Call for action on the consumption of sugar-sweetened beverages: Position Paper on behalf of the European Academy of Paediatrics and the European Childhood Obesity Group

In April 2019 researchers from Poland, Belgium, Austria, Italy, Germany, France, Israel and Cyprus published a Position Paper on behalf of the European Academy of Paediatrics and the European Childhood Obesity Group which outlined the risks incurred by infants, children and adolescents consuming sugar-sweetened beverages. WHO has stated that 41 million children under the age of 5 and over 340 million children and adolescents aged 5–19 were overweight or obese in 2016 and it is thought that dietary patterns, such as the consumption of sugar-sweetened beverages, may contribute to the development of overweight and obesity. Children and parents often think of fruit drinks and juice as being a healthy choice. However, despite the presence of important nutrients in fruit drinks and juice, their consumption should also be limited due to the high sugar content.

Breast milk or infant formula, and water are the only drinks that should be offered before the age 6 months, and should be the main drinks up to 12 months of age. Starting from 4 to 6 months, when solid foods start to be offered, only spring water or natural mineral water (medium-mineralized, low-sodium, low-sulphate) should be offered to infants. Carbonated drinks, including sparkling mineral water and flavoured waters, are not suitable as they have limited nutritional value and can reduce the infant’s appetite for more nourishing foods and drinks. Also, the acidic nature and sugar content of these drinks increase the risk of tooth decay.

It is known that a high intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. In fact recent research has not only found an association between consumption of sweetened beverages and weight gain but also with metabolic syndrome and increased risk of diabetes type 2.

Children who consume soft drinks more frequently show an increased risk for Attention Deficit-Hyperactivity Disorder (ADHD) compared to ­children who “never” consume such drinks. In fact one study found that boys who consumed more than 4 glasses of sugar-sweetened beverages per day had an increased ratio of hyperactivity and conduct problems when compared to boys who consumed 1–6 glasses of sugar-sweetened beverages per week.

Many soft drinks contain fructose as a sweetener instead of sucrose. However fructose can lead to a higher production of triglycerides, very-low-density-lipoproteins and other metabolites that would increase the risk of insulin resistance and hypertension. In addition a high intake of fructose is associated with non-alcoholic fatty liver disease and in fact children with this condition appear to absorb and metabolize fructose more effectively than normal-weight children.


Governments and the health care services should provide information consistently to families, teachers and educational institutions on the health risks of sugar-sweetened beverage consumption and the benefits of replacing sugar-sweetened beverages by water and other non-sweetened beverages.
– Advertising of sugar-sweetened beverages to children should be banned.
– Taxation on sugar-sweetened beverages may contribute to decrease their consumption among children.
– The introduction on compulsory information on front of pack labels of sugar-sweetened beverages on health risks should also be considered.

– Educational and behaviour-changing programmes on appropriate choices of beverages and encouraging water consumption should be implemented in pre-schools and schools, also during training and play.
– Pre-schools and schools should offer unlimited access to drinking water, for example, by water fountains, whereas sugar-sweetened beverages and other sweet beverages should not be made available.

– Parents should avoid the use of sugar-sweetened beverages to please their children.
– Sugar-sweetened beverages should not be easily available at home.

Dereń K et al. Consumption of Sugar-Sweetened Beverages in Paediatric Age: A Position Paper of the European Academy of Paediatrics and the European Childhood Obesity Group. Ann Nutr Metab. 2019;74(4):296-302.

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