Summary: Strategies to reduce sugar-sweetened beverage consumption and increase water access and intake among young children: Perspectives from expert stakeholders

Why does sugar-sweetened beverage (SSB) and water consumption matter?  

  • Nearly half of all children aged 2-5 years in the U.S. consume a sugar-sweetened beverage (SSB) on a typical day.1 This is problematic since SSB consumption is linked to negative health consequences, including obesity.2
  • Research also suggests that the majority of children in the U.S. are inadequately hydrated, with over 20% of children aged 1-5 years not drinking any tap water on a typical day.3
  • For more than a decade, reducing SSB consumption and increasing water access and intake among young children has been the target of many research, policy and advocacy efforts in the U.S.

This fall, EVERGREEN members Kelsey Vercammen, Johannah Frelier, Caitlin Lowery, Dr. Alyssa Moran and Dr. Sara Bleich published a research article in Public Health Nutrition, summarizing stakeholder recommendations on novel and innovative strategies to reduce SSB consumption and increase water access and intake among young children (aged 0-5 years). Vercammen et al. administered two online surveys, wherein the first survey generated a list of strategies and the second survey asked participants to rank strategies identified from survey 1 and peer reviewed literature on 5 domains: feasibility, effectiveness, reach, health equity, and overall importance.

In survey 1, six major themes emerged as frequently recommended strategies to promote healthy beverage consumption: education; campaigns and contests; marketing and advertising; price changes; physical access; and improving the capacity of settings to promote healthy beverages. In addition, labeling and sugar reduction (e.g., reformulation) were recommended as strategies to specifically reduce SSB consumption, while water testing and remediation were recommended as a strategy to specifically promote water intake. In survey 2, stakeholders provided higher ratings to strategies that used policy, systems, and/or environmental changes. This represents a clear departure from the peer-reviewed literature which primarily focuses on individual-level interventions (e.g., nutrition classes).4 Early childcare centers, daycares, and schools were the highest ranked settings for intervention.

While there is high interest in reducing SSB consumption and increasing water access and intake among young children, available resources to do so are limited. Therefore, this study provides important perspectives from expert stakeholders about how resources can be best maximized.

The project was funded by Healthy Eating Research, a program of the Robert Wood Johnson Foundation.

Interested in learning more? Click here for a link to the full-text publication.


1Bleich, S. N., Vercammen, K. A., Koma, J. W., & Li, Z. (2018). Trends in Beverage Consumption Among Children and Adults, 2003‐2014. Obesity26(2), 432-441.

2Bleich, S. N., & Vercammen, K. A. (2018). The negative impact of sugar-sweetened beverages on children’s health: an update of the literature. BMC obesity5(1), 6.

3 Kenney EL, Long MW, Cradock AL et al. (2015) Prevalence of inadequate hydration among US children and disparities by gender and race/ethnicity: National Health and Nutrition Examination Survey, 2009–2012. American Journal of Public Health 105, e113-e118.

4 Vercammen, K. A., et al. “A systematic review of strategies to reduce sugar‐sweetened beverage consumption among 0‐year to 5‐year olds.” Obesity Reviews 19.11 (2018): 1504-1524.