I have a sweatshirt that I like to wear that shows a water faucet handle with the words "Drink Water" emblazoned on the front. The sweatshirt (and other merchandise with the slogan) reflects an initiative by professional snowboarders Austin Smith and Bryan Fox to resist the co-option of their sport and their athletes to shill for the energy drink industry. I purchased the sweatshirt in solidarity with the Drink Water folks, as my own research has shown that children and families are bombarded with advertisements promoting sugar-filled drinks. Excess consumption of these drinks — from soda to sports drinks to energy drinks — is associated with weight gain, as they add on an average of more than 200 calories a day to the diets of children and adolescents and are the largest source of added sugar. Working with the Philadelphia Department of Public Health, my colleagues and I at the Annenberg Public Policy Center helped to develop a media campaign, which ran from 2011 to 2012, to encourage parents to replace sugar-sweetened beverages with healthier alternatives, including low-fat milk, unsweetened iced tea and, of course, water. And while the messages were seen and remembered by a majority of Philadelphians, they were vastly outnumbered by the messages put out by the beverage industry equating soda with happiness, sports drinks with athletic prowess, and energy drinks with success, inspiration and "wiiings."


Now our new study, just published online in the journal Health Education & Behavior, shows that parents have gotten the message that soda is filled with sugar and calories. That might be because in places like Philadelphia, there has been talk of a "soda tax" and in New York there's been a movement to limit the portion sizes of fountain sodas. So campaigns that focus on the amount of sugar in soda seem to be telling parents what they already know (although reinforcement may not be such a bad thing). Our study, based on a representative survey of 371 Philadelphia parents in households with children between the ages of 3 and 16, found something surprising. While parents rated sports drinks as high in sugar, they were nevertheless thought of as "healthier" than soda.

Our study is not the only one to show that parents are confused about what's healthful and what isn't when it comes to the beverages their children drink. A new study by the Rudd Center for Food Policy and Obesity published in the journal Public Health Nutrition, based on an online survey of nearly 1,000 parents, found that only 6 percent said that soda is healthful. But a much larger percentage felt that flavored water (48 percent), fruit drinks (30 percent) and sports drinks (27 percent) are healthful beverages. The authors argue that the messages on the drink packaging can be misleading to parents, especially when they say things like "Vitamin C," "antioxidants" or "real/natural." And with $784 million spent on advertising to promote sugary drinks (based on the most recent data available from 2010), it is no wonder parents are confused.

Those working in the public health arena have been working hard to getting the message out about the link between sugar-sweetened beverage consumption and America's obesity epidemic. They have also been working tirelessly in their communities to put policies in place that would change the beverage environment, such as taking soda machines out of schools and making drinking water stations visible and accessible. It is clear that if we want to help parents make healthful drink choices with their children, we need to provide them with the facts about sugary drinks; access to low-calorie, low-sugar alternatives; and public service advertisements to counteract the flood of messages. And if we can enlist celebrities and athletes in a campaign to make it cool to drink healthfully, then I say we have a fighting chance to persuade kids that it is cool to "drink water."

Jordan, Ph.D., is associate director for policy implementation at the Annenberg Public Policy Center of the University of Pennsylvania. She is also president-elect of the International Communication Association.