Health and nutrition experts recommend that children do not consume drinks with added sugars or nonnutritive sweeteners, yet drinks containing both represent a major portion of beverages consumed by children. One reason may be that the labels of drinks marketed to kids do not help parents and other consumers differentiate among fruit juice and sugar-laden, artificially flavored drinks, finds research from New York University’s School of Global Public Health. The results are published in the American Journal of Public Health.

The researchers examined the labels and ingredients of top-selling children’s juice drinks, including brands with at least $10 million in annual sales. To compare similar products across brands and categories, they focused on “fruit punch”–flavored drinks.

The researchers identified 39 fruit punch–flavored drinks that widely varied in the amount of juice they contained: seven contained 100% juice, 11 were diluted juices (juice and water), eight contained some juice (less than 100%, but more than 2%) with added sugars or low-calorie sweeteners, eight had no or almost no juice (2% or less) and consisted of flavoring and sugar or low-calorie sweeteners, and five called themselves water but had similar ingredients as the drinks with little or no juice.

While the U.S. Food and Drug Administration (FDA) requires products with 100% juice to include statements on the packaging related to added sweeteners, products with less than 100% juice are not required to have the same disclosures. Without this required transparency, the researchers observed many different nutrition claims on beverages.

Of the products containing added sugars—which came from all categories except 100% juice and diluted juice—60% touted positive statements about sweeteners such as “no high fructose corn syrup.” Drinks containing stevia extract included claims such as “no artificial sweeteners” and “no sugar added.”

Nearly all drinks (97%) showed images of fruit on the front of the package, even if they did not contain juice from the fruits pictured—or any juice at all. The researchers found that even though labels depicted 19 different types of fruit, apple juice was the primary juice across products containing juice as an ingredient. Less than half (45%) of drinks with fruit images on the package included juice from the pictured fruits; more than a third (37%) did not contain juice from any of the fruits on the packaging.

The researchers recommend several changes to FDA regulations in order to help consumers make healthier choices, including standardizing the names of products (juice versus waters versus drinks with added sweeteners), differentiating between flavors and ingredients, and prominently disclosing added sweeteners on the front of products.

“We identified numerous labeling practices that obscure the true nature of drinks trying to pass as juice, blurring the distinction between drinks that are acceptable for children and those containing added sugar or sweeteners,” said study author Jennifer Pomeranz, assistant professor of public health policy and management at NYU School of Global Public Health, in a university press release. “The FDA should make it easier for consumers to tell what products are healthy for children—without having to carefully inspect the nutrition panel and decipher each ingredient on the back of the package.”

IFT Weekly Newsletter

Rich in industry news and highlights, the Weekly Newsletter delivers the goods in to your inbox every Wednesday.

Subscribe for free