Feb. 20—The state Department of Health has launched its first campaign taking aim at the beverage industry's marketing of sweetened fruit drinks to keiki.

The state Department of Health has launched its first campaign taking aim at the beverage industry's marketing of sweetened fruit drinks to keiki.

The campaign gets underway as the obesity rate among high school children in Hawaii is on the—from 12.9 % in 2015 to 16.4 % in 2019.

Many popular fruit-­flavored drinks—from punch to sports drinks—are marketed as "natural " or a source of vitamin C, which can mislead the public into thinking they are healthful, the department said, when they might actually contain as much sugar as soda.

The consumption of this added sugar in beverages can lead to tooth decay and weight gain as well as contribute to diet-related diseases such as diabetes. Health experts recommend that keiki avoid sweetened fruit drinks or other sugary beverages. The healthiest choices are simply water or unflavored milk.

After holding several focus groups, the Health Department found many parents and grandparents wanting to make healthful decisions for keiki had been unaware of the high sugar levels, according to Lola Irvin, administrator of the Chronic Disease Prevention and Health Promotion Division.

"It is a cause of concern, " said Irvin. "We're finding that children who are obese have a harder time having normal weight as adults. We know that sugary drinks are a large contributor."

Hawaii's Young Children Health Survey found more than 75 % of keiki in Hawaii consume one or more sweetened fruit drinks, sports drinks, energy drinks or tea drinks daily. Another survey of residents of Kauai, Nanakuli, Waimanalo, Wailuku, Molokai and Hilo—conducted over more than six years—found 13.5 % to 43.5 % of young children in these communities suffer from being overweight or obese.

In Hawaii, about one-quarter of adults suffer from obesity, defined as a body mass index of 30 or greater. Obesity increases the risk for other potential health issues such as diabetes, heart disease and certain cancers. In addition, being overweight places one at greater risk of severe disease and hospitalization from COVID-19.

At the federal level, the U.S. Department of Agriculture recently proposed updates to school nutrition standards for better health. Among them is a proposed limit on added sugars, to be implemented in phases. Currently, there is no limit on added sugars in school meal programs, and children are consuming too many, the USDA noted, particularly in breakfast cereals, flavored milks and yogurt.

By fall 2027, USDA proposes limiting overall added sugars across the weekly menu to less than 10 % of calories per meal.

Eludrizza Tabisola-­Nuesca, a nurse practitioner at Kapiolani Medical Center for Women & Children, said she is seeing a higher number of children contending with excessive weight gain, pre-diabetes and diabetes. Also a certified diabetes educator, Tabisola-Nuesca teaches families how to read labels as a means to avoid being misled. "They see the pretty colors and think, 'Oh look, this is vitamin C, or it's organic. This has vitamins and natural juices.'"

She said, it's important to look at sugars as well as added sugars—and organic does not necessarily mean there are fewer sugars. For patients with Type 2 diabetes, it's also important to look at total carbohydrates.

Tabisola-Nuesca's advice for families is to choose produce-section fruit instead of the fruit juice at the grocery, and to drink water. She recommends plain milk over chocolate milk, which often has double the amount of sugars.

A recent study found half of the youngest children, ages 1 to 5, in Hawaii did not eat a daily vegetable ; 1 in 3 did not eat a daily fruit ; and 54 % drink sugar-sweetened beverages at least once a week. Irvin said eating fruit is the better option as "our bodies don't register being full when we drink sugars versus eating the whole fruit and getting all the fiber."

An effective strategy for avoiding sugary beverages, Tabisola-Nuesca said, is to aim to keep them out of the household. Moderation is key, she said, along with family support for ample physical activity, such as playing basketball or walking 35 to 40 minutes a day.

A bill introduced in the Legislature proposing a fee on sugar-sweetened beverages has made little headway.

, or the "Healthy Ohana Act, " calls for a 2-cent fee to distributors per fluid ounce of sugar-sweetened beverages sold, with those funds going to DOH to support prevention and control of obesity and other chronic diseases.

The measure, introduced by Sen. Karl Rhoads, notes that sugar-sweetened beverages are associated with negative health effects that cost the state an estimated $470 million annually. A study by DOH and the Harvard T.H. Chan School of Public Health concluded that a fee could result in prevention of thousands of cases of childhood and adult obesity.

Attempts to pass similar bills in 2021 and 2022 failed as well as a bid for a, " proposed by former Gov. Neil Abercrombie's administration in 2011.

To get a better understanding of what's in a beverage, the DOH's website lists examples of added sugars under different names, such as cane juice, high fructose corn syrup, dextrose, fruit juice concentrates and fruit nectars. The "Sweet Lies " campaign will run on TV, radio, digital and social media platforms and in malls statewide through April 30. It can also be found at.

SWEET FACTS Common sugars listed as different names in beverages—Cane juice, corn syrup, dextrose, fructose, fruit juice concentrates, fruit nectars (agave nectar ), glucose, high fructose corn syrup, honey, malt syrup, maple syrup, molasses, raw sugar, sucrose, sugar cane Common sugary beverages—Fruit drinks, fruit-flavored drinks such as fruit punch and lemonade, soda and soft drinks, sports and energy drinks, sweetened flavored waters, and sweetened coffee or tea beverages Source : State Health Department,