Children Beverage Research Articles

Do Preschools Offer Healthy Beverages to Children? A Nationwide Study in Poland.

Background: Children’s beverage consumption patterns have received increased attention in light of the obesity epidemic in this group. In day care centers (DCCs), children spend up to 10 h a day, and typically consume half to three quarters of their daily food intake. The purpose of the study was to investigate what beverages are typically served to children in preschools in Poland, and to evaluate the practices associated with adding sugar and other sweetening agents to beverages. Methods: Direct interviews with preschools staff were conducted with a questionnaire regarding offered beverages and adding sugar and other sweetening agents. The menu of 10 consecutive days and inventory reports were analyzed to verify information. Results: A total of 720 preschools were included in the study. Cocoa and milk coffee substitute were served in 95% of preschools, followed by compote (92%), tea (84%), fruit/herbal tea (73%) and water (69%). Water was the only beverage available between meals (93% DCCs). 86% of preschools added sugar to tea/cocoa/coffee substitute drinks, and 74% to compote. Conclusions: In the majority of preschools, beverages which are not recommended were offered. Such an assortment of beverages and common practice of sweetening can increase the amount of added sugar in a children diet. Nutrition education and legal regulations concerning the assortment of beverages served in preschools are urgently needed.

Longitudinal Study Assessing Factors Associated with Mutans Streptococci Acquisition in Infants and Toddlers.

To assess the role of sociodemographic, dietary, and clinical factors in early mutans streptococci (MS) colonization in children aged 6 to 24 months who were followed for 18 months. Ninety-four children (mean age: 11.5 ± 4.99 months at baseline) were enrolled in the study from the Women, Infants and Children Supplemental Nutrition Program during 2003-2004. Salivary MS levels of the children were determined at baseline and at 18 months using a semi-quantitative method. Detailed information about the children's beverage consumption pattern, dietary behavior, and clinical information about oral health status was collected at baseline, 9 months, and 18 months. None of the children included in this study had detectable levels of MS at baseline. Of the 94 children at baseline, 36 (38%) had acquired MS by the 18-month follow-up. The presence of >5 teeth [OR = 3.55 (1.46-9.04); p = 0.0062] was a significant risk factor for MS acquisition among the baseline variables. At 9 months, sports drinks consumption [OR = 5.56 (1.39-26.26); p = 0.0143] and presence of caries [OR = 9.36 (2.55-40.90); p < 0.0001] were significantly associated with MS colonization at 18 months. Higher maternal education [OR = 0.3 (0.07-1.36); p = 0.0351] was a protective factor at all the time points. Sugared beverage consumption, tooth-related factors, and lower maternal education can predict MS acquisition in young children.

Water, juice, or soda? Mothers and grandmothers of preschoolers discuss the acceptability and accessibility of beverages

Intake of sugary beverages is strongly associated with weight gain and obesity among children; however, differences between mothers' and grandmothers' attitudes and practices concerning young children's beverage consumption remain unclear. This is notable since about a quarter of families in the US and the UK rely on grandparents as the main providers of informal childcare. The aim of this study is to examine mothers' and maternal grandmothers' attitudes, knowledge, and practices regarding preschool aged children's beverage consumption. The analysis focuses on identifying intergenerational similarities and differences, given the potential impact that such differences might have on young children's beverage consumption habits. Twenty-two semi-structured interviews, representing eleven families, were analyzed using thematic analysis. The sample included all mother – maternal grandmother dyads from The Grandparents Study, which took place in Eugene, Oregon, USA. More than half of mothers and grandmothers met overweight/obesity criteria. Among the children (mean age 4.7 years; five girls and six boys), seven met overweight/obesity criteria. Most mothers and grandmothers were unemployed, and most reported an annual household income below 30,000 USD. The analysis identified three thematic categories: 1) mothers and grandmothers agree about the hierarchy of healthiness between and within beverages, though juice occupies an ambivalent position; 2) mothers and grandmothers cite role modeling and the home environment as important in regulating preschoolers' beverage intake; 3) mothers and grandmothers balance between restricting sugary beverages and using these beverages as treats. The results suggest that when mothers and grandmothers use soda, juice, and juice-drinks as treats, they do so within a wider dynamic of balancing practices, and within two intersecting domains: the hierarchy of beverages, including the still ambivalent status of juice as healthy or unhealthy, and the definition of ‘special occasion’.

