A new study published in Nutrients has found that warning labels about sugar content on beverage packaging have only a small effect on encouraging children and parents to make healthier drink choices.
Too Much Sugar, Too Young
According to the World Health Organization (WHO), sugar should account for no more than 10% of daily energy intake. Consuming too much sugar is linked to obesity, tooth decay, type 2 diabetes, and other health issues. In Australia, more than half of children consume excessive sugar, with almost 40% of it coming from sugary drinks.
Many parents believe that 100% fruit juice and flavored milk are healthy options. In reality, they contain sugar levels similar to soft drinks. Marketing often highlights their natural ingredients, such as vitamin C or real fruit, making them seem healthier than they are.
Clear, simple front-of-pack nutrition labels may help parents and children make better choices. Labels could include star ratings, sugar content, or warnings. In Australia and New Zealand, the government introduced the Health Star Rating (HSR) system in 2014, but use is voluntary and research on its effectiveness is limited.
Inspired by tobacco packaging, warning labels for sugary drinks might include text warnings, pictures of tooth decay, or graphics showing teaspoons of sugar. These tools have proven effective among adults and teens, but their impact on younger children remains unclear.
Because parents often respond to their children’s preferences, understanding how both groups react to different labels is important for shaping lifelong eating habits.
How the Study Worked
Researchers tested the behavior of 1,229 Australian children aged 4 to 11 and their parents. Each participant was asked to pick a drink from a virtual vending machine. They repeated the task after labels were added to the drink packaging.
Drinks included 100% fruit juice, fruit drinks, soft drinks (with sugar or artificial sweeteners), flavored milk, plain milk, and water. Labels were only added to drinks with sugar, except for the HSR, which appeared on all drinks.
Four types of labels were used:
- A text warning: “WARNING: Drinks high in sugar contribute to tooth decay”
- A graphic showing tooth decay with the words “WARNING” and “HIGH IN SUGAR”
- A label showing how many teaspoons of sugar were in the drink
- The Health Star Rating (HSR), which shows stars based on nutritional value
All labels were shaped like stop signs to grab attention.
What They Found
Only about half of the children and two-thirds of the parents remembered seeing any labels. Of those, 73% of children and 44% of parents could recall them accurately. Children remembered the HSR label best (80%), followed by the text warning (about 70%). Parents mostly remembered the HSR but were less likely to recall the other warnings.
Parents viewed all labels similarly but said the HSR had the least negative emotional effect. Children aged 4 to 7 were more affected by the text and sugar-teaspoon warnings. Older children (8–11) were most influenced by the tooth decay image, which they found clear, believable, and worrying.
Among children, the sugar-teaspoon label influenced drink choice the most, followed by the text warning and the tooth decay label. Still, most children did not change their choices significantly.
Parents were more likely to pick water, soft drinks, and artificially sweetened beverages. While water and sugar-free options are better choices, sugary soft drinks are not. Those who switched drinks after seeing a label tended to pick healthier ones, regardless of label type.
Before labels were added, children’s top three choices were flavored milk, 100% fruit juice, and soft drinks. The labels caused minor shifts. For example, the tooth decay warning made water the second most popular drink. The sugar-teaspoon label also raised water’s rank to third place.
However, over 70% of participants—both parents and children—did not change their choices at all.
What It Means
The study shows that warning labels on their own are not enough to significantly change children’s drink choices. Flavored milk remained the top choice for kids, even after they saw warning labels.
The HSR label had little influence on children, likely because it appears on every drink and doesn’t create a strong emotional response. It did have a modest effect on parents, even though many said it wasn’t useful.
Since many people didn’t even remember the labels, researchers say stronger and clearer warnings are needed. They also suggest combining labels with broader strategies, like tighter regulations and educational campaigns.
The study used a simulated online vending machine, so real-world results may vary. Long-term studies are needed to see the full effects of front-of-pack labeling. Still, the findings provide helpful insights for public health officials working to promote healthier beverage choices among children and families.
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