Beverages in School by Shortie McKinney, PhD, RD, LDN, FADA and Jane Thompson, RD, LDN - December 2005

 

In the past few years, increasing focus has been placed on beverage choice in school. This has been prompted by the suspected relationship of the consumption of sugar-sweetened beverages (i.e., soda) on body weight of children and adolescents.(1) For further information on the subject of sweetened beverage intake and overweight visit the Evidence Analysis Library (EAL) of the American Dietetic Association at: www.adaevidencelibrary.com/evidence.cfm?evidence_summary_id=28.

Overweight and obesity are major problems for youth in the US, with NHANES 1999 to 2002 data estimating that 16 percent of US children (6 years to 19 years) are overweight.(2) Data from the US Department of Agriculture (USDA) Continuing Surveys of Food Intakes by Individuals (CSFII) shows that about 66 percent of boys and 56 percent of girls (12 years to 17 years) drink one or more “regular” soft drinks daily.(3) Soft drinks may displace milk and possibly juice intakes in children and adolescents.(4) Additionally, research has shown soda may replace other nutritive beverages and contribute to low intakes of calcium, magnesium, riboflavin, vitamin A and vitamin C;(5) higher soda intake may result in higher kcal intake, which in turn may contribute to childhood obesity.(4,6) Soda and sugar-sweetened drinks are readily available in many schools across the US, leading to an increasingly unhealthful environment in schools nationwide.

The School Health Policy and Programs Study 2000 reveals that 43 percent of elementary, 74 percent of middle/junior high and 98 percent of senior high schools surveyed have a vending machine or a school store, canteen or snack bar. In 76.3 percent of schools surveyed with vending machines or school stores, canteens or snack bars, students can purchase soft drinks, sports drinks or fruit drinks that are not 100 percent fruit juice. Nearly 50 percent of school districts have “pouring” contracts that give a company exclusive rights to sell soft drinks in the district;(7) these contracts provide funding for school programs. In the American Public Health Association’s policy statement regarding food marketing and advertising to children, soda contracts are seen as “promoting the purchase and consumption of low-nutrient-dense beverages while children are captive in an environment that is dedicated to education.”(8) The presence of vending machines, with appealing but low-nutrient dense foods, may encourage eating habits that are not consistent with nutrition recommendations.(9)

Many school districts have enacted nutritional guidelines for beverages sold during the school day to improve the environment within schools and positively impact student health. The small town of Appleton, WI was one of the first school districts to enact a policy specific to the sale of particular beverages.(10) Soon thereafter, the New York City Department of Education (June 2003), the Los Angeles Unified School District (January 2004) and the School District of Philadelphia (June 2004) adopted more restrictive guidelines for sale of foods and beverages sold in all schools.(11,12,13) Beverage guidelines vary but typically allow only 100 percent juice, water and milk to be sold throughout the school day. Use of fruit juice drinks and sports drinks, as well as diet drinks and caffeinated beverages varies from one school district to another.

Some school districts are interested in measuring impacts of policy change among students; however, little data is available on this subject. One recent study presented by Spangler(14) at the Society for Nutrition Educators conference examined the impact of a beverage policy instituted in a West Virginia school district. Fewer students purchased beverages at vending machines and a small increase was found in the number of drinks bought outside of school.(14) An evaluation of the beverage policy of the School District of Philadelphia found that although many high school students (grades 9 to 12) do not like the policy change, over 60 percent of students believe that the policy may impact their beverage choices.(15) Fewer students (10 percent) stated they bought beverages elsewhere than predicted at pre-policy, implying that convenience is a factor that should not be discounted in beverage selection. Findings also suggest that financial impacts of policy change may not be as dramatic for school districts as once thought.