Trends in Nutrient Content of Children's Menu Items in U.S. Chain Restaurants.

Restaurant food is widely consumed by children and is associated with poor diet quality. Although many restaurants have made voluntary commitments to improve the nutritional quality of children's menus, it is unclear whether this has led to meaningful changes. Nutrients in children's menu items (n=4,016) from 45 chain restaurants were extracted from the nutrition information database MenuStat. Bootstrapped mixed linear models estimated changes in mean calories, saturated fat, and sodium in children's menu items between 2012 and 2013, 2014, and 2015. Changes in nutrient content of these items over time were compared among restaurants participating in the Kids LiveWell initiative and non-participating restaurants. Types of available children's beverages were also examined. Data were analyzed in 2016. There was a significant increase in mean beverage calories from 2012 to 2013 (6, 95% CI=0.8, 10.6) and from 2012 to 2014 (11, 95% CI=3.7, 18.3), but no change between 2012 and 2015, and no differences in nutrient content of other items over time. Restaurants participating in Kids LiveWell reduced entrée calories between 2012 and 2013 (-24, 95% CI= -40.4, -7.2) and between 2012 and 2014 (-40, 95% CI= -68.1, -11.4) and increased side dish calories between 2012 and 2015 (49, 95% CI=4.6, 92.7) versus non-participating restaurants. Sugar-sweetened beverages consistently constituted 80% of children's beverages, with soda declining and flavored milks increasing between 2012 and 2015. Results suggest little progress toward improving nutrition in children's menu items. Efforts are needed to engage restaurants in offering healthful children's meals.

African-American and Hispanic children's beverage intake: Differences in associations with desire to drink, fathers' feeding practices, and weight concerns

Relationships of African-American and Hispanic fathers' feeding practices and weight concerns and preschoolers' desire to drink with children's beverage intake were examined, and associations between fathers' feeding practices and children's weight status were evaluated. Fathers' (Hispanic n = 61, African-American n = 49) difficulty in child feeding, use of food to calm, use of food as reward, and concern about the child being under and overweight as well as their child's desire to drink were assessed. Preschoolers' (ages 2 to 5) total sugar-sweetened beverage (SSB), fruit juice, and water intake were measured by a modified beverage intake questionnaire. Body Mass Index (BMI) and BMI percentile were calculated for fathers and children, respectively. Multiple regressions revealed that, in Hispanics, difficulty in feeding, concern about underweight, use of food to calm, and use of food as a reward were significantly associated with child intake of total SSB, whereas, in African-Americans, child desire to drink was associated with total SSB and fruit juice. Concern about the child being underweight was inversely associated with child BMI percentile in Hispanics. Significant differences in regression coefficients of child SSB intake to fathers' behaviors versus child desire to drink between the two racial-ethnic groups indicated that use of food to calm the child predicted increased intake of SSB by Hispanic but not by African-American children, while child desire to drink predicted increased intake of SSB by African-American but not by Hispanic children. Because of these significant differences, future research might profitably explore socio-cultural influences on associations of additional child feeding behaviors with fathers' attempts to control them. Furthermore, practitioners should consider developing and evaluating different child obesity interventions for these two racial-ethnic groups.

Sugar-Sweetened Beverages: Children's Perceptions, Factors of Influence, and Suggestions for Reducing Intake

ObjectivesThis study aimed to gain an in-depth understanding of children's perceptions of sugar-sweetened beverages (SSBs). DesignNine focus groups were conducted in grade 5 and 6 elementary schoolchildren. SettingNine urban and rural elementary schools in London, Ontario, Canada. ParticipantsFifty-one children, 58% of which were male, 52% of whom were in grade 5, and 84% of whom were Caucasian. Phenomenon of InterestChildren's views on sugar-sweetened beverages. AnalysisThree researchers conducted inductive content analysis on the data independently using the principles of the immersion-crystallization method. ResultsParticipants had a high level of awareness of beverages and their health effects, which was primarily targeted at the sugar content. Dominant factors that influenced children's beverage choices and consumption patterns included taste, parental control practices, accessibility, and advertising. Participants identified a wide array of strategies to reduce SSB consumption in children, including educational strategies for both children and parents and policy-level changes at both the government and school levels. Conclusions and ImplicationsDespite a high level of awareness of SSBs, children believed that further education and policies regarding SSBs were warranted. These data may prove helpful in designing effective interventions targeted at children and parents to reduce SSB consumption by children.

