Join us for our latest edition of Nutrition Stories, a series exploring hot topics in nutrition and dietetics. Our guest is Rachel Stennett, a student in the UF Didactic Program in Dietetics (DPD) in the Food Science and Human Nutrition (FSHN) Department at The University of Florida. In this article, Rachel discusses why water is a healthier choice over sugar-sweetened beverages to ensure children stay hydrated. She also shares tips for how to make drinking water exciting and includes a recipe for fruit-infused water!

Rachel:

In a quaint home in the middle of Florida, we find our young protagonist, Jamie, sprawled out on their bed. After eating an afternoon snack and gulping down their favorite sports drink, they should be ready to take on the world! But this afternoon, the thought of climbing out of bed makes their head spin. They feel sleepy and irritable. Their lips are chapped, and their skin is flushed. Overall, they just feel awful! Jamie doesn’t think they’re sick or hungry, and they went to bed at a reasonable hour last night. What could possibly be the villain threatening our young hero’s plans today?

In recent years, sugar-sweetened beverages (SSBs) have become very popular among American youth. A child’s affinity for sweets, combined with readily available brightly colored and attractively packaged juices and sodas, has created a perfect storm for inadequate water-intake within this age group. Over time, encouraging a child to drink water can feel like a losing battle to caregivers. In this article, we will review some of the recent studies concerning the impact of decreased water and increased SSBs consumption in young children. Additionally, we will present a short video on methods to make drinking water fun and exciting. By the end of this article, caregivers and children will rediscover the power of water!

The World Runs on Water

In their first science class, children are taught that plants need four simple things to survive: air, nutrients, water, and sunlight. Although humans look very different from sunflowers and trees, plants and mammals share these four basic needs in common. Plants are always ready for a refreshing drink of water. However, most Americans struggle to drink even one glass of water per day. In fact, on a given day, 1 out of 5 American children will report drinking no water.¹ 

Children’s body composition has a significantly higher percentage of water than adults’.² To maintain this elevated percentage, it is important for children to remain hydrated. Dehydration can lead to severe complications in physical health and mental development.² Recent animal and human studies have supported this claim, going as far as to propose that water intake is correlated with academic performance in schools.³

The human body would be unable to sustain function if chronically dehydrated. Well-meaning parents and caregivers may give children other beverages (i.e., juice, sodas, etc.) an effort to keep them hydrated.¹

The Bittersweet Reality of Sugar-Sweetened Beverages

Many children gravitate towards SSBs. SSBs encompass any beverage that has added sugar such as fruit juice, soda, sports drinks, and energy drinks.⁴ It is important to note that even though SSBs contain water, they are associated with a plethora of risks.

Risk #1 – SSBs contain excessive amounts of sugars and added-calories.

On average, drinking SSBs can contribute up to 200 extra calories per day in a child’s diet.¹ The added sugar in these drinks is the main contributor of these additional calories. Unlike complex carbohydrates and starches, such as grains and rice, sugar is a simple carbohydrate.⁵ Simple carbohydrates are quickly digested and absorbed into the bloodstream.⁵

The human body’s main goal is to maintain homeostasis, or a state of balance. Since sugar is metabolized at a rapid rate, the body experiences a sudden spike and fall in blood-sugar levels. The body may then signal for hunger levels to increase to maintain a balance in blood-sugar levels.⁶ Consistent intake of excess calories and sugars is associated with an increased risk of obesity, high cholesterol, high blood pressure, mood problems, type II diabetes, and cavities.⁷

Risk #2 – Consumption of SSBs is associated with other unhealthy habits.

If you are having trouble convincing your child to drink more water, you might also be struggling with motivating them to eat their vegetables and exercise. Compared to children who mainly drink water, children who primarily consume SSBs eat significantly less fruit, greens, dairy, whole grains, and seafood and plant proteins.⁸

This trend is concerning as lower quality diets are associated with the same comorbidities of SSBs. In other words, SSBs can signal a decrease in diet quality which leads to an even higher risk of childhood obesity and diabetes.

Risk #3 – SSBs do not provide sufficient hydration.

While sports drinks may provide electrolytes to severely dehydrated athletes and hospitalized patients, they are still classified as SSBs. Unless your child regularly participates in intense daily physical activities, they should rarely consume sports drinks.⁹ Regular consumption of sports drinks in non-athletes is correlated with heart disease and high blood pressure.⁹ Water is sufficient to meet hydration needs without the additional risk factors.

With this newfound knowledge, we can assume that our protagonist Jamie is experiencing signs of dehydration. It is not uncommon for children and teens to experience dry lips, increased sleepiness and irritability, thirst, and lightheadedness when dehydrated.⁷ Although they regularly consume sports drinks, we know that these beverages are not recommended for children who are not participating in regular, intense physical activity. Furthermore, SSBs do not provide sufficient hydration to the body and can contribute to blood-sugar levels “crashing”, which are risk factors associated with lethargy. Now that we have identified the issues surrounding hydration and SSBs, how do we encourage increased water consumption in children?

