such a label, compared to drinks that only include the calorie count or that have no nutritional information at all.
The results come only one week after the U.S Department of Agriculture (DoA) issued new guidelines recommending consumers limit their intake of added sugar to 10% or less of their daily calories. Additionally, the World Health Organization (WHO) suggests that "a further reduction to below 5% or roughly 6 teaspoons (0.8 oz) per day would provide additional health benefits." Research shows that SSBs — including soft drinks and juices marketed for children — contain as many as seven teaspoons of sugar per 6.5 ounces. That's almost double the DoA's recommended daily serving of sugar for that age group — and remember, there are 12 fluid ounces in a normal can of soda.
"In light of the childhood obesity epidemic and studies suggesting that more than half of children under the age of 11 drink SSBs on a daily basis, there is a growing concern about the health effects associated with consumption of these beverages," says lead author Dr. Christina Roberto, an assistant professor of Medical Ethics & Health Policy at Penn Medicine. "Some states have introduced bills requiring SSBs to display health warning labels, but to date, there is little data to suggest how labels might influence purchasing habits, or which labels may be the most impactful."
Researchers conducted an online survey of 2,381 parents who had at least one child between six and 11 years old. Participants were divided into six groups: the control group, who were shown beverages with no warning label, the "calorie label" group, which saw only a label displaying the beverage's calorie count, and four "warning label" groups, each of which saw one of four variations of content warning about possible negative health effects. Each of the participants was asked to choose a beverage to purchase for their child.
It was found that while the specific text of the health warning labels did not affect parents' choice, the mere presence of a label was effective. Though 40% of parents who saw the health warning labels still said they would choose an SSB for their children, this compares to 53% of parents who saw the calorie labels and 60% of participants who saw no labels at all. In this study, placing a health warning on the label cut SSB consumption by a third.
"Regardless of the specific wording," Roberto says, "results show that adding health warning labels to SSBs may be an important and impactful way to educate parents about the potential health risks associated with regular consumption of these beverages, and encourage them to make fewer of these purchases. The findings are in line with similar studies conducted on the effects of warning labels on tobacco products, which have been shown to increase consumer knowledge of health risks related to tobacco use, and encourage smoking cessation."
The researchers also looked at how much potential consumer support there is for the warning labels and found that almost 75% of the participants would support efforts to add them to products. The team hopes the results — which are published online in the journal Pediatrics — will encourage further research into the ways in which labels such as these influence beverage choices for consumers as well as for other processed foods.
"We can now say that warning labels have the potential to educate parents and motivate behavior change when it comes to purchasing SSBs, which could help gain support for bills requiring labels to be added to beverage containers, but there are also many unanswered questions that require further study," says Roberto. "For example, it would be interesting to see if people who choose not to purchase a sugary beverage that contains a warning label end up compensating for those calories by purchasing other high-sugar foods that are unlabeled."