Shirley Temple: judge it as a sweet soda with coloring

We found no study of the Shirley Temple itself, so the evidence on this page is borrowed from what goes into it. The strongest piece is a meta-analysis of 8 randomized trials in 2,783 children, where cutting sugar-sweetened drinks slowed BMI gain by 0.21 kg/m2 against control, with a 95% confidence interval from 0.40 down to 0.01. That upper end sits close to zero, and the trials were about sweet drinks in general. In the same review, adults randomized to add sugar-sweetened drinks gained 1.8 lb (0.83 kg) more than controls. US survey coding puts one Shirley Temple at 225 g, with 28.2 g of total sugars, 126 calories and no caffeine. That is a single value with no range, because the drink changes with the soda and the pour of grenadine.

As people eat it, per 3.5 oz (100 g)

How much is actually in it

• US survey coding gives one Shirley Temple drink of 225 g about 28.2 g of total sugars and 126 calories. — USDA FNDDS food code 92804000, Shirley Temple, recalculated from 100 g values (n = 1 food) Evidence E source
  Per 100 g: total sugars 12.55 g, energy 56 calories, sodium 9 mg, caffeine 0 mg; per drink 225 g: sugars 28.2 g, 126 calories

What a real portion looks like

• US dietary survey coding counts one Shirley Temple drink as 225 g and one fluid ounce as 30 g. — USDA FNDDS portion measures (n = 3 measures) Evidence E source
  1 drink 225 g; 1 fl oz 30 g; quantity not specified 225 g

What it does to your health

• In a meta-analysis of 8 RCTs with 2,783 children, cutting sugar-sweetened drinks slowed BMI gain by 0.21 kg/m2 versus control. — children in 8 randomized trials and 40 cohorts, adults in 16 trials and 21 cohorts (n = 2783) Evidence A source
  Children RCTs: BMI MD -0.21 kg/m2 (95% CI -0.40 to -0.01); adults adding SSB: +1.8 lb (1 to 2.6; metric: 0.83 kg, 0.47 to 1.19); adults removing SSB: -1.1 lb (-1.5 to -0.71; metric: -0.49 kg, -0.66 to -0.32)
• Across 3 RCTs in children, swapping sugar-sweetened drinks for non-caloric drinks or flavored milk cut body fat by 0.70 percentage points, BMI z-score unchanged. — children and adolescents in randomized trials (n = 3 RCTs) Evidence A source
  Body fat % MD -0.70 (-0.78 to -0.62); BMI z-score MD -0.05 (-0.20 to 0.09)
• An umbrella review links each extra 8.5 fl oz (250 mL) a day of sugar-sweetened drinks with 17% higher coronary heart disease risk, on low quality evidence. — meta-analyses of observational studies in people free of disease (n = 73 meta-analyses) Evidence C source
  CHD +17% and all-cause mortality +4% per 250 mL/day SSB; gout +4% per serving/week

Safety, limits and interactions

• In a crossover RCT of 297 children, drinks with artificial colors plus sodium benzoate raised hyperactivity scores, effect size 0.20 at age 3 and 0.12 to 0.17 at age 8 to 9. — 153 children aged 3 and 144 aged 8/9 in the general population, UK (n = 297) Evidence B source
  Age 3, mix A: ES 0.20 (95% CI 0.01-0.39); age 8/9 completers: mix A 0.12 (0.02-0.23), mix B 0.17 (0.07-0.28)
• FDA revoked FD&C Red No. 3 as a color additive under the Delaney Clause, with food reformulation due by January 15, 2027. — US food supply, food and ingested drug manufacturers Evidence E source
  Authorization revoked January 2025; food deadline January 15, 2027, ingested drugs January 18, 2028

What people believe that the data does not support

• A meta-analysis of 15 double-blind trials put the effect of artificial food colors on hyperactivity at 0.283, falling to 0.210 in better trials. — children with hyperactive syndromes in double-blind placebo-controlled trials (n = 15 trials) Evidence A source
  Effect size 0.283 (95% CI 0.079-0.488); 0.210 (0.007-0.414) after excluding small and low-quality trials
• A meta-analysis of 24 food color studies found a small parent-rated effect, g 0.12 after bias adjustment, not reliable for FDA-approved colors alone. — children with ADHD or ADHD symptoms (n = 24 publications) Evidence A source
  Parent reports g 0.18 (0.08-0.24), 0.12 (0.01-0.23) after publication-bias adjustment; teacher reports 0.07 (-0.03 to 0.18)

