School soda bans ineffective

Adolescents that attended middle schools that banned sugar-sweetened beverages continued to drink these products, with 85% of those surveyed reporting that they drank a soda or other sugary beverage in the prior week regardless of their school's policies.

“School is only one aspect of a child's environment and youth have proven to be very adept at compensating for individual changes to their environment,” Daniel R. Taber, PhD, MPH, of the Institute for Health Research and Policy at the University of Illinois in Chicago, and colleagues, reported in the Archives of Pediatric and Adolescent Medicine.

In efforts to curb obesity, the Institutes of Medicine and several other health organizations have urged policymakers to institute universal bans on soda and other sugar-sweetened beverages in schools based on the rationale that since students spend the majority of their day there, these policies could help reduce consumption.

The researchers surveyed a cohort of 6,900 students from 40 states to compare behaviors among students in states with policies banning all sugar-sweetened beverages vs. those that ban only soda and those that do nothing at all. They measured three factor — in-school access, in-school purchasing behaviors and overall consumption — first in 2004, when students were in fifth grade and again in 2007, when students were in eighth grade.

Banning only soda was the least effective policy, with no effect on sugar-sweetened beverage consumption whatsoever, the researchers found.

Rates of in-school access to sports drinks, fruit drinks and other sweetened drinks were identical at 66.6% among students that attended schools that banned soda vs. those with no policy, data indicated. The proportion of students who bought these drinks was also similar, at 28.9% and 26%, respectively.

States that banned any kind of sugar-sweetened beverage in school fared slightly better — the number of students that reported access to sweetened drinks at school was 14.9 percentage points lower, and the number that reported purchasing these beverages were 7.3 percentage points lower (both P<0.001) in these states than in those with no policy.

But when researchers looked at daily overall consumption at school, home or elsewhere, they found that students attending schools with sugary-beverage bans had a 5.8 percentage point higher daily intake than those at schools with no policy (P<0.05). This could be because, “heavier consumers compensated to a greater extent with increased consumption outside of school,” they noted.

“Our study adds to a growing body of literature that suggests that to be effective, school-based policy interventions must be comprehensive,” the researchers wrote.

Promoting unflavored water and low-fat milk, while limiting servings of 100% fruit juice, which often has similar caloric content to other sugar-sweetened beverages, were among several suggestions to improve beverage policies aimed at encouraging student health.

Study limitations included the potential for students to misreport dietary intake and the existence of other unmeasured confounding factors, the researchers noted.

Taber DR et al. Arch Pediatr Adolesc Med. 2011; DOI:10.1001/archpediatrics.2011.200

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