Competitive beverage availability in Boston Public Schools after implementation of a comprehensive, district-wide nutrition policy

Introduction: Increasing attention is being paid to the types of beverages sold in schools as a way to reduce childhood obesity.  In 2004, the Boston School Committee passed district-wide nutrition guidelines for competitive beverages sold outside of the National School Lunch Program in Boston Public Schools (BPS); guidelines were updated in 2010.  We evaluated the extent to which schools were compliant with the guidelines nine years later to determine adherence and sustainability of the policy change.

Approach: From March-June 2013, trained personnel documented the types/brands and sizes of competitive beverages sold in 115 schools.  Nutrient data were gathered from manufacturer websites to determine compliance with BPS guidelines: in elementary schools no competitive beverages except water; in middle/high schools limited size of non-water beverages, limited calories in 100% juices, allowing low-/non-fat unflavored milk and non-fat flavored milks with sugar limits, and prohibiting sugar-sweetened beverages (SSBs), artificial sweeteners, and caffeine.  

Results: 90% of all schools were compliant with BPS beverage guidelines; 75% did not sell competitive beverages. 6% of elementary, 15% of middle, and 21% of high schools were not compliant with the guidelines.  Most frequently observed non-compliant beverages were 100% juice in elementary schools (N=4 schools); low-fat flavored milk and SSBs in middle and high schools (N=2 schools each).   SSBs were sold in 3 of the 115 buildings surveyed.

Discussion:90% of BPS schools were compliant with competitive beverage guidelines nine years after implementation of the policy; SSBs were rarely available. Comprehensive district-wide competitive beverage policy can translate into sustained healthier environments.