Evaluation of Short-Term Changes in Fast-Food Restaurant Online Kids’ Meal Beverage Offerings Following a State-Level Healthy Beverage Default Policy

Powell, Lisa M.; Leider, Julien; Pipito, Andrea A.; Moran, Alyssa J.

doi:10.1016/j.cdnut.2023.100045

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…This is consistent with other studies, which have found no improvements and low compliance with healthy default beverage policies in online settings. 20 , 21 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

“… 21 For comparison, compliance was 7%–30% (with the range based on the different city policies) when these laws were applied to online restaurant menus in Boston, which does not have a HBD policy. 21 Two pre–post intervention–comparison site studies of HBD policies in 1 city 22 and 1 state 23 evaluated short-term (4 months after policy) compliance with HBD laws on online menus and found no change in intervention relative to comparison sites over time. Furthermore, there have been a number of voluntary programs that have aimed to improve the nutritional quality of kids’ meals (e.g., National Restaurant Association's Kids LiveWell program and the Choose Health LA Restaurants initiative), but results associated with such programs have also found mixed improvements, including continued inclusion of sugary beverages with meals.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy

Powell,

Vandenbroeck,

Leider

et al. 2024

AJPM Focus

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“…This is consistent with other studies, which have found no improvements and low compliance with healthy default beverage policies in online settings. 20 , 21 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy

Powell,

Vandenbroeck,

Leider

et al. 2024

AJPM Focus

Self Cite

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“…Likewise, evaluations of healthy beverage default laws regulating restaurant children's meals have found low postpolicy compliance (eg, 6%-41%) and/or no significant difference in prepolicy to postpolicy change between jurisdictions subject to the policy and comparison jurisdictions. [18][19][20] Despite the Staple Food Ordinance and healthy beverage default laws having enforcement mechanisms similar to the Berkeley HCO, including inspections, warnings, and fines, competing public health priorities and limited capacity of enforcement staff may have contributed to low compliance with these other policies. [17][18][19] Future research is needed to identify why there was relatively high compliance with the Berkeley HCO.…”

Section: Discussionmentioning

confidence: 99%

“…[18][19][20] Despite the Staple Food Ordinance and healthy beverage default laws having enforcement mechanisms similar to the Berkeley HCO, including inspections, warnings, and fines, competing public health priorities and limited capacity of enforcement staff may have contributed to low compliance with these other policies. [17][18][19] Future research is needed to identify why there was relatively high compliance with the Berkeley HCO. However, prior research on other policies indicates that compliance may be higher among chain retailers, which comprised 74% of the Berkeley sample, when a policy is simple, when technical assistance is provided, and if retailers are accustomed to regulation.…”

