Front-of-package claims and images persuade parents that sugar-sweetened drinks are healthy choices for their children

Front-of-package claims and marketing messages used to promote fruit-flavored drinks and toddler milks with added sugars contribute to parents' misperceptions about product nutrition and benefits for their young children, according to new research from the UConn Rudd Center for Food Policy and Health. The most recent Dietary Guidelines for Americans recommends that children younger than age 2 consume no added sugars.

The study's findings, published in Maternal & Child Nutrition, also revealed that many parents are confused about different product categories, such as sweetened fruit-flavored drinks, 100 percent juice, toddler milks, and infant formulas. Companies often cross-brand their less healthy products with healthier products and place these similar-looking drinks side-by-side on shelves at retailers, contributing to this confusion.

"Marketing tactics commonly used to promote fruit-flavored drinks and toddler milks appear to mislead, mask and misrepresent true ingredients," says Frances Fleming-Milici, Director of Marketing Initiatives at the Rudd Center and lead author of the study. "Parents were surprised, and many were angry, when they learned of the ingredients in these drinks and that health-related claims on the packages are not supported by scientific research."

Health experts do not recommend serving fruit-flavored drinks or toddler milks. Sugar-sweetened fruit-flavored drinks have very little juice, and many products marketed for young children also have non-nutritive sweeteners. Toddler milks are typically produced by infant formula companies and marketed for children (12-36 months) as the next step after infant formula, but they consist primarily of powdered milk, added sugar (corn syrup solids or other sweeteners), and vegetable oil. Despite expert recommendations, 27 percent of children ages 12 to 18 months, and nearly 50 percent of 2- to 4-year-olds consume sugar-sweetened drinks on a given day.

The research used focus groups in low-to-moderate income neighborhoods in Hartford, CT and Washington, DC to evaluate parents' understanding of common marketing tactics used to promote these drinks and whether they mislead parents to believe the drinks are healthy and/or necessary for children. Participants shared their knowledge, attitudes, and behaviors regarding serving different drinks to their children and were asked to reflect on new information they learned through the focus groups

Key findings include:

• Few parents realized that many fruit-flavored drinks contain non-nutritive sweeteners in addition to added sugar.
• Parents expressed shock that toddler milk package claims are not supported by scientific research and described them as "deliberately misleading."
• Participants discussed the higher price of 100 percent juice relative to sweetened fruit-flavored drinks as a reason why parents may choose sweetened fruit-flavored drinks for their child.
• Participants described their grocery shopping as "rushed," giving them little time to differentiate among children's products at the time of purchase and making them rely on front-of-package information to make purchase decisions.
• Parents perceived that companies monitored the age of their child after signing up for infant formula coupons because they began receiving toddler milk coupons and samples when their child was "closer to a year."

Findings support the need for policies to address potentially misleading marketing of these drinks and demonstrate opportunities to use counter marketing to reduce parents' provision of sweetened fruit-flavored drinks and toddler milks. Current sugary drink reduction campaigns should inform consumers that sweetened fruit-flavored drinks and toddler milks are also sugary drinks, and they should also help them identify added sugar and non-nutritive sweeteners.

"Industry can and should do more," says Fleming-Milici. "Increasing transparency about product ingredients and eliminating misleading marketing of toddler milks and fruit-flavored drinks can go a long way in supporting parents' best efforts to provide healthy drinks to their children."