Over 40% of US children ages 2-5 years consume sugar-sweetened beverages (SSB), a concerning statistic given SSB are a leading contributor to child obesity. One-in-three children eat at quick-service restaurants on any given day and policies that require restaurant kids' meals to offer only healthy default beverages are one strategy to improve children's beverage intake. Researchers at the University of California (UC) Nutrition Policy Institute and the University of Delaware Center for Research in Education and Social Policy recently examined restaurant beverage offerings in 111 quick-service restaurants in California and 16 quick- and full-service restaurants in Wilmington, Delaware before and after restaurant healthy default beverage policies were implemented. California law, SB1192, requires that only water and unflavored milk or a non-dairy equivalent be offered with restaurant kids' meals. The Wilmington policy, ordinance no. 18-046, allows for flavored milk and unsweetened 100% juice or juice diluted with water in addition to the beverages allowed in California. Observations of restaurant menus showed improvement from 2019 to 2020 in beverages offered with kids' meals in California, but not in Wilmington, post-policy. However, during orders of kids' meals, only 1% of restaurant cashiers or servers offered the healthy default beverage in California and none in Wilmington after the policies went into effect. Less than one in four restaurant managers interviewed in California knew about the beverage policy, and none did so in Wilmington, despite most managers in both California and Wilmington expressing support for the policy. This study suggests the need for additional efforts to strengthen the implementation of kids' meal beverage policies. The study was published in the journal Public Health Nutrition by NPI researchers Lorrene Ritchie, Phoebe Harpainter, Marisa Tsai, Gail Woodward-Lopez and Wendi Gosliner in collaboration with Tara Tracy, Kathleen McCallops and Allison Karpyn from the University of Delaware and Isabel Thompson from UC Berkeley. The study was funded by the California Department of Public Health, with funding from the United States Department of Agriculture's Supplemental Nutrition Assistance Program – USDA SNAP, a grant to Duke University from the Robert Wood Johnson Foundation and the University of California, Division of Agriculture and Natural Resources.
The American Public Health Association (APHA) Annual Meeting and Expo is the largest yearly gathering of public health professionals. This year, the annual meeting is being held virtually October 24-28, 2020. Researchers from the University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute will be presenting their work on a variety of collaborative food and nutrition policy studies related to the child care food environment, school meals, the federal Supplemental Program for Women, Infants and Children (WIC), and more. A full list of on-demand poster presentations and live oral presentations is below.
Child care food environment:
- California childcare centers and homes in the federal child and adult care food program offer more nutritious foods to infants
Presenters: Danielle Lee, Klara Gurzo, Lilly Nhan, Elyse Homel Vitale, Sallie Yoshida, Lorrene Ritchie
Poster presentation - Online training increases child care provider knowledge of healthy beverage policy and practices for young children
Presenters: Kaela Plank, Danielle Lee, Abbey Alkon, Marisa Neelon, L. Karina Diaz Rios, Katherine Soule, Lorrene Ritchie
Poster presentation
School meals:
- Impact of a district-wide chocolate milk removal policy on students' milk selection and consumption
Presenters: Hannah Thompson, Lorrene Ritchie, Kristine Madsen, Esther Park, Wendi Gosliner
Oral presentation, Wednesday, October 28, 2020, 8:15-8:30 AM PDT
WIC:
- Families with children 1-5 years old: WIC program perspectives on nutrition education and food benefits
Presenters: Marisa Tsai, Lorrene Ritchie, Shannon Whaley, Catherine Martinez, Martha Meza, Lauren Au, Hallie Randel-Schreiber, Susan Sabatier
Oral presentation, Wednesday, October 28, 2020, 8:00-8:15 AM PDT - Children on WIC followed through age 4 years: What are they eating?