The bottom line

Across 3 randomized trials in children, replacing sugar-sweetened drinks with non-caloric drinks or flavored milk cut body fat by 0.70 percentage points. BMI z-score did not change, in only 2 trials, so this rests on a thin base. An umbrella review of observational meta-analyses links each extra 8.5 fl oz (250 mL) a day of sugar-sweetened drinks with a 17% higher risk of coronary heart disease. That is an association, and it cannot show the drink is the cause. The color question belongs to the grenadine and the maraschino cherry, and which colors they contain depends on the brand. In a crossover trial in the UK general population, 3-year-olds given a drink with a mix of artificial colors plus the preservative sodium benzoate scored higher on hyperactivity than on placebo, effect size 0.20 (95% CI 0.01 to 0.39). That mix was tested as a mix, so no single color can be blamed from it. A meta-analysis of 15 double-blind trials in children with hyperactive syndromes put the effect of artificial colors at 0.283, and at 0.210 once the smallest and weakest trials were dropped, with signs of publication bias. The honest answer on colors is still unsettled. A second meta-analysis found that the effect in studies limited to food colors did not survive correction for publication bias and was not reliable in studies limited to colors approved by the FDA. Who should be careful. Parents of young children who react to colored drinks have the trial above as their reason, and grenadine and cherries without artificial colors remove the question. The FDA revoked approval of Red No. 3 in food under a law that bans additives causing cancer in animals, with reformulation due by January 15, 2027. That is a legal action based on rat data, not proof of harm in people, and Red No. 40 remains allowed. Our cards say nothing about pregnancy or medicines for this drink.

Sources

1. shtm-r2-01 · composition dataset
   Shirley Temple, FNDDS code 92804000, fdc_id 2710611, per 100 g: Total Sugars 12.55 g; Energy 56 kcal; Sodium 9 mg; Caffeine 0 mg; 1 drink 225 g: Total Sugars 28.2 g; Energy 126.0 kcal
   USDA FNDDS, food code 92804000, FDC 2710611 · checked 2026-10-02
2. shtm-r2-02 · portion dataset
   Shirley Temple, FNDDS code 92804000, fdc_id 2710611: 1 fl oz, measure 30000, 30 g; 1 drink, measure 60699, 225 g; Quantity not specified, measure 90000, 225 g
   USDA FNDDS, food code 92804000, FDC 2710611 · checked 2026-10-02
3. shtm-r2-03 · meta-analysis of RCTs and cohorts
   RCTs in children indicated less BMI gain with SSB reduction interventions compared with control (MD: -0.21 kg/m2; 95% CI: -0.40 kg/m2, -0.01 kg/m2). In adults, randomization to addition of SSBs to the diet led to greater body weight gain (MD: 0.83 kg; 95% CI: 0.47 kg, 1.19 kg)
   Am J Clin Nutr, 2023 · checked 2026-10-02
4. shtm-r2-04 · meta-analysis of RCTs
   Substituting sugar-sweetened beverage with non-caloric beverages or flavored milk reduced body fat percentage (- 0.70 [- 0.78, - 0.62] (p < 0.001)) (n:3) but did not change BMI z-score (- 0.05 [- 0.20, 0.09] (p = 0.48)) (n:2).
   Eur J Nutr, 2023 · checked 2026-10-02
5. shtm-r2-05 · umbrella review
   each 250 mL/day increment of sugar sweetened beverage consumption was associated with a 17% and 4% higher risk of coronary heart disease (class II evidence) and all cause mortality (class III evidence), respectively.
   BMJ, 2023 · checked 2026-10-02
6. shtm-r2-06 · randomized crossover trial
   Mix A had a significantly adverse effect compared with placebo in GHA for all 3-year-old children (effect size 0.20 [95% CI 0.01-0.39], p=0.044) but not mix B versus placebo.
   Lancet, 2007 · checked 2026-10-02
7. shtm-r2-09 · agency position
   Manufacturers who use FD&C Red No. 3 in food and ingested drugs will have until January 15, 2027 or January 18, 2028, respectively, to reformulate their products.
   US FDA, constituent update on revoking Red No. 3, 2025 · checked 2026-10-02
8. shtm-r2-07 · meta-analysis of RCTs
   Meta-analytic modeling determined the overall effect size of AFCs on hyperactivity to be 0.283 (95% CI, 0.079 to 0.488), falling to 0.210 (95% CI, 0.007 to 0.414) when the smallest and lowest quality trials were excluded.
   J Dev Behav Pediatr, 2004 · checked 2026-10-02
9. shtm-r2-08 · meta-analysis
   The effect was reliable in studies restricted to food color additives (g = 0.21, 95% CI = 0.06-0.36) but did not survive correction for possible publication bias and was not reliable in studies confined to Food and Drug Administration-approved food colors.
   J Am Acad Child Adolesc Psychiatry, 2012 · checked 2026-10-02