What do Indian children drink when they do not receive water? Statistical analysis of water and alternative beverage consumption from the 2005-2006 Indian National Family Health Survey.

BackgroundOver 1.2 billion people lack access to clean water. However, little is known about what children drink when there is no clean water. We investigated the prevalence of receiving no water and what Indian children drink instead.MethodsWe analysed children’s beverage consumption using representative data from India’s National Family and Health Survey (NFHS-3, 2005–2006). Consumption was based on mothers’ reports (n = 22,668) for children aged 6–59 months (n = 30,656).ResultsAbout 10 % of Indian children had no water in the last 24 h, corresponding to 12,700,000 children nationally, (95 % CI: 12,260,000 to 13,200,000). Among children who received no water, 23 % received breast or fresh milk and 24 % consumed formula, “other liquid”, juice, or two or more beverages. Children over 2 were more likely to consume non-milk beverages, including tea, coffee, and juice than those under 2 years. Those in the lowest two wealth quintiles were 16 % less likely to have received water (OR = 0.84; 95 % CI: 0.74 to 0.96). Compared to those living in households with bottled, piped, or tanker water, children were significantly less likely to receive water in households using well water (OR = 0.75; 95 % CI: 0.64 to 0.89) or river, spring, or rain water (OR = 0.70; 95 % CI: 0.53 to 0.92) in the last 24 h.ConclusionsAbout 13 million Indian children aged 6–59 months received no water in the last 24 h. Further research is needed to assess the risks potentially arising from insufficient water, caffeinated beverages, and high sugar drinks at early stages of life.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1946-4) contains supplementary material, which is available to authorized users.

Relationships between Fathers' Feeding Practices and Preschool Children's Beverage Intake

Paternal feeding practices and child beverage intake have seldom been examined together. Low‐income fathers (n=92; median age=34 yrs; 53% African‐American, 47% Hispanic) provided demographics, responded to Preschooler Feeding and the Comprehensive Feeding Practices Questionnaires, and completed a quantitative child beverage intake questionnaire. Analyses of variance, the Kruskal‐Wallis test, and Pearson's correlation were used for comparisons. Child's median age was 4 years; 88% lived with fathers. Feeding practices scores (1=never, 5=always) were: Difficulty in child feeding 2.5±0.8, concern about child being overweight 1.7±0.8, use of food to calm child 1.8±0.8, concern about child being underweight 2.0±0.9; and use of food as reward 2.9±1.0. Average daily intake (fl. oz) of total sugar‐sweetened beverages (SSB) was 11.9±15.6, fruit juice 8.4±6.7, juice drinks 4.8±6.1, soda 2.3±3.3, sports drinks 1.6±4.4. Difficulty in child feeding was negatively correlated with child water intake (r=–0.21) and positively correlated with flavored milk intake (r=0.25). Use of food to calm child was positively correlated with child juice drink intake (r=0.24). Use of food as reward was positively correlated with total child SSB (r=0.26), juice drinks (r=0.23), and flavored milk (r=0.28). Identifying links between minority fathers' feeding practices and children's SSB intake provides needed information on the influence of this understudied group of parents.

Outcome of a food observational study among low-income preschool children participating in a family-style meal setting.

In the United States, one out of every seven low-income children between the ages of 2 and 5 years is at risk for overweight and obesity. Formative research was conducted to determine if preschool children participating in family-style meals consumed the minimum food servings according to U.S. Department of Agriculture dietary guidelines. Participants were 135 low-income children aged 3 to 4 years who attended an urban child care center. Participant's parents completed a Family Demographic Questionnaire to provide information on race/ethnicity, parent's level of education, and household income. Direct observation of children's food and beverage consumption during school breakfast and lunch was collected over 3 consecutive days. Dietary data were assessed using the Nutrition Data System for Research software. Height and weight measurements were obtained to determine risk for obesity. Descriptive statistics were reported by using the Statistical Package for the Social Sciences Version 16. Among 135 participants, 98% identified as Mexican American, 75% lived at or below poverty level, and 24% reported a family history of diabetes. Children consumed less than half of the calories provided between breakfast and lunch and did not consume the minimum recommended dietary food servings. Despite the poor dietary intake, physical measurement findings showed 25% obesity prevalence among study participants. Findings support the need for evidenced-based early childhood obesity prevention programs that provide behavior change opportunities for children, their families, teachers, and menu planners. Family-style meal settings are ideal opportunities for implementing nutrition education strategies to prevent early childhood obesity.

