Drinking sugar-sweetened beverages (SSB), instead of plain water, is associated with poorer health outcomes and a higher risk of developing diet-related chronic diseases. However, public distrust of the local water supply may deter the intake of plain drinking water. A recent study investigated the perceptions of tap and bottled water safety, as well as plain water and SSB intake of participants following reports on drinking water quality violations in the US, specifically the Flint water crisis. Researchers used survey data on 4,041 American adults in 2018. They found that 1 in 7 adults did not think their tap water at home was safe to drink, 2 in 5 adults thought bottled water was safer than tap water, and 1 in 4 adults did not like the taste of their local tap water. Those with negative perceptions of tap water safety and taste reported low tap water intake and were more likely to consume bottled water. The study also identified an association between perceiving bottled water as safer than tap water and a higher SSB intake. This research provides guidance for effective interventions to promote water consumption and address perceptions of water safety. The study was published in the American Journal of Public Health Promotion by the following researchers: Sohyun Park, Stephen Onufrak, and Heidi Blanck of the Centers for Disease Control and Prevention, Angie Cradock of Harvard T.H. Chan School of Public Health, Anisha Patel of Stanford University, and Christina Hecht of the Nutrition Policy Institute.

Healthy default beverage laws require restaurants to list healthier beverages—such as water or unflavored milk as opposed to sugary drinks—as the default option for children's meals. These laws intend to address unhealthy beverage consumption by young children, directing consumers toward healthier beverage choices at no additional cost. New research evaluates the adherence of children's meals to healthy default beverage laws from online restaurant meal ordering platforms available in Los Angeles, Baltimore, and New York City. Among over 100 of the top-grossing restaurant chains sampled, fewer than 3% of online children meal orders in any jurisdiction adhered to the strictest interpretation of the healthy default beverage laws. Varying adherence to healthy default beverage laws by jurisdiction was found and may be attributable to differing definitions of a healthy beverage. For example, California's law considers non-flavored milk and water as healthy default beverage options, while Baltimore and New York laws also allow 100% juice and flavored milk. Policy can be optimized by clearly defining  healthy beverages, bundled children's meals, and what constitutes adherence to the law for online ordering platforms. The study, published in the American Journal of Preventative Medicine, was conducted by Daniel Zaltz and Sara Benjamin-Neelson of Johns Hopkins Bloomberg School of Public Health, Danielle Lee, Gail Woodward-Lopez, and Lorrene Ritchie of the Nutrition Policy Institute, and Sara Bleich of Harvard T.H. Chan School of Public Health with partial support from a grant from the National Institutes of Health (no. T32DK062707).

A new research brief developed by the Nutrition Policy Institute describes a study that identified limited implementation of California's Healthy Default Beverage Law (SB 1192) for orders made online. The law requires restaurants selling children's meals that include a beverage to make the default beverage water, sparkling water, flavored water with no added natural or artificial sweeteners, or unflavored milk or non-dairy milk alternative. Researchers randomly sampled 226 fast food restaurants located in Supplemental Nutrition Assistance Program-Education (SNAP-Ed) eligible census tracts in California and “ordered” 631 kids' meals from restaurant websites and three popular online ordering platforms. Researchers recorded beverage offerings as well as additional charges (“upcharges”) for beverages. Findings indicate that only 6% of orders reflected optimal implementation of the Healthy-by-Default Beverage law. Further, 41% of orders that offered water had an upcharge ($0.51 on average) and 11% of orders that offered unflavored milk had an up charge ($0.38 on average). No observations had upcharges for soda. The findings indicate that, in order to support California's SNAP-Ed goal for reducing sugar sweetened beverage intake, specific language, monitoring, and future legislation may be necessary to ensure the law is applied to online-ordering and in-restaurant self-service kiosks. The study and research brief were authored by NPI's Cal Fresh Healthy Living Evaluation Unit, including Hannah Thompson, Ron Strochlic, Sonali Singh, Kaela Plank, Anna Martin, and Gail Woodward-Lopez.

A new study from the Prevention Research Center on Nutrition and Physical Activity at the Harvard T.H. Chan School of Public Health and the University of California's Nutrition Policy Institute found that in 2016-2018, many students in the US attended public schools that did not have a drinking water lead-testing program in place. Of the seven states in this study, only one was found to require schools to test for lead, though all seven states included some level of guidance on what to do when lead concentrations are too high. Drinking water is important for proper hydration and oral health and can serve as a substitute for sugary drinks. Unsafe drinking water can lead to a variety of negative impacts on health. Moreover, if students and families are not assured that water has been tested and found safe, they may avoid drinking it. Improving federal guidance, educating school staff, and increasing technical and financial support for more widespread testing programs can reduce students' lead exposure. The study was published in the American Journal of Public Health. Researchers include Angie Cradock, Jessica Barrett, Chasmine Flax, and Mary Kathryn Poole from the Harvard T. H. Chan School of Public Health, Laura Vollmer from the University of California, Division of Agriculture and Natural Resources, and Christina Hecht with the Nutrition Policy Institute. The research was supported by Healthy Eating Research (grant 280-0799), the Centers for Disease Control and Prevention (U48DP006376), and a training grant in nutrition from the National Institutes of Health (DK 007703–22).