The Influence of Pediatric Resident
Counseling on Limiting Sugar-
Sweetened Drinks in Children
Sule Doymaz, MD, and Daniel R. Neuspiel, MD, MPH
Clinical Pediatrics
Volume 48 Number 7
September 2009 777-779
© 2009 The Author(s)
10.1177/0009922809332685
http://clp.sagepub.com
777
and increased risk for the development of type 2
diabetes.
8
In more recent studies, the role of sugar-
sweetened beverage consumption in adolescent obesity
has been investigated, and it has been found that soft
drinks currently constitute the leading source of
added sugars in the diet.
9
In US children and adolescents,
up to 15% of total calorie intake is attributable to sugar-
sweetened beverages and fruit juices.
10
Primary care pediatricians may play a crucial role
as the first line of responders in childhood obesity. The
pediatrician can identify children at risk and implement
intervention measures, including counseling, follow-up,
and outcome determinations. In this study, we aimed
to assess the effects of pediatric resident counseling
on reducing sugar-sweetened drink consumption in
childhood and adolescence.
Methods
This study was conducted as a quality improvement
project by a pediatric resident and carried out at a
pediatric continuity practice in a hospital outpatient
department in New York City. Seventy participants
between the ages of 2 and 20 years were included in
the study. None of the participants had any ongoing
medical problems and presented for routine well-
child visits. The participants were randomly assigned
to 2 groups: test or control. During the initial visit
before the counseling, parents or guardians of the
participants were asked whether they were willing to
voluntarily join the study. All study participants were
asked about the amount and the type of daily drink
consumption, and these data were recorded. In the test
group, predefined counseling points were relayed to
both the parent and the child by a pediatric resident,
O
besity is considered to be one of the major
health problems affecting all levels of soci-
ety and is approaching modern-day epi-
demic status.
1
Obesity is strongly associated with
major health risk factors such as diabetes, high blood
pressure, high cholesterol level, asthma, arthritis,
and poor health status. The American Academy of
Pediatrics (AAP) has declared that childhood over-
weight and associated comorbidities are significant
health problems for the pediatric population, caus-
ing important health and financial burdens to the
society. The AAP indicated the need for pediatri-
cians to assume a leadership role in the prevention,
advocacy, and research fields in this important issue.
2
The relationship between the consumption of
sugar-sweetened drinks, childhood obesity, and
associated health risks has been addressed by several
investigators.
3-6
It has been demonstrated that for
each additional serving of sugar-sweetened drinks,
there are increases in both the body mass index
(BMI) and odds ratios for frequency of obesity.
3
In a
comparative Canadian study, obese children consuming
significantly more sugar-sweetened drinks were found
to have a higher BMI as a results of higher calorie
intake.
7
Similarly, in older people, higher consumption
of sugar-sweetened beverages was found to be
associated with a greater magnitude of weight gain
From the Department of Pediatrics, Beth Israel Medical Center,
Albert Einstein College of Medicine, New York (SD), and the
Department of Pediatrics, Levine Children’s Hospital, Charlotte,
North Carolina (DRN).
Address correspondence to: Daniel R. Neuspiel, Department
of Pediatrics, Levine Children’s Hospital, 1350 S. Kings Dr.,
2nd Floor, Charlotte, NC 28207; e-mail: Daniel.neuspiel@
carolinashealthcare.org.