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			 Researchers found those beverages such as soft drinks, sweet tea and 
			flavored milk add about 179 more calories to meals. 
 “Sugar-sweetened beverages are increasingly linked to health 
			problems such as diabetes,” said senior study author Brian Elbel of 
			the New York University School of Medicine.
 
 “Any information we can find about why this high-risk group of kids 
			is purchasing these drinks is important,” he said. “We haven’t had a 
			great sense of who these kids are, especially at fast food 
			restaurants.”
 
 The research team analyzed nearly 500 receipts and surveys collected 
			in fast-food restaurants in New York City and in nearby Newark and 
			Jersey City, New Jersy during 2013 and 2014. They found that 60 
			percent of the drinks bought for children were sugar-sweetened, and 
			combination meals were more likely to include a sugary drink.
 
 “It’s always tough to get data on kids that represents the real 
			world, and this was based on what kids are actually purchasing, not 
			some experimental setting,” Elbel told Reuters Health. “We were 
			surprised by the broad variety of purchase predictors we saw.”
 
			
			 
			In addition to ordering a combination meal, male children and those 
			above age 12 were more likely to get a sugar-sweetened beverage and 
			consume a higher number of calories and grams of sugar. Caregivers 
			and parents who had a high school degree or less, bought the meal 
			during dinner hours, and ate at the restaurant were also more likely 
			to purchase sugary drinks for their kids.
 “We know that families frequent fast-food restaurants often, and 
			these places have highly caloric meals,” Elbel said. “A 
			preponderance of healthy food is not being purchased.”
 
 About 17 percent of children under age 19 in the U.S. are classified 
			as obese by the Centers for Disease Control and Prevention. A major 
			contributor to the recent growth in obesity has been increased 
			calories, the study authors write in the American Journal of Public 
			Health. The Dietary Guidelines for Americans recommend that children 
			limit sugar intake to 10 percent of total calories, or about 120-180 
			calories.
 
 “We’re no longer fighting about whether children need to drink fewer 
			sugary drinks. That’s accepted,” said Marlene Schwartz, director of 
			the Rudd Center for Food Policy and Obesity at the University of 
			Connecticut in Hartford, who was not involved with the study.
 
			
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			“The question now is finding the best way to do that,” she told 
			Reuters Health. “Based on this study, if parents substitute milk or 
			water for the sugary drink, that eliminates almost 200 calories 
			right there.”
 One limitation of the study is that the researchers didn’t account 
			for drink refills, and they couldn’t observe how much of each drink 
			was consumed, only what was purchased. In addition, the study only 
			surveyed walk-in customers, not drive-through customers, who make up 
			a significant portion of fast-food restaurant traffic across the 
			country.
 
 “The New York City context makes this a little less generalizable to 
			other areas,” Elbel said. The results also may not apply to fast 
			casual dining, sit-down restaurants or full-service restaurants.
 
 The new study's findings support an ordinance passed in Stockton, 
			California, in June that decouples sugar-sweetened beverages from 
			combination meals, making water or milk the default choice for kids’ 
			meals rather than soda. The “healthy-by-default” rule was passed 
			unanimously by the Stockton City Council, following on a similar 
			ordinance passed in Davis, California.
 
 “We have to put the pressure on restaurants to see a change,” 
			Schwartz said. “If more consumers speak up, more restaurants will 
			listen.”
 
 SOURCE: http://bit.ly/2eBfWZs American Journal of Public Health, 
			online September 15, 2016.
 
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				reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published, 
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