Beverage Consumption & Health of Immigrant and Refugee Children in Canada

Sugar-sweetened beverages have displaced milk in many children's diets in recent decades. Associations between children's beverage intake patterns and overweight/obesity, bone health and cardiovascular risk have been reported. The growing immigrant and refugee population in Canada is vulnerable to risk of nutrition-related chronic diseases; however, beverage research in this subpopulation, particularly children, is lacking.

Traditional and Medicinal Uses of Essential Oil Producing Tree Sclerocarya birrea in South-Central Zimbabwe

A field investigation was conducted in south-central Zimbabwe to assess the traditional and medicinal uses of essential oil producing Sclerocarya birrea; and its contribution to food supply, dietary diversity and income generation among communal farmers. In order to record and document the contribution of S. birrea to household food supplies to communal farmers in south-central Zimbabwe, one hundred and sixteen participants from 4 villages were interviewed between December 2011 and January 2012. Data collected included traditional and medicinal uses of S. birrea; fruit harvesting, processing and income generation activities from S. birrea and its products. The main product harvested by the participants was the fruit. The ripe fruits were eaten raw (100 %), seed kernels were eaten raw (100 %) or roasted (33.6 %), fruit juice fermented to produce children's beverage (22.4 %) or traditional beer (35.3 %), making jam (14.7 %), oil processing (8.6 %) and added to maize, millet and sorghum porridge (4.3 %). S. birrea was used medicinally for cold and flu, diarrhea, sore eyes and toothache. The leaves and fruits were browsed by livestock. S. birrea is also an important non-timber forest product (NTFP) for generating income among rural communities in south-central Zimbabwe with oil, wooden crafts and utensils generating the most cash income. This study showed that S. birrea plays an important role in the socio-cultural life of rural communities in south-central Zimbabwe. These results confirm findings from other studies conducted in rural communities in developing countries that wild plant resources are important for household livelihoods.

Latino caregivers are less assertive with family and friends about their child's beverage consumption

Caregiver behavioral skills are key to changing children's eating habits. The relationship between demographic characteristics and caregiver assertiveness with family and close friends regarding their child's beverage consumption were examined with baseline data from an intervention study aimed at reducing sugar‐sweetened beverage (SSB) consumption by pre‐school children. Caregivers of preschoolers (n=472) provided demographic information and completed an Information‐Motivation‐Behavioral Skills measure related to child SSB consumption (IMB‐mCSSB). Caregiver assertiveness was defined with 2 items on the IMB‐mCSSB. Caregivers with high assertiveness indicated that “telling [close friends or family] that I do not want my child to have certain drinks” would be “easy” or “very easy.” Logistic regressions showed that although caregiver age, gender, and food security status were not associated with assertiveness, ethnicity was significantly related (p &lt; .0001). Only 57% of Latino caregivers rated the assertiveness items as “easy” or “very easy” compared to 79% of African American, 73% of West Indian, and 76% of White caregivers. These results suggest that culturally sensitive assertiveness training with Latino caregivers may be a helpful component in interventions aimed at modifying child consumption behavior. Funding: USDA/NRI 2008–55215‐19071

Reducing Calories and Added Sugars by Improving Children's Beverage Choices

Because childhood obesity is such a threat to the physical, mental, and social health of youth, there is a great need to identify effective strategies to reduce its prevalence. The objective of this study was to estimate the mean calories from added sugars that are saved by switching sugar-sweetened beverages (including soda, fruit-flavored drinks, and sport drinks) and flavored milks consumed to unflavored low-fat milk (<1% fat) at meals and water between meals. Simulation analyses used 24-hour dietary recall data from the third School Nutrition Dietary Assessment Study (n=2,314), a 2005 national cross-sectional study of schools and students participating in the National School Lunch Program, to estimate changes in mean calories from added sugars both at and away from school. Overall, these changes translated to a mean of 205 calories or a 10% savings in energy intake across all students (8% among children in elementary school and 11% in middle and high schools). Eighty percent of the daily savings were attributed to beverages consumed away from school, with results consistent across school level, sex, race/ethnicity, and weight status. Children's consumption of sugar-sweetened beverages at home contributed the greatest share of empty calories from added sugars. Such findings indicate that parental education should focus on the importance of reducing or eliminating sugar-sweetened beverages served at home. This conclusion has implications for improving children's food and beverage environments for food and nutrition educators and practitioners, other health care professionals, policy makers, researchers, and parents.

