J Pediatr. 2013;163:1323-8.
Question: Among young children, what is the association of soda consumption with negative behavior?
Design Prospective birth cohort from the Fragile Families and Child Wellbeing Study.
Setting 20 large US cities.
Participants Children age 60 months.
Intervention Daily soda consumption vs. none.
Conclusions Soda consumption is associated with negative behavior among very young children.
Commentary During the past two decades, there have been substantial studies on the adverse effects of soft drinks on human health, especially chronic disease among adults. Find-
ings from these studies have led to changes in policies (eg, taxing soft drinks) in some countries. The study by Suglia et al focuses on soft drinks and behavior among children.
Consistent with ﬁndings among adolescents in Norway and US, high soft drink consumption is positively related to behavior problems in children age 5 years. The study is important because of its large sample size and ability to adjust for a range of confounding factors. The study’s ﬁndings are supported by existing evidence. In addition to the chemicals in soft drinks mentioned by the authors, phthalates from plastic packaging may also explain the link. A high maternal prenatal urinary phthalates level is associated with child behavior problems at age 3 years. Data from the National Health and Nutrition Examination Survey suggest that there is an association between phthalates and attention deﬁcit disorder in children. High consumption of soft drinks among young children is of great concern and supports focusing attention towards reducing consumption.
Zumin Shi, PhD
University of Adelaide
Adelaide, South Australia