During routine yearly checkups, we ask about your child’s nutrition including soda consumption. When I ask this, parents often respond, “no doc, we don’t give him/her soda," but add that if they do drink soda, it's clear, such as Sprite, 7up, Sierra Mist), etc. But parents wonder, are clear sodas really healthier than dark sodas?  It looks clear, it’s not brown, it smells like lemon-lime…it must be OK, right? Not so much. Let’s look into this a little further.

So first let’s first start with the simple fact that clear sodas are still soda! We discourage sodas for several reasons but mainly for the sugar content. For example, a can of Sprite has 38 grams of sugar and a can of Coke has 39 g of sugar. So you can see there’s not much of a difference between the two. That’s about 9 teaspoons of sugar in one can!!

Studies show that kids who drink more than 10% of their daily calories from added sugar are more likely to have abnormal cholesterol levels and a higher chance of getting Type 2 diabetes.

The other main reason we discourage sodas is the caffeine content. It is true that clear sodas do not have caffeine. However, there are many other options for a hydrating drink without sugar such as good old-fashioned water. If your child does not like water, try adding fresh fruit or mint or from time to time try a zero-sugar sparkling water to satisfy that craving for “fizz.”

So what about diet sodas?  Most experts would recommend that children should avoid diet sodas in kids. Many diet sodas are sweetened with artificial sweeteners and long terms effects are still not clear.

There you have it! Clear soda is not a healthy choice for a drink. Opt for water!

On Monday, the American Academy of Pediatrics and the American Heart Association released policy recommendations “targeted at federal, state and local policy makers to improve child nutrition through reduced sugary drink intake.” The concern is that the extra sugar contributes to the high prevalence of childhood and adolescent obesity. Excess sugar also increases the risk of a host of other health issues including dental decay, cardiovascular disease, hypertension, insulin resistance and type 2 diabetes.

The focus on sugary drinks is because they are the “leading source of added sugars in the U.S. diet, provide little to no nutritional values, are high in energy density, and do little to increases feelings of satiety (feeling full).”

The suggested action that should be taken includes:

• Increase the price of sugary drinks, using an excise take.
• Decrease the marketing of sugary drinks to children and teens.
• Require the amount of sugar content on nutrition labels, restaurant menus and ads.
• Make healthy beverages such as milk and water the default on children’s menus.
• Require hospitals to limit or disincentivize purchasing sugary drinks.

Justin Smith, M.D., a Cook Children’s pediatrician in Trophy Club, states, “The cards are stacked against parents in many ways. When the default option for a kids meal is soda, juice or chocolate milk, parents don’t often realize that those aren’t the best options for kids. The policy even addresses sugary beverage consumption in hospitals because it’s been a problem there as well.”

Dr. Smith adds that pediatricians have to continue to educate parents and address the issue at the individual visit level. But he’s not sure if this strategy has made a significant difference in the amount of sugary drinks children are consuming. “The intake of sugary beverages is harming children, but many of them aren’t ready to make healthy choices without some guidance,” Dr. Smith said. “Parents can help but for those parents that don’t know or don’t help their children make those choices, we may need some changes at a bigger level.”

Fighting obesity is a passion of Kim Mangham, M.D., a Cook Children’s pediatrician in Keller, and she calls sugar a “huge” factor in today’s kids becoming obese.

“Sugar affects the pleasure centers in your brain much like other addictive substances,” Dr. Mangham said. “I advise my parents to try to avoid offering beverages and processed foods high in sugar and added salt because kids will start to prefer these foods over the healthy natural fruits and vegetables.”

Dr. Mangham says removing sugary drinks from your home will lead to less weight gain in kids and that sticking to water and milk is a great first step in helping kids achieve a life free from the many burdens of obesity.

Joel Steelman, M.D., an endocrinologist at Cook Children's, states the higher sugar intake that makes kids obese is particularly easy to get when children drink it in the form of sodas or other sugar-sweetened beverages. He uses this formula to explain:

“Obesity, particularly when we’re talking about obesity in the waist area, leads to diabetes and metabolic syndrome risk,” Dr. Steelman said. “The fructose component in sucrose (table sugar) or in high fructose corn syrup is strongly suspected in impacting how our liver works and raising risk for diabetes. Also, high sugar intake can create a continued craving for more sugar.”

These health risks hit home for Dr. Mangham. Her mother has type 2 diabetes and so do her siblings. When she speaks to families she talks to them about their family history and educates them on their risks of getting the disease.

“Parents are in control of the amount of sugar their children get per day, even if they don’t realize it,” Dr. Mangham said. “I advise my families to try to keep it out of the house, so everyone can be healthier. Kids are not mature enough to know when they have had enough candy or candy bars or donuts. They need their parents to set appropriate limits.”