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Doctors: Curtail Soft Drinks in Schools

Pediatricians call for severe restrictions on soda machines

MONDAY, Jan. 5, 2004 (HealthDayNews) -- The nation's most influential group of child doctors recommends soft drink sales in schools be severely restricted.

A policy statement from the American Academy of Pediatrics (AAP) says that sweetened drinks -- including fruit drinks as well as soft drinks -- are now the main source of added sugar in the daily diets of children. According to the pediatricians, between 56 percent and 85 percent of children in school consume at least one soft drink daily.

The statement appears in the January issue of the academy's publication, Pediatrics.

Over the past 20 years, consumption of soft drinks has surged by 300 percent, while sizes have grown from 6.5 ounces in the 1950s to 20 ounces in the late 1990s. Each 12-ounce serving of a carbonated, sweetened soda has 150 calories and the equivalent of 10 teaspoons of sugar and has been associated with a 60 percent increase in the risk of obesity.

Obesity, which is one of the main health problems facing today's youth, is just one issue associated with sugared drinks. Each soft drink consumed means less milk is being taken in. As milk is the principal source of calcium for most Americans, this raises the specter of future osteoporosis and fractures. There's also the likelihood of more cavities and enamel erosion.

At the same time, however, school districts have been signing contracts to put vending machines in schools in return for increased revenue. "The schools don't just decide to have soft drinks in school because the kids want it. They need the money," says Dr. Barbara Frankowski, chairwoman of the AAP's committee on school health. "In a sense, what a lot of schools are funding might be the football team, but 20 kids on a football team make out good and the whole rest of the school gets obese. You're selling the kids down the river when the school really has the best interest in mind. It's just unfortunate that they have to resort to that."

The AAP statement recommends that pediatricians help educate school authorities, patients and parents to eventually eliminate sweetened soft drinks in schools.

The policy also advocates that vending machines be turned off during lunch hours and, even better, during school hours; that vending machines be eliminated in elementary schools; that consumption and advertisement of sweetened soft drinks be prohibited within the classroom; that non-sweetened alternatives such as milk be offered; that school districts invite public discussion before signing any contracts; and that vending machines not be placed in cafeterias.

A prepared statement from the National Soft Drink Association says the AAP "fails to acknowledge that federal regulations already prohibit the operation of soft drink machines in school cafeterias and food service areas during breakfast and lunch." The trade group further states the academy "fails to include a meaningful discussion of the critical need for daily physical activity to combat childhood obesity."

A second study in the same issue of the journal found, not surprisingly, that eating fast food could put children and teens at risk for obesity.

"Fast food consumption has increased dramatically in parallel with the obesity epidemic," says study author Dr. David Ludwig, director of the obesity program at Children's Hospital Boston. "On average, teenagers get a staggering 25 percent of calories from fast food and soft drinks alone."

At the same time, there has been a relative dearth of data on what effect this trend has on the health of children, Ludwig adds.

In an attempt to fill the gap, Ludwig and his colleagues looked at the dietary patterns of 6,212 American children and adolescents aged 4 to 19. They found that on any given day, almost one in three (30.3 percent) of the kids surveyed reported consuming fast food. This was true across genders, income groups, racial-ethnic groups and geographic locations.

Children who ate fast food consumed an average of 187 calories more than those who did not. Also, children took in about 126 calories more on the days they ate fast food vs. the days they did not.

"On fast-food days, children took in substantially more total calories, ate more saturated fat, more added sugars, but consumed less fiber and fewer fruits and vegetables," Ludwig says. "In addition, diets were higher in energy density. They were getting more calories per bite, so the study suggests that fast food has an adverse effect on children's diets in many ways that could quite plausibly increase the risk for obesity."

"This, together with other studies that have been published, provide a strong argument to suggest that the advertising and marketing of fast food directly to children should be limited," he adds.

More information

The American Academy of Pediatrics has information on healthy food choices for children of school age. The U.S. Department of Agriculture also has a Child Care Nutrition Resource System.

SOURCES: David Ludwig, M.D., Ph.D., director, obesity program, Children's Hospital, Boston; Barbara Frankowski, M.D., professor, pediatrics, Vermont Children's Hospital, Burlington; National Soft Drink Association statement; January 2004 Pediatrics
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