CHAPEL HILL, NC. — Picture warnings on sodas and other sugary drinks could help fight childhood obesity, according to a recent study published in the journal PLOS Medicine. 

The study was the first to examine in a realistic setting whether pictorial health warnings on sugary drinks like juice and soda influence which beverages parents buy for their children. The findings were promising, with the warnings reducing purchases of sugary drinks by 17%.

Researchers from the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health ran the study in the “UNC Mini Mart,” a laboratory space that is set up to mimic a convenience store shopping experience.

“When people make choices about what food to buy, they are juggling dozens of factors like taste, cost and advertising and are looking at many products at once,” said Lindsey Smith Taillie, PhD, an assistant professor in the Gilling School’s nutrition department and senior author of the study. “Showing that warnings can cut through the noise of everything else that's happening in a food store is powerful evidence that they would help reduce sugary drink purchases in the real world.”

More than 320 parents of children ages 2 to 12 participated in the randomized trial, which included two types of soda labels. One label featured a pictorial warning about heart disease and type 2 diabetes while the other displayed a barcode. Participants were instructed to purchase one beverage for their child, along with other products on a shopping list created to mask the study’s design. Nearly half (45%) of parents in the barcode group bought a sugary drink for their child, compared to 28% in the pictorial warning group. The warnings also reduced calories purchased from sugary drinks and led to parents feeling more in control of healthy eating decisions.

“We think the paper could be useful for policymakers in the United States and globally,” said Marissa G. Hall, PhD, an assistant professor in the Gilling School’s health behavior department and lead author of the study. “This evidence supports strong, front-of-package warnings to reduce sugary drink consumption in children.”

The Robert Wood Johnson Foundation last fall found the rate of obesity among US children ages 10 to 17 remained high at 16.2% for 2019-20. The highest rates were among youth of color and youth from households with low income.

The report listed several potential policies and actions to prevent childhood obesity, including making universal school meals permanent and extending eligibility for the Special Supplemental Nutrition Program for Women, Infants and Children.