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School food & beverage restrictions

Health Factors: Diet & Exercise
Decision Makers: Educators Local Government State Government Federal Government
Evidence Rating: Some Evidence
Population Reach: 10-19% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Competitive foods and beverages in schools can be limited through restrictions on foods not provided through the National School Lunch Program. Such restrictions can include items sold as à la carte options, in vending machines, school stores, or at fundraisers, and can be a full ban or a limit on sale times.

Expected Beneficial Outcomes

Improved dietary choices
Reduced unhealthy food sales
Reduced unhealthy food consumption
Reduced sweetened beverage consumption

Evidence of Effectiveness

There is ­­­­­­­­­­­­­­­­­­­­­some evidence that limiting access to competitive foods and beverages in schools leads to healthier diets among children (Cradock 2011, Fernandes 2008, Gonzalez 2009, Jaime 2009, Larson 2010). Additional evidence is needed to confirm the magnitude of these effects.

Limiting access to unhealthy foods has been associated with significant but small reductions in unhealthy food sales (Jaime 2009, Taber 2011, Neumark-Sztainer 2005). Among middle school students, such policies appear to decrease consumption of foods with low nutritional value at school, without an offsetting increase in consumption at home (Schwartz 2009). Adolescents with access to competitive foods through school cafeteria snack bars consume fewer healthy foods and nutrients than those without access to such foods (Cullen 2004, Templeton 2005). However, policies limiting access to unhealthy foods do not appear to increase fruit and vegetable consumption (Vericker 2013).

Limits on sugar sweetened beverages and snacks have been shown to increase consumption of healthy foods and milk in some circumstances (Gonzalez 2009, Whatley-Blum 2008). Efforts to restrict the availability of sugar sweetened beverages have been shown to reduce consumption for kindergarteners (Fernandes 2008) and high school students in Boston (Cradock 2011), but a study of middle schoolers finds no such reduction (Taber 2011). In a study of 5th and 8th grade students, competitive beverage availability was associated with increased consumption of sweetened beverages among males, minorities, and children living in poverty (Vericker 2013).

States with strong laws governing competitive food nutrition content across grade levels may reduce adolescent body mass index (BMI) increases and the likelihood of adolescents remaining overweight (Taber 2012). A California-based study connects policies limiting access to competitive foods with improvements in overall overweight trends in 5th grade boys and 7th graders in CA (Sanchez-Vaznaugh 2010); however, other studies do not show an association between competitive food sales and weight gain for children in grades 5 through 8 (Van Hook 2012).

Implementation

United States

As of 2012, 39 states have policies with nutrition standards for competitive foods (CDC-Competitive foods 2012). As of 2004, only 39% of the nation’s largest school districts restricted competitive food sales (Larson 2007).

Wisconsin

Wisconsin has no state limitations regarding access to competitive foods. However, all school districts are required to write wellness policies, many of which might include some limitations on competitive foods.

Several school districts in Wisconsin ban sugar sweetened beverages throughout the day, and others place limits on competitive foods during lunch hours: examples include Lac du Flambeau, Appleton, and Marshfield. The Platteville school district does not allow items that are in direct competition with the National School Lunch program (Fox 2005a).

Implementation Resources

CDC MMWR-School health guidelines 2011 - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH). School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report (MMWR). 2011:60(RR-05):1-71. Accessed on December 7, 2015

Citations - Evidence

Cradock 2011 - Cradock AL, McHugh A, Mont-Ferguson H, et al. Effect of school district policy change on consumption of sugar-sweetened beverages among high school students, Boston, Massachusetts, 2004-2006. Preventing Chronic Disease. 2011;8(4):A74. Accessed on December 8, 2015
Cullen 2004 - Cullen KW, Zakeri I. Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school. American Journal of Public Health. 2004;94(3):463–7. Accessed on December 8, 2015
Fernandes 2008* - Fernandes MM. The effect of soft drink availability in elementary schools on consumption. Journal of the American Dietetic Association. 2008;108(9):1445-52. Accessed on February 5, 2016
Gonzalez 2009 - Gonzalez W, Jones S, Frongillo E. Restricting snacks in US elementary schools is associated with higher frequency of fruit and vegetable consumption. Journal of Nutrition. 2009;139(1):142–4. Accessed on February 5, 2016
Jaime 2009* - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53. Accessed on March 14, 2016
Larson 2010 - Larson N, Story M. Are “competitive foods” sold at school making our children fat? Health Affairs. 2010;29(3):430–5. Accessed on November 23, 2015
Neumark-Sztainer 2005 - Neumark-Sztainer D, French SA, Hannan PJ, Story M, Fulkerson JA. School lunch and snacking patterns among high school students: associations with school food environment and policies. International Journal of Behavioral Nutrition and Physical Activity. 2005;2(1):14. Accessed on March 1, 2016
Sanchez-Vaznaugh 2010* - Sanchez-Vaznaugh EV, Sánchez BN, Baek J, Crawford PB. 'Competitive' food and beverage policies: Are they influencing childhood overweight trends? Health Affairs. 2010;29(3):436-46. Accessed on May 20, 2016
Schwartz 2009* - Schwartz MB, Novak SA, Fiore SS. The impact of removing snacks of low nutritional value from middle schools. Health Education & Behavior. 2009;36(6):999–1011. Accessed on January 28, 2016
Taber 2011* - Taber DR, Chriqui JF, Powell LM, Chaloupka FJ. Banning all sugar-sweetened beverages in middle schools: Reduction on in-school access and purchasing but not overall consumption. Archives of Pediatrics & Adolescent Medicine. 2012;166(3):256-62. Accessed on November 9, 2015
Taber 2012 - Taber DR, Chriqui JF, Perna FM, Powell LM, Chaloupka FJ. Weight status among adolescents in States that govern competitive food nutrition content. Pediatrics. 2012;130(3):437–44. Accessed on May 24, 2016
Templeton 2005* - Templeton SB, Marlette MA, Panemangalore M. Competitive foods increase the intake of energy and decrease the intake of certain nutrients by adolescents consuming school lunch. Journal of the American Dietetic Association. 2005;105(2):215–20. Accessed on May 24, 2016
Van Hook 2012 - Van Hook J, Altman CE. Competitive food sales in schools and childhood obesity: A longitudinal study. Sociology of Education. 2012;85(1):23–39. Accessed on May 24, 2016
Vericker 2013* - Vericker TC. Limited evidence that competitive food and beverage practices affect adolescent consumption behavior. Health Education & Behavior. 2013;40(1):19–23. Accessed on November 20, 2015
Whatley-Blum 2008* - Whatley Blum JE, Davee A-M, Beaudoin CM, et al. Reduced availability of sugar-sweetened beverages and diet soda has a limited impact on beverage consumption patterns in Maine high school youth. Journal of Nutrition Education and Behavior. 2008;40(6):341-7. Accessed on November 17, 2015

Citations - Implementation

CDC-Competitive foods 2012 - Centers for Disease Control and Prevention (CDC). Competitive foods and beverages in US schools: A state policy analysis. Atlanta: US Department of Health and Human Services (US DHHS); 2012. Accessed on March 3, 2017
Fox 2005a - Fox S, Meinen A, Pesik M, Landis M, Remington PL. Competitive food initiatives in schools and overweight in children: A review of the evidence. Wisconsin Medical Journal. 2005;104(5):38-43. Accessed on February 5, 2016
Larson 2007 - Larson N, Story M. School foods sold outside of meals (competitive foods). Minneapolis: Healthy Eating Research; 2007. Accessed on November 9, 2015

Page Last Updated

January 19, 2014

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