Snacks, Sweetened Beverages, Added Sugars, and Schools

Abstract

Concern over childhood obesity has generated a decade-long reformation of school nutrition policies. Food is available in school in 3 venues: federally sponsored school meal programs; items sold in competition to school meals, such as a la carte, vending machines, and school stores; and foods available in myriad informal settings, including packed meals and snacks, bake sales, fundraisers, sports booster sales, in-class parties, or other school celebrations. High-energy, low-nutrient beverages, in particular, contribute substantial calories, but little nutrient content, to a student' s diet. In 2004, the American Academy of Pediatrics recommended that sweetened drinks be replaced in school by water, white and flavored milks, or 100% fruit and vegetable beverages. Since then, school nutrition has undergone a significant transformation. Federal, state, and local regulations and policies, along with alternative products developed by industry, have helped decrease the availability of nutrient-poor foods and beverages in school. However, regular access to foods of high energy and low quality remains a school issue, much of it attributable to students, parents, and staff. Pediatricians, aligning with experts on child nutrition, are in a position to offer a perspective promoting nutrient-rich foods within calorie guidelines to improve those foods brought into or sold in schools. A positive emphasis on nutritional value, variety, appropriate portion, and encouragement for a steady improvement in quality will be a more effective approach for improving nutrition and health than simply advocating for the elimination of added sugars.

Impact of school policies on non-communicable disease risk factors – a systematic review

“…The effective policy interventions targeted at the school level to reduce sugar consumption among school children were to have a school nutrition policy restricting SSBs. These findings are consistent with those reported in independent reviews on determinants of high sugar intake [49, 50]. Tobacco use is a well-established independent risk factor for NCDs and the most prevalent behavioral risk factor globally [51].…”

Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association

“…The American Academy of Pediatrics Council on School Health and Committee on Nutrition advises using the minimal amount of added sugars necessary to promote the palatability, enjoyment, and consumption of nutrient-rich food items. 117 Thus, it is important to be judicious when including added sugars in children’s diets. SSBs, sweets, and sweetened grains are more likely to have a negative impact on diet quality, whereas sweetened dairy products and presweetened cereals may have a positive impact.…”

“…127 The American Academy of Pediatrics concluded that data on NNSs are scarce in terms of the long-term benefits for weight management in children and adolescents or the consequences of long-term consumption. 117 Because of the lack of research in children, a recommendation either for or against the routine use of NNSs in the diets of children cannot be made at this time.…”

The Sweet Path to Metabolic Demise: Fructose and Lipid Synthesis

“…Reducing fructose intake is also critical. The American Academy of Pediatrics provides clear guidelines to limit juice and sweetened beverage intake in children [97], and advocates limiting sales of sugar sweetened beverages (SSB) in schools [98]. Decreasing SSB has been shown to lead to weight loss in overweight children [99].…”