Water Does Not Have to Be Boring

In comparison to SSBs, plain water seems like the boring, not-so-fun option. It is not sweet and it comes in bland packaging. To combat the attractiveness of SSBs, recent studies have suggested that a combination of communicating the dangers of SSBs and environmental changes (i.e., decreased access to SSBs) provide promising results for inducing behavioral change in children.¹⁰ Since we have already established the risks of SSBs, in this section we will review some methods to make drinking water fun!

Method #1 – Customize a reusable water bottle for your child.¹¹

A great way to kick off healthier habits is to engage your child in the change. Try presenting your child with their own water bottle, personalized cup, or bendy straws that they can make their own. Leave this item in easy reach of your child, so that they can fill it with water whenever they like.

Method #2 – Add fruits or herbs to enhance the water.¹¹

Fruits and herbs are a great way to enhance the flavor of water without added sugars. For instance, strawberries, watermelon, cucumbers, mint, and ginger are excellent options. Furthermore, many fruits have a high water content. As your child drinks their water, they may be inclined to snack on the fruit within their beverage as well. Thus, the fruit serves as a treat and a hidden hydration source. In the video below, we demonstrate how to make fruit-infused water with fun ice cubes!

Method #3 – Lead by example.¹¹

The saying “monkey see, monkey do” holds a lot of truth. To solidify the behavioral change, it is important that caregivers model the change that they want to see within their children. Modeling a contrary behavior such as caregivers consuming SSBs may lead to frustration for children. Moreover, it perpetuates the accessibility of SSBs within the home. Although children may be able to buy SSBs at school, a higher percentage of SSBs are consumed at home.

Incorporating More Water is Just the Beginning

While SSBs may be our little hero’s kryptonite, with a bit of education and small daily changes, Jamie is beginning to drink more water than ever before. As a result, they are feeling ready to take on the world again! Although it would be ideal to cut out all sugary drinks from your child’s diet, focusing on incorporating more water should be the primary goal. Taking candy away from a baby is not as easy as it seems, but there are ways to make it less of a challenge.

References

1. Bohn K. Not drinking water may boost kids’ consumption of sugary beverages [Internet]. Penn State University; 2019 [cited 2024 Mar 1]. Available from: https://www.psu.edu/news/research/story/not-drinking-water-may-boost-kids-consumption-sugary-beverages/#:~:text=%E2%80%9CKids%20should%20consume%20water%20every,healthy%20and%20have%20more%20calories.%E2%80%9D
2. Chong-Su K, Woo Young C, Dong-Mi S. Dehydration impairs physical growth and cognitive development in young mice. Nutrients. 2020 Feb 29;12(3):670. doi.org/10.3390%2Fnu12030670
3. Beerman K. Water consumption affects cognitive function in children [Internet]. Nutrition; 2019 [cited 2024 Mar 1]. Available from: https://nutrition.org/water-consumption-affects-cognitive-function-in-children/
4. CDC. Get the facts: sugar-sweetened beverages and consumption [Internet]. 2022 [cited 2024 Mar 1]. Available from: https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html
5. Benton JM. Carbohydrates and sugar [Internet]. Kids Health; 2017 [cited 2024 Mar 1]. Available from: https://kidshealth.org/en/parents/sugar.html#:~:text=Foods%20that%20are%20high%20in,can%20lead%20to%20tooth%20decay
6. Beyond Type 1. High blood sugar and hunger [Internet]. Diabetes Food Hub; 2022 [cited 2024 Mar 1]. Available from: https://www.diabetesfoodhub.org/articles/high-blood-sugar-and-hunger.html#:~:text=Why%20do%20you%20crave%20food,and%20hunger%20pangs%20might%20become
7. Rethy J. Choose water for healthy hydration [Internet]. Healthy Children; 2020 [cited 2024 Mar 1]. Available from: https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Choose-Water-for-Healthy-Hydration.aspx
8. Leung CW, DiMatteo SG, Gosliner WA, Ritchie LD. Sugar-sweetened beverage and water intake in relation to diet quality in U.S. children. American Journal of Preventive Medicine. 2018 Mar;54(3):394-402. doi.org/10.1016/j.amepre.2017.11.005
9. Muñoz-Urtubia N, Vega-Muñoz A, Estrada-Muñoz C, Salazar-Sepúlveda G, Contreras-Barraza N, Castillo D. Healthy behavior and sports drinks: a systematic review. Nutrients. 2023 Jul;15(13):2915.doi.org/10.3390%2Fnu15132915
10. Kamin T, Koroušić Seljak B, Fiddler Mis N. Water wins, communication matters: school-based intervention to reduce intake of sugar-sweetened beverages and increase intake of water. Nutrients. 2022 Apr;14(7):1346. doi.org/10.3390%2Fnu14071346
11. National Center on Early Childhood and Wellness. Encouraging your child to drink water [Internet]. Early Childhood Learning and Knowledge Center; 2022 [cited 2024 Mar 1]. Available from: https://eclkc.ohs.acf.hhs.gov/publication/encouraging-your-child-drink-water#:~:text=Make%20drinking%20water%20fun%20for,that%20can%20be%20carried%20anywhere

Header photo credit: Engin Akyurt on Unsplash.

Music: Flying by TrackTribe from the YouTube Audio Library.

Looking for more posts sharing stories about nutrition hot topics? Check out the rest of the UF/FSHN Nutrition Stories Series!

1