Sodas in Schools: A Sticky Situation

School beverage policies should address obesity, tooth decay, and low-nutrient drinks' contributions to chronic illness.

Sodas in Schools: A Sticky Situation

At first glance, it might seem as if the American Beverage Association (ABA) cares more about kids than profits.

Its recommendation, released last August, to limit the availability of soft drinks in schools appears to be a proactive stance against childhood obesity.

"Childhood obesity is a serious problem in the U.S.," Susan Neely, ABA president and chief executive officer said at the time. "We intend to be part of the solution by increasing the availability of lower-calorie and/or nutritious beverages in schools."

To "support efforts of parents and children to adopt healthy lifestyles," the ABA encourages" all companies involved in the sale of beverages, "as well as school districts, to implement the ABA’s voluntary policy, which recommends the following "beverage choices" by grade level:

  • Elementary schools: only bottled water and 100-percent juice.
  • Middle schools: bottled water, 100-percent juice, sports drinks, no-calorie soft drinks and low-calorie juice drinks. No full-calorie soft drinks or full-calorie juice drinks with 5 percent or less juice until after school hours.
  • High schools: bottled water, 100-percent juice, sports drinks and juice drinks. No more than 50 percent of the vending selections will be soft drinks.

Let’s take a closer look at the policy.

First, the health problems associated with soft drinks, sports beverages, and juice drinks extend far beyond the elementary school years. Obesity isn’t the only concern. Osteoporosis and tooth decay are also related to nutrient-poor food and beverage choices, so preventive strategies must extend throughout childhood and adolescence.

Robert P. Heaney, M.D., an internationally recognized expert in bone and calcium nutrition at Creighton University, refers to osteoporosis as a "pediatric disorder that rears its ugly head in adulthood." In the clinical report, "Optimizing Bone Health and Calcium Intakes of Infants, Children, and Adolescents," published in the February 2006 issue of Pediatrics, physicians Frank Greer and Nancy Krebs explain that during the critical time when youth build peak bone mass, many are failing to meet calcium needs. Only 10 percent of girls and 30 percent of boys between the ages of 12 to 19 meet recommended calcium intakes.

Greer and Krebs also note the possibility that low bone mass may be a contributing factor to fractures in children. "The big problem with soda is that it’s calories replacing milk," said pediatrician Melvin Heyman, a member of the American Academy of Pediatrics (AAP) Committee on Nutrition.

Because both sugar and acidity harm teeth, regular and diet soda, as well as fruit drinks and sports beverages, contribute to dental decay. Last summer, researchers from the University of Birmingham, U.K., reported that sports drinks can cause up to 30 times more tooth enamel loss than water. Jonathan Shenkin, a pediatric dentist on this side of the Atlantic voiced similar concerns at the Institute of Medicine’s February 2005 meeting on nutrition standards in schools. Sports drinks, termed "electrolyte replacement beverages" by the industry, are simply more sugar water when it comes to the teeth.

Second, I wonder why school districts would adopt policies promoted by the ABA, formerly known as the National Soft Drink Association, over recommendations from dentists and doctors. In 2004, the AAP called on pediatricians to "work to eliminate sweetened drinks in schools." The AAP advised offering "real" fruit and vegetable juices, water, and low-fat white or flavored milk to students at all grade levels.

In anticipation of public debate over their position, the ABA posted a series of questions and answers on its website. Well written and thoughtful, they could be convincing if you didn’t know better. For example, the ABA says that "available data indicate that the average per capita intake of full-calorie soft drinks from vending machines is not greater than 16 ounces, or less than one 20-ounce bottle a week" and that "this is a relatively low level of consumption that is unlikely to contribute to childhood obesity."

The AAP has different statistics. It reports that between 56 and 85 percent of children in school consume at least one soft drink daily, with the highest amounts ingested by adolescent boys. Of this group, 20 percent consume four or more servings daily. Children’s soft drink consumption has increased by 300 percent over the past 20 years, mirroring escalating obesity rates. Serving sizes shot up from 6.5 ounces in the 1950s to 20 ounces by the late 1990s. It will take a 110-pound child 75 minutes of bike riding to burn off the calories in one 20-ounce bottle of soda.

Further, the beverage industry’s claim that soft drinks are "absolutely not" a major contributor to growing rates of childhood obesity lacks credibility. In 2001, researchers at Harvard University reported that each 12-ounce sugared soft drink consumed daily "increases a child’s risk of obesity by 60 percent." In the AAP’s 2004 policy statement on "Soft Drinks in Schools," lead author Robert Murray, M.D., said, "Overconsumption is a common problem among children today."

The ABA states, "Healthy and active kids can certainly enjoy soft drinks and juice drinks." However, the Centers for Disease Control and Prevention report that too many youth are not healthy and active. The majority of high school students’ diets fall short in fruit, vegetables, and milk. Nor are youth participating in sufficient levels of physical activity.

Neely says she wants parents to have the assurance that their children aren’t drinking excessive amounts of sweetened drinks at school. Unfortunately, restricting soft drinks to no more than 50 percent of choices won’t stop a student from overconsuming. If the beverages are sold, they’re available for consumption.

Much like the wolf dressed as Grandma in "Little Red Riding Hood," the beverage industry’s policy appears friendly and caring on the surface. Yet the industry is clearly calculating and protecting continued sales and the branding of our youth.

In December 2005, the ABA announced the hiring of Kevin Keane, former Assistant Secretary of Public Affairs for the U.S. Department of Health and Human Services. Talk about a sweet revolving-door situation. Keane was a senior advisor to Secretary Tommy Thompson, and managed the department’s communications, including multimillion-dollar advertising and public service campaigns.

In another sweet deal, the National Association of State Boards of Education (NASBE) is conducting a "symposium on student wellness" this April in Chicago, with financial support from the American Beverage Association. Global P.R. giant Porter Novelli will be at the table too. When asked why NASBE would partner with industry rather than a medical association, a NASBE staff person replied, "Because we’ve been unable to find funding anywhere else on the topic."

And therein lies the heart of the problem – underfunded public education, sold to the highest bidders.

If the beverage industry really had kids’ best interests at heart, it would shrink portion sizes and stop fighting school districts, parents, and legislators nationwide when they try to truly protect children’s health by allowing only health-promoting beverage choices in public schools, consistent with the AAP's recommendations.

We can be shortsighted and rely on dollars generated from sales of nutrient-poor foods and beverages, but we’ll pay dearly later. Obesity and related heart disease and diabetes threaten to shorten the new generation’s life spans.

Schools are the second most important environment for children, following the home. Therefore, parents, teachers, administrators, the medical community, and legislators have a responsibility to ensure that schools are safe food environments. But when consumed regularly over time, nutrient-poor foods and beverages are unsafe, because they contribute to chronic disease.

President Harry S. Truman said it best in 1946 upon signing the National School Lunch Act: "No nation is any healthier than its children."

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