What's in Your Drink? Poster Educates Families About Sugar Content and Fatty Liver Disease

J Nutr Educ Behav. 2021 Oct;53(10):851-857. doi: 10.1016/j.jneb.2021.04.463. Epub 2021 Aug 6.


Objective: Drinking sugar-sweetened beverages is a risk factor for developing childhood obesity and nonalcoholic fatty liver disease (NAFLD). This study investigated the impact of an educational poster in pediatric offices on family's knowledge of sugar content in beverages and assessed awareness of NAFLD.

Design: Preclinic visit surveys asked patients' caregivers about the sugar content in beverages and awareness of NAFLD. Postclinic visit surveys assessed improvement in knowledge of sugar content and willingness to change dietary habits.

Setting: Outpatient visits in a single center in Houston between September and November 2019.

Participants: One hundred and forty-nine caregivers were surveyed, and patients' median age was 5.5 years (range, 0-18 years) with 57% males.

Intervention: Educational posters displayed the sugar content of common beverages in each clinic room.

Main outcome measures: Outcomes measured included pre-post clinic visit change and predictors of change in (1) knowledge of sugar content in beverages and (2) intent to change beverage consumption. Baseline awareness of NAFLD and associated predictors were also assessed.

Analysis: Logistic regression identified factors associated with an intended change in beverage consumption, change in survey score, and NAFLD awareness.

Results: Increased knowledge of sugar content with median scores of 25% preclinic to 50% postclinic (P < 0.001). Eighty-eight percent of caregivers were very/moderately likely to provide their children fewer sugar-sweetened beverages. Sixty percent of caregivers were aware of NAFLD, but only 32.8% were concerned.

Conclusions and implications: Posters in clinics increased awareness of the sugar content in beverages, and most caregivers reported intent to decrease children's sugary beverage consumption.

Keywords: alcoholic fatty liver disease; child; nutrition; obesity; sugar-sweetened beverages.

MeSH terms

  • Beverages
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Liver Diseases*
  • Male
  • Pediatric Obesity*
  • Sugar-Sweetened Beverages*
  • Sugars


  • Sugars