- Author: Danielle L. Lee
- Contributor: Gail Woodward-Lopez
A new study from University of California researchers suggests that most fast food restaurants in low-income neighborhoods in California are not offering beverages online in a way that is consistent with the state's healthy beverage law for children's meals sold on the restaurant's website and popular online ordering platforms like DoorDash, GrubHub, and UberEats. California's Healthy-By-Default Beverage law requires restaurants to offer only plain or sparkling water with no added sweeteners, unflavored milk or unflavored non-dairy milk as the default beverage in children's meals. The law also requires that menus, menu boards and advertisements for children's meals include only approved default options. Researchers found that less than six percent of the observations they made on the online ordering platforms of 245 fast food restaurants across low-income California neighborhoods were offering children's meal beverages that were consistent with the Healthy-By-Default Beverage law in its most restrictive interpretation. This is cause for concern as online ordering platforms are gaining popularity. The study was published online in the journal Public Health Nutrition by Nutrition Policy Institute researchers Hannah Thompson, Anna Martin, Ron Strochlic, Sonali Singh, and Gail Woodward Lopez as part of the NPI CalFresh Healthy Living evaluation.
In the United States, over 25 million people work and learn at colleges and universities, consuming an untold number of meals, snacks, and beverages while on campus. Unlike in K-12 schools, higher education institutions are not governed by federal policies to ensure that foods and beverages sold on campus meet minimum nutrition standards. While many universities participate in voluntary campus wellness initiatives, only one university–the University of California (UC), Berkeley–has officially adopted a comprehensive, campus-wide nutrition policy, the Food and Beverage Choices (FBC) Policy. Researchers at the UC Nutrition Policy Institute and UC Berkeley collaborated with the FBC policy implementation team to publish a case report in the Journal of Nutrition Education and Behavior, presenting detailed information on the development, establishment, implementation and evaluation of the FBC policy. The report includes discussion of the challenges and barriers encountered during policy implementation and offers valuable insight for other universities seeking to develop and implement their own nutrition policies. The report was developed by Zachary Rickrode-Fernandez of Center for Environmental Health and UC Berkeley, Janice Kao of the UC Nutrition Policy Institute, and Mary Lesser and Kim Guess of UC Berkeley.
California's 2010 Healthy Beverages in Child Care Act (AB2084) specifies that only unflavored low-fat milk or nonfat milk be served to children aged 2 years or older, allows no more than 1 daily serving of 100% juice, prohibits beverages with added sweeteners, and requires that safe drinking water be readily accessible throughout the day in all licensed California (CA) child care centers and family child care homes. A state-wide survey of CA child care providers conducted in 2016 by the University of California, Nutrition Policy Institute (NPI) suggested that less than half (45%) of providers fully adhered to the beverage policy. Researchers at NPI partnered with the UCSF School of Nursing, California Childcare Health Program and UC Division of Agriculture and Natural Resources (UC ANR) Cooperative Extension (CE), with support from a UC ANR grant, to develop a brief online training in English and Spanish for providers to increase adherence with the policy. Researchers evaluated the online training, 'Healthy Beverages in Early Care and Education', combined with six months of ongoing technical assistance from CE nutrition educators. The study enrolled 65 licensed child care providers in California. Results suggest that the online training can improve providers' awareness of the policy and knowledge of healthy beverage practices; however, it may not improve providers' adherence to the policy. Further, it suggests that additional technical assistance from CE nutrition educators beyond 6-months may be required to further increase awareness, knowledge, and policy adherence. Results from the study were published in the Journal of Nutrition Education and Behavior on June 1, 2021. The study was conducted by NPI researchers Danielle Lee, Kaela Plank, Hannah Thompson, Christina Hecht and Lorrene Ritchie in collaboration with Marisa Neelon from UC ANR, Karina Díaz Rios from UC Merced, and Abbey Alkon from the UCSF School of Nursing. The training is available online for free in English and Spanish for California child care providers, and for $15 for providers located outside of California.
Lorrene Ritchie, director and cooperative extension specialist, and Gail Woodward-Lopez, director of research at the UC ANR Nutrition Policy Institute (NPI) were quoted in an August 25, 2020 article in Morning Ag Clips titled "New policies can help provide healthy beverages to children." The article highlights California's Healthy Default Beverage law, California State Senate Bill 1192, which requires that all restaurants in California as of January 6, 2019 offer only healthy beverages -- plain water or unflavored milk -- as the default beverage with kids' meals. The article also highlights research findings from NPI researchers in collaboration with University of Delaware on the impact of the law in California and a similar law in Wilmington, Del. Dr. Ritchie is quoted, "Parents look at menu boards and kids look at menu boards, but it is likely that what the cashier says also influences which drink they choose. In our data collection, we would order a kids' meal and wait for them to offer a drink. But mostly they said, ‘What drink do you want?' instead of ‘Do you want water or milk with that?'”. Woodward-Lopez is quoted, “NPI in partnership with the California Department of Public Health is working with some local health departments to provide training and materials to help restaurants comply with the letter and spirit of the law. Our next step is to measure whether this health department support is effective. The role of default beverage policies in this context is important and not well understood.” Read the full article online.
At fast food and sit-down restaurants across California, kids' meals come with water or milk automatically. At least, that should be the case since state law requires restaurants to offer the healthy beverages by default to reduce the amount of sugary beverages served to children. California Senate Bill 1192, authored by Sen. Bill Monning (D-San Luis Obispo), went into effect in January 2019, but research by the UC ANR Nutrition Policy Institute (NPI) has found that implementation has not been universal. The results, along with results from a similar study in Wilmington, Del., were published in an issue brief Aug. 20 on HealthyEatingResearch.org. Before the law, 10% of menu boards observed by the researchers in California list only the healthy beverages. Data collected after the law went into effect showed 66% of menu boards list the healthy default beverages. NPI researchers also collected data on the proportion of cashiers who verbally offered only healthy beverages with kids' meals when orders were placed. This happened only 5% of the time before the law was enacted, and dropped to 1% after. The law doesn't specify whether the cashier must offer the default beverages, but the spirit of the law suggests they should, as it would likely have a greater impact on the selections that children and parents make. In interviews with NPI researchers, most restaurant managers expressed support for the legislation, but didn't know much about it. The research brief was written by NPI researchers Lorrene Ritchie, Phoebe Harpainter, Marisa Tsai, Gail Woodward-Lopez and Wendi Gosliner in collaboration with lead author Allison Karpyn and Laura Lessard, Jesse Atkins, Kathleen McCallops and Tara Tracy of the University of Delaware. The research was funded by the Robert Wood Johnson Foundation and by the California Department of Public Health with funding from the United States Department of Agriculture. Read the full research brief online.
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