Analysis of the erosive effects of children's beverages using a pH-cycling model

Copyright © 2013 by Journal of Korean Academy of Oral Health This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives: The aims of this in vitro study were (1) to assess the erosive potential of several children’s beverages in comparison to cola and orange juice, by using an in vitro pH-cycling model, and (2) to investigate the factors related to dental erosion caused by the beverages. Methods: Eight different children’s beverages (Chorongi, Capri-sun, Grateful nature wisdom, I-kicker, Koal-koal koala, My friend pororo, Qoo, and Strong zzanggu), Cola, and an orange juice, which are available in the Korean market, were used. To characterize each test beverage, the pH, titratable acidity to pH 7.0, concentration of calcium and phosphorus, and degree of saturation with respect to hydroxyapatite (DSHAP) were analyzed. Erosive potential of the test beverages was assessed by the depth of enamel loss observed in specimens subjected to pH cycling for 8 days. This cycle consisted of exposure to each beverage for 20 min, thrice daily, and to a remineralizing solution every day. The correlation between the depth of the enamel loss and the chemical properties of the beverages was assessed by Spearman’s rank correlation coefficients and multiple linear regression tests (P<0.05). Results: The depth of enamel loss caused by the beverages was found to vary from 0.11 to 105.47 μm. Enamel loss with all the children’s beverages tested was lesser compared to that with Cola (P<0.05) but was similar or greater than that with orange juice, except in one beverage. The pH, concentration of calcium, and DSHAP were significantly correlated with the depth of enamel loss (r=―0.842, r=―0.796, and r=―0.867, respectively; P<0.01). Multiple regression analysis showed that pH and concentration of calcium were impact variables for the erosive potential of test beverages (P<0.05). Conclusions: The children’s beverages tested had lower erosive potential than Coca Cola, but five (I-kiker, Grateful nature wisdom, Qoo, Capri-sun, and Chorongi) of them had higher erosive potential than orange juice. Moreover, among the chemical properties of beverages, significant factors affecting enamel loss were pH value and concentration of calcium.

Parent Support and Parent-Mediated Behaviors Are Associated with Children's Sugary Beverage Consumption

Consumption of sugary beverages has been identified as a contributor to childhood obesity. Studies have established the importance of specific parenting practices to children's beverage consumption; however, no study has examined multiple operationalizations of parenting to better understand where to focus future interventions. The present study examined the relationship between children's sugary beverage consumption and a parenting model that included household food rules, parent modeling of food rules, parent-mediated behaviors, and parent support. Baseline data from Project MOVE/me Muevo were used. Participants included 541 children, aged 5 to 8 years old, and their parents. Parents completed a 45-minute self-administered survey in Spanish or English, providing information about their child's dietary intake, as well as their parenting practices. Children's sugary beverage consumption included nondiet soda, noncarbonated sugary drinks, and sport drinks. Household food rules and parent modeling of food rules were assessed with seven items each. Parent-mediated behaviors consisted of four behaviors. Parent support was assessed with five items. Parent support and parent-mediated behaviors, including total screen time and eating at fast-food restaurants at least weekly, were associated with greater consumption of sugary beverages in children. No other parenting variables were significant. Encouraging caregivers to promote healthy dietary behaviors and provide healthy choices, limiting children's television and computer use, and reducing fast-food consumption can contribute to reductions in sugary beverage consumption among children.