The beverage industry has responded to the policy changes in schools in a variety of ways. To provide alternatives for vending, new products that comply have been added and packaging has been updated to be more attractive to children and adolescents. Beverage companies have also developed educational materials to help promote healthy beverage purchases. One of the most important responses has been the development of a voluntary beverage policy to restrict sales of carbonated soft drinks in schools.(16) The voluntary policy allows for vendors to sell only water and 100 percent fruit juice in elementary schools. Under policy, diet sodas, water, 100 percent juice, dairy-based drinks and diet juice drinks can be sold in middle schools and full calorie sodas and juice “drinks” can be made available after school hours. In high schools, where most beverage revenue is generated,(7) ABA policy states that students will be offered a variety of beverages including water, sports drinks, 100 percent juice and fruit “drinks”. Policy also allows for no more than 50 percent of the vending slots to be filled with carbonated soft drinks.(16)

The topic of school district beverage policies is a very new topic, with little published research. As more school districts implement school wellness policies(17) or specific beverage policies limiting the sale of sodas, hopefully more research will surface supporting the positive impacts of beverage policy change. Efforts to date may be useful in school districts nationwide as they strive to make similar changes in their school food service.


REFERENCES

  1. Sweetened Beverage Intake and Childhood Overweight. American Dietetic Association Evidence Analysis Library Web site. Available at: www.adaevidencelibrary.com/evidence.cfm?evidence_summary_id=28. Accessed November 8, 2005.
  2. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004;291(93):2847-2850.
  3. USDA Food Surveys Research Group. Food and nutrient intakes by children 1994-1996, 1998 Table set 17. USDA Agricultural Research Service Web site. Available at: www.ars.usda.gov/Services/docs.htm?docid=7716. Accessed June 14, 2004.
  4. Harnack L, Stang J, Story M. Soft drink consumption among US children and adolescents: nutritional consequences. J Am Diet Assoc. 1999;99(4):436-441.
  5. Guenther P. Beverages in the diets of American teenagers. J Am Diet Assoc. 1986;86:493-499.
  6. Berkey C, Rockett H, Field A, Gillman M, Colditz G. Sugar-added beverages and adolescent weight change. Obesity Research. 2004;12(5):778-788.
  7. Wechsler H, Brener N, Keuster S, Miller C. Food service and foods and beverages available at school: results from the School Health Policies and Programs Study 2000. Journal of School Health. 2001;71(7);313-324.
  8. Policy statement 2003-17 on food marketing and advertising directed at children and adolescents: implications for overweight. American Public Health Association Web site; 2003 Policy Statements. Available at: www.apha.org/legislative/policy/2003/2003-017.pdf. Accessed March 5, 2005.
  9. Marie S, Hunt A, Gerald B, Murimi M. Vending machine practices in Louisiana high schools. The Journal of Child Nutrition and Management. 2004;28(1).
  10. Appleton School District Beverage Policy. Appleton School District Web site. 2003. Available at: www.aasd.k12.wi.us/SBA/Policies/341.34Student%20Nutrition%20Policy%20_June%209%202003_pdf. Accessed December 1, 2004.
  11. Regulation of the Chancellor, number A-812. New York City Department of Education. Available at: http://docs.nycenet.edu/dscgi/admin.py/Get/File-487/A-812.pdf. Accessed December 3, 2004.
  12. LA Unified School District Beverage Policy. LA Unified School District Web site. Available at: cafe-la.lasud.k12.ca.us/healthy.htm. Accessed September 2, 2004.
  13. Beverage Policy for the School District of Philadelphia. School District of Philadelphia Web site. Available at: www.philsch.k12.pa.us/offices/foodservices/bevpol04.pdfAccessed December 1, 2004.
  14. Serrano E, Spangler J, Hosig K. Changes in teen beverage consumption as a result of school policy change. Presented at: The Society for Nutrition Educators; July 23-27, 2005; Orlando, FL.
  15. Thompson J, Lim S, Nachmani J, McKinney S. Evaluation of a Beverage Policy Among Philadelphia Foodservice Managers and High School Students. Paper presented at: The Society for Nutrition Educators; July 23-27, 2005; Orlando, FL.
  16. Beverage industry school vending policy. American Beverage Association Web site. 2005. Available at: www.americanbeverageassociation.com/schools/vending_policy.asp. Accessed August 25, 2005.
  17. American Dietetic Association Wellness Policies. American Dietetic Association Web site. Available at: www.eatright.org/ada/ada/files/ADAWellnessPolicy.ppt. Accessed November 10, 2005.