Banning Soda Isn't Enough

It took the whole village a few decades to create the obesity epidemic. We slowly allowed the development of a food environment in which junk, fast and highly processed foods became available everywhere and anytime. Marketing and advertising of these food products permeated every real and virtual space making every moment and every deed a consumption occasion.

When we noticed that obesity rates among kids tripled and looked at what kids consumed, it was shocking to see that sugar sweetened beverages contribute about 300 (empty) calories a day to a teen's diet, making them the single largest source of added sugar. Indeed, sugary drinks have become a way of life, and their makers make sure fueling stations are densely spread so a kid would never have to go without.

And since so much time is spent at school, where kids are a captive and impressionable audience, school became another sugary drink fueling station. Vended sugary drinks offered schools a source for much needed funds, and so developed the unholy union between the companies that want to imprint their brand's image in kids' minds and the institution that's trusted to teach kids critical thinking and prepare them for a healthy and productive life.

Does changing the vending machine's content change kids' habits?

When the Institute of Medicine called for the removal of all sweetened beverages from schools and the American Academy of Pediatrics advised theirelimination, some school districts and states did nothing, some opted to replace soda with lower-sugar options, such as sports drinks and vitamin water, and other cities and states went further and placed all-out bans on sweetened drinks.

A new study published in the Archives of Pediatrics and Adolescent Medicineexamines the effect of different policies using data gathered from almost 7000 middle school students from 40 states; 22 of these school districts had no policy governing sales of sugary drinks in middle schools, 11 banned sales of soda only allowing all other sugary drinks, and 7 banned all sugary drinks, including sports drinks and fruit drinks (but not 100% fruit juice).

So how would you expect the kids to respond to the different vending policies?

I think no one would be surprised to hear that in schools that banned only soda, kids bought the other vended sugary beverages instead. Banning soda did nothing to reduce sugary drink consumption in schools with a partial policy.

But here's an even more discouraging result: In schools that banned all sugary drinks kids indeed consumed fewer sugary drinks at school, but their consumption did not decrease overall; kids were able to find sugary drinks out of school, and filled the sugar gap before and after school.

In other words, school vending policies only changed the school environment, and didn't seem to be enough to change kids' access and behavior overall.

So are school policies useless?

It will take a village

The study authors, led by Daniel Taber, suggest it would take a comprehensive alteration of kids' environment to change their sugary drink habits

"Experts have recommended broader policies, such as SSB (sugar-sweetened beverage) taxes or regulations of food marketing aimed at children. Future research should explore the effect that school-based policies have on youth diet and weight gain when implemented in conjunction with policies in other sectors."

It would be naive to expect that changes at school can result in instant improvement when other sectors aren't cooperating.

But there's enormous value in creating a healthy school environment.

Giving a yellow card to kids shouting obscenities on the athletic field doesn't guarantee the same words won't be used when refs are out of earshot, but it still does teach kids sportsmanship - this is as much as we should expect from our schools. Teaching kids good nutrition doesn't guarantee they'll eat well given the many unhealthy options all around them, but demonstrating through a school policy that chips and a sports drink aren't food sends an educational message. Schools should be parents' partners in teaching healthy eating habits. But schools can't to do it all on their own.

At this point it will take a village to change our habits.

Dr. Ayala

Full disclosure: I'm vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I'm also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.

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