Beverage patterns and trends among school-aged children in the US, 1989-2008

BackgroundHigh intake of sugar-sweetened beverages in childhood is linked to increased risk of obesity and type II diabetes later in life. Using three nationally representative surveys of dietary intake, we investigated beverage patterns and trends among US school-aged children from 1989/91 to 2007/08.Methods3, 583 participants ages 6-11 y old were included. We reported per capita trends in beverage consumption, percent consuming, and amount per consumer for the following categories of beverages: sugar-sweetened beverages (SSB), caloric nutritional beverages (CNB) and low calorie beverages (LCB). Statistically significant differences were tested using the Student's t test in Stata 11.ResultsWhile per capita kcal contribution from total beverages remained constant over the study period, per capita consumption of SSBs increased and CNBs decreased in similar magnitude. The substantial increase in consumption of certain SSBs, such as fruit drinks and soda, high fat high sugar milk, and sports drinks, coupled with the decrease in consumption of high fat low sugar milk was responsible for this shift. The percent consuming SSBs as well as the amount per consumer increased significantly over time. Per capita intake of total milk declined, but the caloric contribution from high fat high sugar milk increased substantially. Among ethnicities, important differences in consumption trends of certain SSBs and 100% juice indicate the complexity in determining strategies for children's beverage calorie reduction.ConclusionsAs upward trends of SSB consumption parallel increases in childhood obesity, educational and policy interventions should be considered.

Research Evidence for Reducing Sugar Sweetened Beverages in Children

Aims and Objectives: Sugar sweetened beverages (SSBs) have become commonplace in our society and are positively associated with an increase in body mass index (BMI) in our youth.Methods: This project presents an evidence-based review of the current research literature from 2001 to 2009 to examine the association between SSBs and children’s BMI.Results: An analysis of nine primary research studies is reported and eight of nine studies support that a decrease or reduction in SSBs by our youth can have a positive impact on their BMI.Conclusion: Education and political action by nurses to promote a decrease in SSB intake is a step in the right direction in reducing obesity in our children.

Factors Associated with Dental Caries Experience in 1‐Year‐Old Children

Dental caries in early childhood is an important public health problem. Previous studies have examined risk factors, but they have focused on children during the later stages of the disease process. The purpose of this study was to assess the factors associated with caries in children aged 6 to 24 months as part of a cross-sectional analysis. Two hundred twelve mothers with children 6 to 24 months of age were recruited from Special Supplemental Nutrition Program for Women, Infants, and Children clinic sites in southeastern Iowa for participation in a longitudinal study of dental caries. Baseline assessments included detailed questions regarding the children's beverage consumption, oral hygiene, and family socioeconomic status. Dental caries examinations using the d(1)d(2-3)f criteria and semiquantitative assessments of salivary mutans streptococci (MS) levels of mother and child were also conducted. Counts of the number of teeth with visible plaque were recorded for maxillary and mandibular molars and incisors. Of the 212 child/mother pairs, 187 children had teeth. Among these children, the mean age was 14 months, and 23 of the children exhibited either d(1), d(2-3), or filled lesions. Presence of caries was significantly associated with older age, presence of MS in children, family income <$25,000 per year, and proportion of teeth with visible plaque. Results suggest that not only microbial measures, including MS and plaque levels, are closely associated with caries in very young children, but that other age-related factors may also be associated with caries. Continued study is necessary to more fully assess the risk factors for caries prevalence and incidence in preschool children.

Beverage Consumption of Mother–Toddler Dyads in Families with Limited Incomes

Beverage intake and diet quality of toddlers from families with limited incomes were described and compared to their mother's beverage intake. At both 2 and 3 years of age, the children's average milk intake was adequate, the juice intake was twice that recommended, and the intake of sweetened beverages was high. Mothers who consumed more than 12 fl oz of soft drinks per day were nearly four times more likely to have a child with poor diet quality. Health practitioners should do focused screening of mothers' and children's beverage intakes to quickly assess those at high risk for poor diets.

The potential for sodium hexametaphosphate (SHMP) found in common children drinks to limit acid production in the oral biofilm

Sodium hexametaphosphate (SHMP) is a widely used industrial preservative commonly found in children's drinks. In this paper we examined the effect of SHMP incorporated into children's drinks on acid production by the oral biofilm by monitoring salivary concentrations of lactic acid. Twelve healthy adult subjects with an average age 36 years (range 26-54 years) consumed 10 ml from four children's beverages (Coca Cola and three types of Sunny Delight supplemented with SHMP) and a standard solution of sucrose. Saliva was collected at intervals following exposure of the oral biofilm to the drinks and the clearance of carbohydrates and the appearance of lactate was measured using standard enzymatic techniques. All the carbohydrates derived from the drinks were cleared from saliva within 15 min of consumption. Comparison of two drinks [Sunny D Normal and Sunny C] with the same carbohydrate, but different SHMP concentrations suggested that SHMP in these beverages had no significant effect on acid production. In this clinical study the role of SHMP, incorporated in common beverages, did not inhibit acid production from carbohydrates.