The 2020–2025 Dietary Guidelines for Americans (DGA) recommend following a healthy dietary pattern at every age including choosing nutrient-dense foods and beverages and limiting foods and beverages high in added sugars. (1)

Despite this guidance, beverages are an often overlooked component of the diet in childhood and disparities in consumption exist. For example, national surveillance data show:

• sugar-sweetened beverages are the top sources of added sugars for children and adolescents ages 2-19 years, providing between 21 and 37% of total calories from added sugar. (2)
• a significantly lower percentage of Black children 2-19 years old (73%) consumed water compared to their Hispanic (85%), white (86%), and Asian (96%) peers. (3)
• the primary source of caffeine for 13–17 year olds was coffee and tea and the secondary source was caffeinated sodas. (4)
• consumption of beverages with non-sugar sweeteners among children 2-17 years old has doubled (6% to 13%) from 1999-2008. (5)

As practitioners, we know beverages can play a key role in overall health and nutrition across the lifespan. So, what can we do to support healthy beverage habits among children and families?

First, we should all use the same set of evidence-based recommendations to ensure families receive consistent messaging about beverage consumption.

Healthy Eating Research (HER) convened two expert panels representing four key national health and nutrition organizations (Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentistry, the American Academy of Pediatrics, and the American Heart Association) to develop evidence-based recommendations to guide healthier drink choices for young children ages 0 to 5 years and children and adolescents ages 5 to 18 years. (6-7)  In doing so, HER also developed a complementary suite of resources designed to not only educate parents and caregivers but also assist practitioners in implementing these recommendations in practice.

Here is a list of my top five favorite resources/materials for practitioners:

• Infographic overviews of the beverage consensus beverage recommendations for young children ages 0 – 5 years and children and adolescents ages 5 – 18 years
• One-page handouts with detailed information by age (0 – 5 years) and beverage type
• Tool to determine if a plant-based milk alternative is appropriate for young children (0 – 5 years) and children and adolescents (5 – 18 years)
• Meeting Daily Fluid Needs Tool (5 – 18 years)
• Short videos (0 – 5 years) to be used in public health campaigns or played in clinic waiting rooms

Second, we should have universal screening for beverage consumption during well child and primary care visits to facilitate nationwide efforts to support healthy habits and  population-level data collection that is consistent, accurate, and actionable.

Healthy Eating Research (HER) convened an advisory committee with expertise in child nutrition and electronic health records (EHR) to support the development of a toolkit to provide health care systems and providers with tools and resources to successfully incorporate and implement a beverage screener in the EHR. The toolkit, Screening for Beverage Consumption in Early Childhood Using Electronic Health Records: Implementation Toolkit for Health Care Systems:

• explains the role of health care systems and providers in implementing healthy beverage recommendations
• outlines possible options for implementing an EHR-based beverage screener into clinic workflow, such as: when the data is collected, who conducts the screening, where to document responses in the EHR, and how often to screen and for whom.
• provides validated beverage screener questions (currently available for use in the EPIC platform), as well as other resources like sample after visit summary messages and algorithms

This is just the tip of the iceberg. There are a variety of other policy, systems and environmental efforts that could be implemented at the national, state, and local levels.

References:

1. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.
2. Bowman SA, Clemens JC, Friday JE, Schroeder, N, LaComb RP. Added Sugars in American Children’s Diet: What We Eat in America, NHANES 2015-2016. Food Surveys Research Group. Dietary Data Brief No. 26. December 2019.
3. Martin CL, Clemens JC, Moshfegh AJ. Beverage Choices among Children: What We Eat in America, NHANES 2017-2018. Food Surveys Research Group Data Brief No. 32. October 2020.
4. Tran NL, Barraj LM, Bi X, Jack MM. Trends and Patterns of Caffeine Consumption Among US Teenagers and Young Adults, NHANES 2003- 2012. Food Chem Toxicol. 2016;94:227- 242.
5. Sylvetsky AC, Welsh JA, Brown RJ, Vos MB. Low-Calorie Sweetener Consumption is Increasing in the United States. Am J Clin Nutr 2012; 96: pp. 640-646.
6. Lott M, Callahan E, Welker Duffy E, Story M, Daniels S. Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations. Technical Scientific Report. Durham, NC: Healthy Eating Research, 2019. Available at http://healthyeatingresearch.org.
7.  Lott M, Reed L, Deuman K, Story M, Cradock AL, Patel AI. Healthy Beverage Consumption in School-Age Children and Adolescents: Recommendations from Key National Health and Nutrition Organizations. Technical Scientific Report. Durham, NC: Healthy Eating Research, 2025. Available at http://healthyeatingresearch.org.

Disclosure: I was previously employed by HER (2019-2022) during which time I supported implementation of the consensus recommendations for young children and served as a consultant to HER (2023-2024) during the development of the consensus recommendations for children and adolescents.