Section: Discussionmentioning

confidence: 99%

Food Environment After Implementation of a Healthy Checkout Policy

Falbe,

Marinello,

Wolf

et al. 2024

JAMA Netw Open

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ImportanceIn March 2021, Berkeley, California, became the world’s first jurisdiction to implement a healthy checkout policy, which sets nutrition standards for foods and beverages in store checkouts. This healthy checkout ordinance (HCO) has the potential to improve customers’ dietary intake if stores comply by increasing the healthfulness of foods and beverages at checkouts.ObjectivesTo compare the percentage of checkout products that were HCO compliant and that fell into healthy and unhealthy food and beverage categories before and 1 year after HCO implementation in Berkeley relative to comparison cities.Design, Setting, and ParticipantsIn this cohort study in which Berkeley implemented an HCO and other cities did not, a difference-in-differences analysis was conducted of 76 258 product facings at checkouts of 23 stores in Berkeley and 75 stores in 3 comparison cities in California. Data were collected in February 2021 (approximately 1 month before implementation of the HCO) and 1 year later in February 2022 and analyzed from October 2023 to May 2024.ExposureThe HCO, which permits only the following products at checkouts in large food stores: nonfood and nonbeverage products, unsweetened beverages, and foods with 5 g or less of added sugars per serving and 200 mg or less of sodium per serving in the following categories: sugar-free gum and mints, fruit, vegetables, nuts, seeds, legumes, yogurt or cheese, and whole grains.Main Outcomes and MeasuresA product facing’s (1) HCO compliance and (2) category, including healthy compliant categories and unhealthy noncompliant categories, determined using a validated photograph-based tool to assess product characteristics.ResultsOf the 76 258 product facings at store checkouts, the percentage that were HCO compliant increased from 53% (4438 of 8425) to 83% (5966 of 7220) in Berkeley, a 63% increase relative to comparison cities (probability ratio [PR], 1.63; 95% CI, 1.41-1.87). The percentage of food and beverage checkout facings that were HCO compliant increased in Berkeley from 29% (1652 of 5639) to 62% (2007 of 3261), a 125% increase relative to comparison cities (PR, 2.25; 95% CI, 1.80-2.82). The percentage of Berkeley food and beverage facings consisting of candy, sugar-sweetened beverages, and other sweets significantly decreased (candy: from 30% [1687 of 5639] to 6% [197 of 3261]; PR, 0.21; 95% CI, 0.10-0.42; sugar-sweetened beverages: from 11% [596 of 5639] to 5% [157 of 3261]; PR, 0.41; 95% CI, 0.23-0.75; other sweets: from 7% [413 of 5639] to 3% [101 of 3261]; PR, 0.37; 95% CI, 0.15-0.88), while the percentage consisting of unsweetened beverages (from 4% [226 of 5639] to 19% [604 of 3261]; PR, 4.76; 95% CI, 2.54-8.91) and healthy foods (from 6% [350 of 5639] to 20% [663 of 3261]; PR, 2.90; 95% CI, 1.79-4.72) significantly increased.Conclusions and RelevanceThis cohort study of the first healthy checkout policy found substantial improvements in the healthfulness of food environments at checkouts 1 year after implementation of the policy. These results suggest that healthy checkout policies have the potential to improve the healthfulness of store checkouts.

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Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption

Knapp,

Moore,

Lederer

et al. 2024

Health Promotion Practice

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Purpose. This study identified restaurant manager/owner factors that may contribute to adoption of a restaurant-based healthy eating program, Eat Fit. Findings may be used to engage restaurants in efforts to increase access to and availability of healthy foods, promote healthy food choices, and work toward improving diet and lowering obesity and chronic disease risk in the community. Methods. Cross-sectional survey data were collected from restaurant managers/owners interested in partnering with Eat Fit. Variables included restaurant manager/owner beliefs, perceived staff knowledge/skills, support, self-efficacy, outcome expectancies, and barriers and facilitators to implementation. Results. Forty-nine managers/owners participated. Most managers/owners held positive beliefs about offering healthy food items in restaurants (83.7%). Most agreed that restaurants could influence eating behaviors (83.7%) and that restaurants have a responsibility to offer healthy options (77.6%). Most managers/owners perceived high levels of support (83.7%) and were confident in their ability (95.9%) to implement the Eat Fit program. The most cited barriers were customer preference, ingredient availability, staff knowledge, and operational challenges. The most common reasons for involvement in the program were a desire to increase access to healthy food, to entice customers looking for healthier food, a belief that restaurants should offer healthy food, and opportunities to market through Eat Fit. Conclusions. This research contributes to knowledge about beliefs and perceptions of restaurant manager/owners. Efforts to engage restaurants should focus on benefits of offering healthy food and the role restaurants can play in promoting health. Furthermore, programs may benefit from enhanced restaurant staff training, customer-targeted marketing, and educational efforts.

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Evaluation of Short-Term Changes in Fast-Food Restaurant Online Kids’ Meal Beverage Offerings Following a State-Level Healthy Beverage Default Policy

Cited by 3 publications

References 16 publications

Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy

Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy

Food Environment After Implementation of a Healthy Checkout Policy

Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption

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