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CNN — Are you feeding your children fresh fruit and vegetables, whole grains, fish and plant-based proteins? Parents often think about what foods are healthiest for their little ones.
But what about what your kids drink? Four leading national health and nutrition organizations recommend you also consider their beverage intake.
The consensus statement summarizes the latest evidence and provides recommendations for healthy beverage intake in school-age children and adolescents. They include total hydration needs by age, the types of beverages that are recommended, those that should be limited, and those that should be avoided.
They help to answer common questions from parents, such as how much milk should kids drink, whether juice or juice drinks are recommended, and if sports drinks are healthy for children.
To break down these recommendations, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner and is the mother of two young children.
CNN: Why is it important to consider what our kids are drinking?
Dr. Leana Wen: There are several reasons families should care about their kids’ beverage choices, just as they care about their food choices.
To start, it’s important that children get most of their calories from nutritious substances rather than so-called empty calories that have little or no nutritional value. Moreover, about 1 in 5 children and adolescents have obesity, according to the US Centers for Disease Control and Prevention.
Having a healthy diet is key to reducing obesity and its myriad medical consequences such as diabetes and heart disease. Consumption of sugar-packed sodas and other sugar-sweetened drinks is strongly associated with developing overweight and obesity. And these beverages also contribute to tooth decay.
What kids drink is a key component of their overall diet, so it’s crucial that parents are aware of what products are healthy and recommended — and, equally, what should be avoided. This is not often easy, as some products may be marketed as healthy but are not.
CNN: How much fluid should school-age kids drink every day?
Wen: Hydration needs depends on age. According to the expert panel, kids 5 to 8 years old should be drinking about 40 fluid ounces a day, which is about 5 cups. Those 9 to 13 years old should drink between 54 to 61 ounces, which is about 7 to 7.5 cups. Those 14 to 18 years old should drink between 61 to 88 ounces, or between 7.5 to 11 cups. These are general estimates, because total hydration needs will vary depending on the child’s size, level of physical activity and climate in which they live.
CNN: I assume that water is the top recommended beverage, right?
Wen: Yes. Plain drinking water is just fine, and in fact is the best beverage for school-aged children. The vast majority of your kids’ hydration needs can be met through water alone.
CNN: What about milk and juice?
Wen: Let’s take these separately. The experts recommend plain pasteurized milk — up to 20 fluid ounces a day for 5- to 8-year-olds and up to 24 fluid ounces a day for older children. Note that sweetened-flavored milk (chocolate milk, strawberry milk and so forth) is not recommended due to the high amounts of added sugars per serving.
The limit is a lot lower for juice. According to this panel, a small amount of 100 percent juice is OK. And I mean a small amount: less than four to six ounces per day for five- to eight-year-olds, less than six to eight ounces for nine- to 13-year-olds, and less than eight ounces in 14- to 18-year-olds.
That means even adolescents should limit their intake of 100 percent juice to less than one cup per day.
Regarding juice, these are upper limits, not minimum amounts. Your kids don’t need to drink any juice to have a healthy diet. Children should try to meet their daily fruit recruitment by eating whole fruit, not by drinking juice.
CNN: What about soy milk and almond milk? And is there a place for juice drinks that aren’t 100% juice?
Wen: Plant-based milk alternatives like soy and almond milk are only recommended when there is a specific medical reason — such as an allergy to milk protein or if the child has to have a specific diet. Parents who choose these beverages should look for unsweetened products that do not have sugar or non-sugar sweeteners.
Juice drinks are in the same category as other sugar-sweetened beverages, including sodas. These are not recommended for children.
CNN: Are diet drinks OK if they don’t contain sugar?
Wen: The panel also does not recommend beverages that contain artificial chemical, non-sugar sweeteners. They cite lack of evidence on the safety and impact of these substances on the long-term health among children and adolescents.
CNN: How about sports drinks? How can children who participate in after-school and recreational sports keep hydrated?
Wen: Sports drinks are not recommended for several reasons. First, many contain high amounts of sugar. Second, they are generally unnecessary. Most people can hydrate sufficiently using water, and they can replenish lost electrolytes through food.
A third issue to watch out for is that some sports drinks are conflated with energy drinks that contain caffeine and other stimulants. These are not substances that children should be consuming. The expert panel is clear that beverages with caffeine and other stimulants are not recommended for children and adolescents.
CNN: What’s your takeaway from this guidance on drinks, and how will you apply them to your own kids?
Wen: My overall takeaway is that plain drinking water is the best form of hydration. It’s ideal to get kids used to drinking water to replenish their fluids rather than to rely on sweetened substances. Pasteurized milk is also a good source of hydration. While 100% juice can be consumed in small amounts, all other drinks, including flavored milk and juice drinks, should not be part of daily consumption.
This is generally what my family does. We emphasize water and milk. Juice is a treat — not something we offer every day. If my kids are at a party and there are juice drinks, we will let them drink those, but we tell them it’s a “special occasion” beverage. We do not offer sodas or sports or energy drinks.
Overall, I think the expert panel is right to raise awareness of the importance of healthy drinks, which should be considered just as much as healthy food in forming children’s diets.
