Working in partnership to improve children’s oral health: the ‘give up loving pop’ sport programme

The ‘Give Up Loving Pop’ or GULP Sport model is a school-based oral health improvement programme that encourages children to swap sugar-sweetened beverages for tap water. It works through a partnership model: Councils commission the programme and target delivery, Health Equalities Group (HEG) coordinates the delivery of the programme, and the charitable foundations of professional sports clubs deliver it in schools.

Delivery focuses on schools in areas of higher deprivation, where tooth decay and excess weight are most prevalent. The programme has been commissioned by councils across England and has reached over 15,000  children. Evaluation shows significant shifts towards water across several settings.

Tooth decay is almost entirely preventable, yet it remains the most common reason children aged 5–9 are admitted to hospital. In 2024/25 there were more than 34,000 hospital extractions for decay in children and young people aged 0 to 19 in England at an estimated cost of £51.2 million . Decay accounts for the large majority of extractions in primary-school-age children, and the burden falls hardest on children in deprived communities, where extractions are more than three times the rate of the most affluent areas.

Children's free-sugar intake is more than double the recommended maximum. On average, children get around 10 per cent of their dietary energy from free sugars, and fewer than one in ten meet the recommended limit; sugar-sweetened drinks are among the largest contributors, particularly among teenagers . That limit – no more than 5 per cent of dietary energy – reflects clear evidence that free sugars, and sugar-sweetened drinks in particular, are major drivers of both tooth decay and excess weight . The GULP Sport model sets out to change this by shaping children's everyday routines, encouraging them to choose water at school, during sport and physical activity, at home, and in out-of-home settings.

The programme began in 2015 as a regional awareness-raising campaign led by HEG’s Food Active programme – a collaborative programme of council public health teams across the North West of England. The turning point came when a local council saw the potential for its football club’s charitable foundation to carry the message into primary schools. Community sports coaches were able to deliver messaging in a format that children engaged with. That insight was developed into a structured Key Stage 2 programme and has since been refined and scaled through partnerships with councils and clubs across the country.

• Reduce children’s consumption of sugar-sweetened beverages and establish water as the default choice across school, sport and home.
• Concentrate delivery in schools serving communities with higher levels of deprivation, where tooth decay and excess weight are most common.
• Improve children’s understanding of sugar, hydration and oral hygiene – without lecturing or moralising or overwhelming them with information.
• Give councils a deliverable, good-value prevention offer that supports local oral health, healthy weight and supervised toothbrushing initiatives and supports the best start in life for children.

The GULP Sport model is built on a three-way partnership:

• Local authorities commission and target delivery: Public health teams fund the programme, aligning delivery strategically to local action plans addressing healthier weight and/or poor oral health. Local public health intelligence, alongside national datasets including Indices of Multiple Deprivation (IMD), National Child Measurement Programme (NCMP), and National Dental Epidemiology Programme (NDEP), are synthesised to develop a detailed understanding of local need, shaping where delivery is focused.
• HEG coordinates the programme: Designs projects with commissioners, recruits and trains delivery partners, supplies delivery materials and resources, provides quality assurance and runs a standardised monitoring and evaluation framework. It also advises on targeting schools and cross-referencing school postcodes against the Index of Multiple Deprivation so that delivery is focused on the schools serving the most deprived neighbourhoods. This means a council can commission a quality-assured, well-targeted programme without having to build one in-house.
• Charitable foundations associated with professional sports clubs deliver the programme in primary schools: The charitable arms of professional football and rugby league clubs bring trusted coaches, the credibility of the club’s badge, and established relationships with local schools – reach and authenticity that health professionals often cannot replicate easily.

In the classroom, the programme has four sessions consisting of a launch assembly introducing a 21-day GULP Challenge, followed by three structured Key Stage 2 PSHE sessions – Tooth Titans, Sugar Detectives and Hydration Heroes – supported by reusable water bottles and consistent ‘water-first’ messaging. 

The partnership model is deliberately not tied to one type of place. Because delivery sits with charitable foundations that understand their local neighbourhoods, the programme can adapt to the communities each commissioning authority wants to reach; urban, coastal and rural alike. What stays constant is the focus on schools in areas of higher deprivation, since the oral health burden is concentrated there, whether in a city, a former industrial town, a coastal community or a rural area. Because targeting is done school by school – cross-referencing each school’s postcode against deprivation data – the programme can reach deprived school communities even within otherwise less-deprived areas.