Presenters: Lorrene Ritchie, Lauren Au, Shannon Whaley, Christine Borger
Oral presentation, Wednesday, October 28, 2020, 9:30-9:50 AM PDT - Feeding beliefs and practices among low-income caregivers: Findings from year 4 of the WIC infant and toddler feeding practices study-2
Presenters: Courtney Paolicelli, Christine Borger, Lorrene Ritchie, Shannon Whaley
Oral presentation, Wednesday, October 28, 2020, 9:50-10:10 AM PDT
- Prevalence of overweight and obesity among children receiving WIC
Presenters: Christine Borger, Shannon Whaley, Lorrene Ritchie
Oral presentation, Wednesday, October 28, 2020, 10:10-10:30 AM PDT - Longer participation in WIC is associated with healthier outcomes for children at age 4 years
Presenters: Shannon Whaley, Christine Borger, Lauren Au, Lorrene Ritchie
Oral presentation, Wednesday, October 28, 2020, 10:30-10:50 AM PDT
Other topics:
- Exploring housing and food insecurity among California university students: A holistic and comprehensive definition of students' basic needs
Presenters: Suzanna Martinez, Erin Esaryk, Laurel Moffat, Lorrene Ritchie
Oral presentation, Tuesday, October 27, 12:00-12:15 PM PDT - Healthy default beverages in kids' meals: Evaluating policy implementation and impact in California and Delaware
Presenters: Allison Karpyn, Wendi Gosliner, Laura Lessard, Kathleen McCallops, Marisa Tsai, Tara Tracy, Phoebe Harpainter, Danielle Lee, Anna Martin, Lorrene Ritchie, Gail Woodward-Lopez
Oral presentation, Tuesday, October 27, 4:45-5:00 PM PDT - Perceived produce availability and child fruit and vegetable intake: The healthy communities study
Presenters: Laurel Moffat, Lorrene Ritchie, Wendi Gosliner, Kaela Plank, Lauren Au
Oral presentation, Wednesday, October 28, 2020, 10:15-10:30 AM PDT - Limited progress found in healthy checkout among food stores in economically disadvantaged California neighborhoods, 2011-2017
Presenters: Wendi Gosliner, Sriddharshi Hewawitharana, Janice Kao, Sadie Costello, Gail Woodward-Lopez
Poster presentation - A replication study of school-based SNAP-ed programmatic efforts to address student nutrition and physical activity outcomes
Presenters: John Pugliese, Lauren Whetstone, Sridharshi Hewawitharana, Gail Woodward-Lopez
Poster presentation
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.
- Author: Danielle L. Lee
A recent study by Nutrition Policy Institute (NPI) researchers assessed differences in quick-service, or fast-food, restaurants with and without voluntary healthy default beverage standards for kids' meals. ‘Voluntary standards' are restaurant commitments to offer healthier drinks with kids' meals. Researchers evaluated the beverages shown on kids' meal menu boards, beverages offered by cashiers with kids' meals, and kids meal beverages selected by customers in 111 quick-service restaurants--70 with voluntary standards and 41 without--in SNAP-Ed eligible neighborhoods in 11 California counties. Data was collected by menu board and cashier order observations and customer surveys in December 2018 prior to the January 2019 implementation of a new California law (SB-1192) that requires all restaurants offering a kids' meal make the default beverage offered water, unflavored milk or a nondairy milk alternative and that only these beverages be displayed on kids' meal menus or advertisements.
Results from the study showed that significantly more quick-service restaurants with voluntary healthy default beverage standards for kids' meals offered unflavored milk or water on their menu boards compared to restaurants without voluntary standards. Customers at restaurants with voluntary standards reported purchasing healthier drinks and less soda compared with customers at restaurants without voluntary standards. These results suggest the voluntary healthy default beverage standards were effective at positively influencing restaurant practices and customer behavior. However, not all quick-service restaurants followed their own standards and much room for improvement remains. Additional intervention may be necessary to support full implementation of the standards and to maximize the impact on customer behavior and jurisdictions passing healthy default beverage laws for restaurant kids' meals may need to provide education and outreach alongside enforcement to ensure full implementation. The study was published online on July 22, 2020 in the International Journal of Environmental Research and Public Health by NPI researchers Phoebe Harpainter, Sridharshi Hewawitharana, Danielle Lee, Anna Martin, Wendi Gosliner, Lorrene Ritchie and Gail Woodward-Lopez. Read the full study online.
