The association between state bans on soda only and adolescent substitution with other sugar-sweetened beverages: a cros
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RESEARCH
Open Access
The association between state bans on soda only and adolescent substitution with other sugarsweetened beverages: a cross-sectional study Daniel R Taber1,2*, Jamie F Chriqui1,3, Renee Vuillaume4, Steven H Kelder2, Frank J Chaloupka1,5
Abstract Background: Across the United States, many states have actively banned the sale of soda in high schools, and evidence suggests that students’ in-school access to soda has declined as a result. However, schools may be substituting soda with other sugar-sweetened beverages (SSBs), and national trends indicate that adolescents are consuming more sports drinks and energy drinks. This study examined whether students consumed more nonsoda SSBs in states that banned the sale of soda in school. Methods: Student data on consumption of various SSBs and in-school access to vending machines that sold SSBs were obtained from the National Youth Physical Activity and Nutrition Study (NYPANS), conducted in 2010. Student data were linked to state laws regarding the sale of soda in school in 2010. Students were cross-classified based on their access to vending machines and whether their state banned soda in school, creating 4 comparison groups. Zero-inflated negative binomial models were used to compare these 4 groups with respect to students’ selfreported consumption of diet soda, sports drinks, energy drinks, coffee/tea, or other SSBs. Students who had access to vending machines in a state that did not ban soda were the reference group. Models were adjusted for race/ ethnicity, sex, grade, home food access, state median income, and U.S. Census region. Results: Students consumed more servings of sports drinks, energy drinks, coffee/tea, and other SSBs if they resided in a state that banned soda in school but attended a school with vending machines that sold other SSBs. Similar results were observed where schools did not have vending machines but the state allowed soda to be sold in school. Intake was generally not elevated where both states and schools limited SSB availability – i.e., states banned soda and schools did not have SSB vending machines. Conclusion: State laws that ban soda but allow other SSBs may lead students to substitute other non-soda SSBs. Additional longitudinal research is needed to confirm this. Elevated SSB intake was not observed when both states and schools took steps to remove SSBs from school.
Background For decades, diet patterns around the world have shifted toward greater consumption of sugar-sweetened beverages (SSBs) [1]. Some of the most striking trends have occurred in the United States (U.S.), where the proportion of daily energy intake that came from SSBs increased from 4.8% to 10.3% from 1977-78 to 1999-2001 [2]. The proportion was even higher among 12- to 19-year-olds, who consumed 13.5% of their energy from SSBs in 1999-2000 [3]. By * Correspondence: [email protected] 1 Institute for Health Research and Policy, University of Illinois at Chicago,1747 West Roosevelt Road, Chicago, IL 60608 Chicago, IL, USA Full list of author
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