Childhood obesity is on the rise. In the US, the country most affected by it, 1 in 5 children and teenagers are obese — even among the 2 to 5 age group, the obesity incidence in the US is 13.4%. But a new strategy could help counteract that: labeling sodas like cigarettes, with health warnings, could reduce children’s sugar uptake.

As most parents will tell you, kids love their sugary drinks. The problem is that these drinks have no real nutritional value, and contain a lot of sugar.

Marissa G. Hall, assistant professor in Gillings’ Department of Health Behavior and lead author of the new study, says sugary drinks have become a major problem for kids. They’re contributing to type 2 diabetes, cavities, and a number of other health problems. Hall and colleagues wanted to see whether label warnings could convince parents to make healthier choices for their children and reduce the consumption of sugary drinks.

“Health warning labels with images (pictorial warnings) are a proven strategy for reducing smoking, but haven’t been extensively tested for sugary drinks,” Hall told ZME Science. We wanted to conduct a study to understand whether pictorial warnings could shift parents to make healthier drink choices for their kids. We found that the warnings worked – parents who saw the warnings were more likely to choose a healthy beverage for their child than parents who did not see the warning.”

They carried out the study in a unique laboratory — the “UNC Mini Mart.” The space is essentially a replica of a convenience store, mimicking the experience of shoppers. This then allows researchers to see how different tweaks and changes would affect shopper behavior.

In particular, they wanted to see if visual labels, warning buyers of the health problems associated with sugar intake, would reduce the consumption of sodas. They did.

“In our study, we used images visually depicting type 2 diabetes and heart damage,” Hall explained. “These images performed well when we pre-tested them. We wanted to use large, attention-grabbing images following best practices for warning label design. Our studies have found that images are most effective when they attract attention and make people think about the harms of the product. “

In the study, 326 parents (25% of which were Black, and 20% of which were Latino) participated in a trial in which drink labels either presented health warnings (of diabetes or heart damage) or a barcode. Participants were then instructed to choose one drink and one snack for their child, as well as a household good. After the survey, participants completed a survey about their collection and were allowed to keep their drink of choice (as well as a small cash reward).

Overall, there was a 17% reduction in purchases of sugary drinks — 45% of parents in the control study bought a sugary drink for their child, compared to 28% in the pictorial warning group.

Hall says authorities could take note of this and implement policies to reduce the consumption of sugary drinks.

“Health warning labels for sugary drinks could be mandated at the local or state level, or by the federal government. So far, 7 US states have proposed health warnings for sugary drink containers. And 7 countries currently require similar warning labels on unhealthy foods and beverages. So warning labels policies are gaining momentum here in the US and worldwide. Our research shows that implementing warning labels on sugary drinks encourages parents to select healthier beverages for their children, the first time this had been shown in a randomized trial,” the researcher concludes.

The study was published in PLOS Medicine.