School beverage vending access and purchasing patterns among Arkansas adolescents

Adolescent obesity prevalence has increased substantially over the past few decades. Unless the epidemic abates, many adolescents will become overweight adults with serious chronic diseases or conditions. Non-nutritive sweetened beverage consumption may significantly contribute to increases in caloric intake and, thus, provoke weight gain. Arkansas' legislative Act 1220 of 2003 targeted obesity among school-aged children and adolescents through multiple efforts that include limiting access and availability to school vending machines and school stores. Arkansas adolescents, 14-18 years of age, participated in annual telephone interviews (2004-2007) with findings indicating a decline in access to beverage vending machines from 97% at baseline prior to implementation of Act 1220 to 75% three years later. Daily beverage-vending purchases (BVP) declined significantly from 18% to 10% of adolescents across this same period. At baseline, students averaged 12 BVP a month; in 2007, the average had decreased to 7 purchases per month. Consumption of less healthy sweetened beverages remained steady, but consumption of healthier choices (e.g., diet sodas, bottled water) rose (2005, 81%; 2007, 92%). Female students showed greater increases in healthier beverage selections than males. Differences were also seen between overweight (≥ 85th age- and gender-adjusted BMI percentile) and not overweight (< 85th percentile) students such that in 2007, 46% of overweight students reported zero BVP within the past month, compared to 26% of their not-overweight peers. State efforts to provide healthy options for student purchase likely contributed to the results. Females and overweight students showed the greatest improvements in choosing healthier beverages.