Child beverage choices in Guatemala deemed unhealthy

beverage containers
Beverage containers targeting children and young adults in Guatemala contain both inaccurate health claims (photo on left) and health endorsements (photo on right).

A new study focusing on beverages targeted to children in Guatemala found that most were of poor nutritional quality. Published in Public Health Nutrition, this study analyzed package marketing strategies along with health claims and compared them with the actual nutritional content. These beverages, marketed for children, consisted of fruit drinks, milk, carbonated beverages, water, rice/soy products, and energy drinks. Guatemala still struggles with a high undernutrition prevalence but already a third of children are considered to be overweight or obese. Offering healthy beverage choices to children could help reduce the obesity epidemic.

Lead study author, Joaquin Barnoya, MD, MPH, associate professor of surgery at Washington University School of Medicine, suggests policy changes so that only evidence-based health claims can be placed on beverages packages. According to their findings, over 75% of beverages targeted to children contained health evoking images, including fruits, vegetables, plants or items children would identify as healthy.  However, only 11% of these beverages would be classified as “healthy” using the UK Nutrient Profile Model.

“Beverage packages are an effective marketing strategy that the industry is using to reach consumers, particularly young ones,” Dr. Barnoya says. “It, therefore, needs to be regulated to avoid misleading terms and ensure that any health claim or endorsement is backed up by strong evidence.”

Packaging designed targeting children was found on over 50% of the beverages. Cartoon and spokescharacters, as well as bright colors, encourage children to choose beverages based solely on appearance rather than nutritional value. Health claims were also found on 64% of beverages.  These can mislead parents and create a ‘health halo’ effect in which they believe they are purchasing healthy items for their children, when in reality, they may not be.

In an effort to acknowledge and understand this health crisis, Andrew Perry, MD, a medical resident at Washington University School of Medicine (WUSM), requested and was granted funding from the Forum for International Health and Tropical Medicine at WUSM to conduct this research. “Package designs incorporate multiple techniques to create an impression that the product is healthy,” says Perry. “Unfortunately, in our sample, that does not hold up when compared with the NPM score. Combine this with the “pester power” of children, and it becomes easy for a well-meaning parent to purchase unhealthy beverages for their children while thinking they are making healthy choices.”

This study confirms the need for public health and policy changes to encourage appropriate beverage choice and availability for children in Guatemala. Direct-to-consumer marketing regulations and endorsements from public health associations in Guatemala are likely to have an impact to reduce the availability of poor nutritional quality beverage choices for children, and their parents. Healthy beverage choices may also help the childhood obesity epidemic in Guatemala, and similar countries.

Perry A, Chacon V, Barnoya J. Health claims and product endorsements on child-oriented beverages in Guatemala. Public Health Nutr. 2017 Nov 16:1-5. doi:  10.1017/S1368980017003123. [Epub ahead of print] PubMed PMID: 29143691.