A peer-reviewed evaluation of recent commissioned delivery, published in the British Dental Journal in 2026, examined 89 schools and 141 Year 3 classes, reaching around 4,230 children . Of the participating schools, 62 per cent were in the most deprived 30 per cent of neighbourhoods nationally, reflecting the programme’s equity focus. Among children with matched before-and-after data, the proportion choosing water rose significantly in every setting measured:

All changes were statistically significant (p<0.001). The largest gains were in school and sport – the settings the programme most directly shapes – and improvements were most pronounced among children in the most deprived communities, which is the programme’s central aim.

These results are consistent with earlier GULP Sport projects. Since 2016, more than a dozen community trusts have delivered the programme to over 15,000 children across England. Teachers and coaches consistently report that the change endures – classes filling water bottles each morning, and children still using them months and years later. The programme also brings an environmental benefit: reusable bottles replace single-use plastic, and sessions on plastic pollution link healthier hydration to children's concern for the environment.

A participating Year 3 teacher reflected: 

GULP has been great for our children. They really responded to the coaches coming in… my class now has a habit of filling their water bottles up in the morning and sipping throughout the school day.”

• Partnership is the model’s strength: Local commissioners identify need and provide funding, HEG coordinates the project and evaluates its impact, and a trusted organisation engages schools and delivers the programme to children.
• Trusted messengers matter as much as the message: Coaches and the club badge give the programme a credibility that classroom teaching alone can struggle to achieve.
• Making the healthy option the default – ‘water-first’ – works better than asking children to resist a long list of products they have no control over buying: Supplying water bottles gives children a tool to change their behaviour – something that is much more challenging when trying to address consumption of other high fat, sugar, and/or salt products as there is often no obvious substitute. 
• Consistent evaluation across sites builds a credible, transferable evidence base that supports future commissioning.

Because the programme is evidence-led, locally commissioned and demonstrably good value, it has been adopted by many local authorities with very different political administrations. Framing the offer around shared priorities – children’s health and opportunity, prevention, health harms and value for money – rather than any single policy agenda helps build consensus.
 

• Target by need, at school level: Cross-reference individual school postcodes with IMD data – alongside NCMP and NDEP intelligence – to prioritise the schools serving the most deprived neighbourhoods. A school-level approach reaches need that whole-district averages miss, including in coastal and rural communities.
• Work through trusted local institutions: A professional club’s charitable foundation brings reach, credibility and existing relationships with schools.
• Plan for the local context: Build travel, school size and scheduling into project design and costings, particularly for more dispersed communities.
• Align the offer to existing strategies – oral health, healthy weight and Core20PLUS5 – to strengthen the case for investment.
• Commission over multiple years where possible: Multi-year funding reduces the administrative burden of repeated commissioning and recommissioning, enables longitudinal evaluation that tracks change in the same schools and cohorts over time, and gives coordinating and delivery organisations the medium-term security to retain trained coaches, sustain school relationships and plan ahead.
   

As GULP Sport has scaled, its evaluation has developed alongside delivery, with consistent pre- and post-delivery surveys used across projects. The main opportunity now is to bring these datasets together. As the programme reaches more areas, pooling data across projects – supported by the multi-year, longitudinal commissioning recommended above – would create larger samples and more statistically powerful findings, allow change to be tracked over time in the same schools and children, and enable richer breakdowns by factors such as age, deprivation and setting. 

Protecting the integrity of the GULP brand is a growing priority for HEG and its partners. Because the programme is delivered through charitable organisations associated with professional sports clubs, HEG is introducing intellectual property agreements with delivery partners that set out clearly what club community organisations can and cannot use the GULP brand for. This safeguards the brand and its consistent “water-first” message, and guards against drift or undue influence – including from clubs’ own commercial sponsorships. 

The GULP Sport programme has grown steadily for a decade and is now embedded in several local oral health and healthy weight strategies. New commissioning authorities and delivery partners continue to join, extending the programme to new parts of England and to new sports. The model is scalable and good value, which matters as councils and the NHS face tighter budgets. Sustaining it will depend on continuing to position oral health as a core part of wider child health and prevention strategies, rather than a separate, siloed concern – and on the strength of the partnerships between coordinators, commissioners and clubs that make delivery possible.
 

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Viggars M, Patel R, Yusuf H, Philpott M. ‘Give Up Loving Pop’: reimagining oral health promotion through sport, social practice, and prevention. British Dental Journal 2026; 240: 297–302

Health Equalities Group website