Nutritional Disorders Telehealth Network Project

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Elimination of Juice/Empty Calories

Eliminate the dietary practice of excess consumption of sweetened beverages (including fruit juice)
Background Education for Providers
Overconsumption of sweetened beverages can be a common practice among children who are overweight. For the purpose of weight management, sweetened beverages will be defined as any beverage having no more than 3 grams of sugar per 8-ounce serving (other than low-fat or non-fat white milk).   Common sweetened beverage choices of pediatric patients include: 100 percent fruit juice, regular Kool-Aid®, regular soda, sports drinks, juice drinks, flavored milks, lemonade, coffee drinks, and some flavored “waters”. Guidelines for healthy, normal-weight children include up to 8-ounces of 100% fruit juice per day. For the child who can benefit from weight management, sweetened beverages should be avoided as much as possible as they can provide a significant number of excess calories with little to no nutritional benefit.
Non-flavored (aka white milk) naturally has 12 grams of sugar per 8-ounce serving. Due to the numerous other health benefits of low-fat or non-fat white milk, white milk can remain as a consistent beverage choice as long as the child does not consume excessive amounts. Please refer to the USDA Dietary Guidelines for the age-appropriate amounts of milk.
Outside of meal and/or snack times, the preferred beverage choice for children is water. If the child was previously drinking sweetened beverages, the transition to water may be more challenging and flavored “sugar free” can be used as a substitute for the sweetened beverages. Suitable beverage choices would include those with no more than 3 grams of sugar per 8-ounce serving. Examples include: sugar free Kool-Aid®, diet soda, low calorie flavored “waters”, reduced calorie sports drinks, sugar free lemonade. Due to the popularity of these products, you can also encourage families to look for store-brand varieties of these products.
If the child does not routinely drink water, misunderstood cues for thirst are often interpreted as “hunger” by a child. In the context of structured meals and snacks, do not allow the child to graze only offer water between meal and snack times. If the child frequently asks for food and/or snacks, first offer water.
Instructions for Provider
Steps to achieve a reduced consumption of sweetened beverages can happen through a variety of ways. Talking with the family about the different ways and what they feel will work best will likely lead to the best results. You can use any of the below techniques, or a combination of the below techniques. Keep in mind that the steps to work toward better beverage choices may need to be done without children observing the changed beverage items.
  • Dilute 100% fruit juice with extra water. Initially have a 50/50 ratio of juice to water. Progress to 25% juice and 75% water. Then advance to mostly water and a “splash” of juice.
  • If purchasing flavored milks, start making your own with low-fat or non-fat white milk and limited amounts of flavoring or using sugar free varieties of flavored syrups/powders (examples: HERSHEY®’S syrup, Nesquik® powder).
  • If a family has never tasted sugar free varieties of beverages before, have them conduct “taste tests” to find the ones they like.
  • If sweetened beverages are routinely purchased by the family, establish agreements to reduce the amount purchased. Can be replaced with sugar free varieties or water.
  • Purchase water bottles for family members that can be re-used.
Supplemental Materials
© 2015 Medical College of Wisconsin
Page Updated 04/15/2014