# Parent and Child Choice of Sugary Drinks Under Four Labelling Conditions

## TL;DR

This study examines how different nutrition labels affect the beverage choices of Australian children and their parents, finding that some labels help children choose healthier drinks.

## Contribution

The study compares the effectiveness of four label designs on children's beverage choices, a gap in previous research focused mainly on parents.

## Key findings

- Teaspoons of sugar labels, text-based warnings, and tooth decay pictorials were more effective for children than Health Star Ratings.
- Parent beverage choices were not significantly influenced by the label design.
- Children's healthier choices increased under specific label conditions.

## Abstract

Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks.