Evaluating the Impact of the Healthy Beverage Executive Order for City Agencies in Boston, Massachusetts, 2011-2013.

INTRODUCTION: Intake of sugar-sweetened beverages (SSBs) is associated with negative health effects. Access to healthy beverages may be promoted by policies such as the Healthy Beverage Executive Order (HBEO) established by former Boston mayor Thomas M. Menino, which directed city departments to eliminate the sale of SSBs on city property. Implementation consisted of "traffic-light signage" and educational materials at point of purchase. This study evaluates the impact of the HBEO on changes in beverage availability. METHODS: Researchers collected data on price, brand, and size of beverages for sale in spring 2011 (899 beverage slots) and for sale in spring 2013, two years after HBEO implementation (836 beverage slots) at access points (n = 31) at city agency locations in Boston. Nutrient data, including calories and sugar content, from manufacturer websites were used to determine HBEO beverage traffic-light classification category. We used paired t tests to examine change in average calories and sugar content of beverages and the proportion of beverages by traffic-light classification at access points before and after HBEO implementation. RESULTS: Average beverage sugar grams and calories at access points decreased (sugar, -13.1 g; calories, -48.6 kcal; p<.001) following the implementation of the HBEO. The average proportion of high-sugar ("red") beverages available per access point declined (-27.8%, p<.001). Beverage prices did not change over time. City agencies were significantly more likely to sell only low-sugar beverages after the HBEO was implemented (OR = 4.88; 95% CI, 1.49-16.0). DISCUSSION: Policies such as the HBEO can promote community-wide changes that make healthier beverage options more accessible on city-owned properties.

A fizzy environment: availability and consumption of sugar-sweetened beverages among school students.

OBJECTIVE: Reducing sugar-sweetened beverage (SSB) consumption has been targeted in obesity prevention strategies internationally. This study examined associations between SSB availability at school and in the home, and consumption among Australian school students. METHOD: Secondary analysis of the 2010 New South Wales Schools Physical Activity and Nutrition Survey (n=8058) was conducted. Logistic regression analyses tested the impact of SSB availability at school and in the home on consumption category (low, ≤1 cup/week; moderate, 2-4 cups/week; high, ≥5 cups/week). RESULTS: Students in years K-10 (ages 4-16years) who usually purchased sugar-sweetened soft drinks or sports drinks from their school canteen were almost three times as likely to be high consumers (AOR 2.90; 95%CI 2.26, 3.73). Students in years 6-10 (ages 9-16years) were almost five times as likely to be high consumers if soft drinks were usually available in their home (AOR 4.63; 95%CI 3.48, 6.17), and almost ten times as likely to be high consumers if soft drinks were usually consumed with meals at home (AOR 9.83; 95%CI 6.06, 15.96). CONCLUSION: Limiting the availability of SSBs in the home and school environments is a prudent response to address high SSB consumption among school students, albeit only part of the solution for obesity prevention.

The relationship between parental education and adolescents' soft drink intake from the age of 11-13 years, and possible mediating effects of availability and accessibility.

The present study examined the prospective relationship between parental education and adolescents' soft drink intake over 20 months, and possible mediating effects of adolescents' availability and accessibility of soft drinks at home. A total of 866 adolescents, with data on two time points in the Norwegian HEalth In Adolescents (HEIA) cohort study (2007-9), were included in the analyses. Data on intake and determinants of soft drinks were collected from adolescents and both parents by questionnaires. Mediation analyses using linear regression investigated the total and direct effects of parental education on adolescents' soft drink intake from the age of 11-13 years. In order to investigate prospective relationships, two models were set up to measure the (1) prediction and (2) change in consumption over 20 months. Possible mediation effects of availability and perceived accessibility at home were further examined in both models. The results showed that a lower level of parental education predicted a higher intake of soft drinks among adolescents after 20 months, and that higher perceived accessibility of soft drinks reported by adolescents and mothers explained 39 % of the total effect. No relationship was observed between parental education and the change in adolescents' intake of soft drinks over 20 months. Interventions aimed at families with low parental education should target the perceived accessibility of soft drinks at home in order to diminish social differences in adolescents' soft drink consumption.

Industry self-regulation to improve student health: quantifying changes in beverage shipments to schools.

OBJECTIVES: We developed a data collection and monitoring system to independently evaluate the self-regulatory effort to reduce the number of beverage calories available to children during the regular and extended school day. We have described the data collection procedures used to verify data supplied by the beverage industry and quantified changes in school beverage shipments. METHODS: Using a proprietary industry data set collected in 2005 and semiannually in 2007 through 2010, we measured the total volume of beverage shipments to elementary, middle, and high schools to monitor intertemporal changes in beverage volumes, the composition of products delivered to schools, and portion sizes. We compared data with findings from existing research of the school beverage landscape and a separate data set based on contracts between schools and beverage bottling companies. RESULTS: Between 2004 and the 2009-2010 school year, the beverage industry reduced calories shipped to schools by 90%. On a total ounces basis, shipments of full-calorie soft drinks to schools decreased by 97%. CONCLUSIONS: Industry self-regulation, with the assistance of a transparent and independent monitoring process, can be a valuable tool in improving public health outcomes.

Does the EU sugar policy reform increase added sugar consumption? An empirical evidence on the soft drink market.

Whereas National Health authorities recommend a decrease in the consumption of 'added' sugar, a reform on the sugar market will lead to a 36% decrease of the sugar price in the EU. Using French data on soft drinks purchases, this paper investigates the anticipated impact of this reform on the consumption of sugar-sweetened beverages. The reform of the EU sugar policy leads to a decrease in regular soft drink prices by 3% and varies across brands. To assess substitution within this food category, we use a random-coefficients logit model that takes into account a large number of differentiated products and heterogeneity in consumers' behavior. Results suggest that price changes would lead to an increase in market shares of regular products by 7.5% and to substitutions between brands to the benefit of products with the highest sugar content. On the whole, it would raise consumption of regular soft drinks by more than 1 litre per person per year and consumption of added sugar by 124 g per person per year, this increase being larger in households composed of overweight and obese individuals.

Soft drinks: time trends and correlates in twenty-four European countries. A cross-national study using the DAFNE (Data Food Networking) databank.

OBJECTIVE: To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries. DESIGN: Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks. SETTING: Twenty-four European countries. SUBJECTS: Nationally representative samples of households. RESULTS: The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household. CONCLUSIONS: Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents.

Policies that restrict sweetened beverage availability may reduce consumption in elementary-school children.

OBJECTIVE: We investigated whether having a policy regarding the availability of sweetened beverages in school was associated with children's purchase and total weekly and daily consumption of sweetened beverages. DESIGN: Data were obtained from 10 719 children aged 9-13 years and 2065 elementary schools in the Early Childhood Longitudinal Study-Kindergarten cohort. Multilevel logistic regression was used to determine the magnitude and significance of relationships between the availability of different beverages and purchase of sweetened beverages at school and overall consumption of beverages. RESULTS: The purchase of sweetened beverages by children in school was strongly associated with the administrative policy of sweetened beverage availability. Compared with children in schools without an administrative policy that allowed sweetened beverages, children in schools with the policy were three times more likely to be either occasional or frequent consumers of sweetened beverages. CONCLUSIONS: A policy of availability of sweetened beverages makes an independent contribution to children's purchase and consumption of sweetened beverages in the 5th grade year.

Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia.

OBJECTIVE: There is limited knowledge of what influences sugary drink purchasing decisions in the Australian population. This study aimed to identify the most common locations and reasons across different demographic groups for purchasing sugary drinks in Australia. METHODS: A total of 891 respondents (who purchased sugary drinks for personal consumption at least occasionally) from a broader national population telephone survey of Australian adults conducted in 2017 (n=3,430) were included in the analysis. RESULTS: 'Taste' was a ubiquitous reason for purchase (94%) and the majority also agreed with 'easily available' (76%). Males, younger people and people of lower socioeconomic status (SES) were significantly more likely to agree that sugary drinks were 'cheap' and 'better value than water'. Furthermore, males and younger people were more likely to report buying sugary drinks because they were 'part of a meal deal'. The most common purchase locations were supermarkets (56%), followed by convenience stores (19%) and food or entertainment venues (17%). CONCLUSION: Taste is paramount in decisions to purchase sugary drinks, and widespread availability and value for money support consumption. Implications for public health: Policies and interventions targeting point-of-sale sugary drink purchasing decisions among the most 'at risk' consumers are warranted.

Hospitals lead by poor example: An assessment of snacks, soda, and junk food availability in Veterans Affairs hospitals.

OBJECTIVE: The Veterans Health Administration is the largest integrated health care system fully funded through the US government; however, compliance with government dietary recommendations within Veterans Affairs (VA) hospitals is not well known. The aim of this study was to determine which foods are available at VA hospitals and whether these foods comply with government recommendations. METHODS: Process verification for a Freedom of Information Act request was used to assess government-run inpatient and outpatient VA hospital facilities by accessing the location, quantity, and contents of vending machines. These foods and beverages were then quantified and compared with the US Department of Agriculture Dietary Guidelines for Americans 2015-2020 (eighth edition). RESULTS: Of the beverages supplied, 49% contained >55 g of sugar, supplying >10% of daily calories in added sugar in a single serving. Of all beverages, 50% contained >50 g of added sugar (range 17-77 g per bottle/can). The 65 available food items were comprised of 28% candy, 14% potato chips/puffed corn snacks, 11% pastries/frosted baked goods, 11% crackles/pretzels, and 8% nuts/trail mix, and the remainder consisted of jerky, pork rinds, gum, and popcorn. Nuts/trail mix and granola-items meeting nutritional guidelines-comprised five and three options in total, respectfully. CONCLUSIONS: All VA Hospitals contain vending machines providing a majority of soda, candy, and junk foods that directly conflict with healthy food choice recommendations from US governing health bodies. Few sources meeting US dietary guidelines are available in vending machines at these government-run facilities, which serve as poor examples for patients who are attempting to follow a healthy diet.

[Food model in western Andalusia]. / Modelo alimentario en Andalucía occidental.

INTRODUCTION: As is known, the type and amount of food consumption determine the nutritional composition of the diet. A healthy nutritional composition plays an essential role in the prevention of diseases such as cardiovascular, diabetes mellitus type 2 and obesity. Regarding overweight and obesity, its prevalence has increased in recent years in our country and more markedly in Andalusia, reaching quite worrying figures, due to unfavorable changes in lifestyle and nutrition. In Andalusia, food consumption figures are lower than national ones and this contrasts with the higher prevalence of overweight and obesity in this Community. In addition, the sale of soft drinks in Andalusia are higher than the national average and sedentary lifestyle is higher. Among the strengths of the food model in western Andalusia, it is worth mentioning the follow-up of a model more adjusted to the Mediterranean diet by women and the elderly. There is a tendency to abandon the Mediterranean diet among the youngest and low socio-economic levels. On the nutritional profile, the lipids (39.1%) exceed the recommendations at the expense of carbohydrates, the consumption of saturated fatty acids (11.3%) exceeds the recommendations and the intakes of zinc and folic acid do not reach the values recommended. In general terms, there is an abandonment, fundamentally on the part of the youngest people of the typical foods of the Mediterranean diet.

INTRODUCCIÓN: Como es sabido, el tipo y la cantidad de consumo de alimentos determinan la composición nutricional de la dieta. A su vez, una saludable composición nutricional desempeña un papel esencial en la prevención de enfermedades como las cardiovasculares, la diabetes mellitus tipo 2 y la obesidad. En cuanto al sobrepeso y a la obesidad, su prevalencia ha ido aumentando en los últimos años en nuestro país, y de forma más marcada en Andalucía, hasta alcanzar cifras bastante preocupantes debido a los cambios desfavorables en el estilo de vida y en la alimentación. En Andalucía se observan cifras de consumo de alimentos inferiores a las nacionales, lo que contrasta con la mayor prevalencia de sobrepeso y obesidad en esta comunidad. Además, las cifras de venta de bebidas refrescantes y de gaseosas en Andalucía son superiores a la media nacional, y el sedentarismo es elevado. Entre las fortalezas del modelo alimentario en Andalucía occidental cabe destacar el seguimiento de un modelo más ajustado a la dieta mediterránea por parte de las mujeres y las personas mayores. Se tiende al abandono de la dieta mediterránea entre los más jóvenes y en los niveles socioeconómicos más desfavorecidos. Sobre el perfil nutricional, los lípidos (39,1 %) superan las recomendaciones a expensas de los hidratos de carbono, el consumo de ácidos grasos saturados (11,3%) también supera las recomendaciones y las ingestas de zinc y ácido fólico no alcanzan los valores recomendados. En términos generales se observa un abandono, fundamentalmente por parte de las personas más jóvenes, de los alimentos típicos de la dieta mediterránea.

The effect of soft drink availability in elementary schools on consumption.

OBJECTIVE: To quantify the association among soft drink availability, school-based purchases, and overall consumption for elementary school children in the United States. DESIGN: The study is a cross-sectional, descriptive analysis of children in fifth grade across the United States. Measures of soft drink availability, purchases, and consumption are reported by the child in direct assessments by interviewers. SUBJECTS/SETTING: Subjects in the analysis are from the Early Childhood Longitudinal Survey-Kindergarten Cohort. The baseline sample from this survey is nationally representative of kindergarten students in the 1998-1999 school year. The analytic sample obtained from the sixth wave includes 10,215 children in fifth grade in 2,303 schools across 40 states. MAIN OUTCOME MEASURES: Consumption of any soft drink in the past week, purchase of any soft drink at school in the past week, overall consumption of soft drinks in the past week, overall purchases of soft drinks at school in the past week, and share of all consumption that was school-based. STATISTICAL ANALYSES PERFORMED: chi(2) square tests and t tests were conducted to determine significant differences across sociodemographic groups. Multivariate logistic regressions were conducted to estimate the effect of availability on the odds of any soft drink consumption and overall consumption level. RESULTS: In this study, 26% of children who have access to soft drinks at school consume them. Those who consume more soft drinks at school, such as low-income and black non-Hispanic children, are more likely to consume more soft drinks overall. Controlling for covariates, limiting availability of soft drinks at school is associated with a 4% decrease (odds ratio 1.38) in the rate of any consumption overall. CONCLUSIONS: These findings suggest that soft drink availability at school may have limited impact on overall consumption for elementary school children. Further research about predictors of consumption, how children respond to reduced availability, as well as food environments at home and at school, may identify next steps toward improving the diets of children.

The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities.

BACKGROUND: We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. METHOD: Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). FINDINGS: We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB's. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. INTERPRETATION: Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB.

Soft drink availability, contracts, and revenues in American secondary schools.

BACKGROUND: Soft drinks have been widely available in the nation's schools for some years, but recently, in response to rising concern about the epidemic of obesity among youth, concerns have been raised as to whether they should be available, and if so, under what circumstances. This paper looks at how widespread soft drink availability is at present in schools, as well as the availability of other classes of beverages. Because overweight occurs disproportionately among minorities and those of lower socioeconomic status (SES), this paper also seeks to determine to what extent environmental conditions differ for these students. Differences between middle and high schools are also examined. METHODS: Data for 2004 and 2005 were used from two ongoing United States national surveys: the Youth, Education, and Society (YES) study of school administrators (N=345), and the Monitoring the Future (MTF) study of secondary school students in 8th, 10th, and 12th grades surveyed in those same schools (N=37,543). Data were gathered in YES on the availability of various beverages in schools from vending machines and other venues, as well as about the presence and nature of pouring rights contracts with soft drink bottlers. Data were analyzed in 2006. RESULTS: The vast majority of high school students today have soft drinks available to them in the school environment both through vending machines (88%) and in the cafeteria at lunch (59%), with middle schools providing somewhat less access. Diet soft drinks are less available, particularly at lunch. Most students (67% in middle and 83% in high school) are in schools that have a contract with a bottler. Revenues to schools generated by soft drink sales are quite modest. Hispanics are most likely to have soft drinks available throughout the school day. The SES of the students correlates negatively with whether the school allows advertising and promotion of soft drinks. CONCLUSIONS: Current school practices regarding soft drink availability, advertising, and sales would seem likely to be contributing to the extent of overweight among American young people, and to some extent to the higher risk faced by Hispanic and lower SES youth.

Support for Food and Beverage Worksite Wellness Strategies and Sugar-Sweetened Beverage Intake Among Employed U.S. Adults.

PURPOSE: Sugar-sweetened beverage (SSB) consumption is high among U.S. adults and is associated with obesity. Given that more than 100 million Americans consume food or beverages at work daily, the worksite may be a venue for interventions to reduce SSB consumption. However, the level of support for these interventions is unknown. We examined associations between workday SSB intake and employees' support for worksite wellness strategies (WWSs). DESIGN: We conducted a cross-sectional study using data from Web-based annual surveys that gather information on health-related attitudes and behaviors. SETTING: Study setting was the United States. SUBJECTS: A total of 1924 employed adults (≥18 years) selected using probability-based sampling. MEASURES: The self-reported independent variable was workday SSB intake (0, <1 or ≥1 times per day), and dependent variables were employees' support (yes/no) for the following WWSs: (1) accessible free water, (2) affordable healthy food/drink, (3) available healthy options, and (4) less available SSB. ANALYSIS: Multivariable logistic regression was used to control for sociodemographic variables, employee size, and availability of cafeteria/vending machine. RESULTS: About half of employees supported accessible free water (54%), affordable healthy food/drink (49%), and available healthy options (46%), but only 28% supported less available SSB. Compared with non-SSB consumers, daily SSB consumers were significantly less supportive of accessible free water (adjusted odds ratio, .67; p < .05) or less available SSB (odds ratio, .49; p < .05). CONCLUSION: Almost half of employees supported increasing healthy options within worksites, although daily workday SSB consumers were less supportive of certain strategies. Lack of support could be a potential barrier to the successful implementation of certain worksite interventions.

Is trade liberalisation a vector for the spread of sugar-sweetened beverages? A cross-national longitudinal analysis of 44 low- and middle-income countries.

Does trade and investment liberalisation increase the growth in sales of sugar-sweetened beverages (SSBs)? Here, for the first time to our knowledge, we test this hypothesis using a unique data source on SSB-specific trade flows. We test whether lower tariffs effectively increase imports of SSBs, and whether a higher level of imports increase sales of SSBs. Cross-national fixed effects models were used to evaluate the association between SSBs sales and trade liberalisation. SSBs per capita sales data were taken from EuroMonitor, covering 44 low- and middle-income countries from 2001 to 2014, SSBs import data were from TradeMap, Foreign Direct Investment data were from EuroMonitor, and data on applied tariffs on SSB from the World Trade Organisation tariffs database, all 2015 editions. The results show that higher tariffs on SSBs significantly decreased per capita SSB imports. Each one percent increase in tariffs was associated with a 2.9% (95% CI: 0.9%-5%) decrease in imports of SSBs. In turn, increased imports of SSBs were significantly associated with greater sales of SSBs per capita, with each 10 percent increase in imports (in US$) associated with a rise in sales of 0.36 L per person (95% CI: 0.08-0.68). Between 2001 and 2014, this amounted to 9.1 L greater sales per capita, about 40% of the overall rise seen in this period in LMICs. We observed that tariffs were inversely but not significantly associated with sales of SSBs. In conclusion, lower tariffs substantially increased imports of SSBs in LMICs, which translated into greater sales. These findings suggest that trade policies which lower tariff barriers to SSB imports can be expected to lead to increased imports and then increased sales of SSBs in LMICs, with adverse consequences for obesity and the diseases that result from it.

Change in non-alcoholic beverage sales following a 10-pence levy on sugar-sweetened beverages within a national chain of restaurants in the UK: interrupted time series analysis of a natural experiment.

BACKGROUND: This study evaluates changes in sales of non-alcoholic beverages in Jamie's Italian, a national chain of commercial restaurants in the UK, following the introduction of a £0.10 per-beverage levy on sugar-sweetened beverages (SSBs) and supporting activity including beverage menu redesign, new products and establishment of a children's health fund from levy proceeds. METHODS: We used an interrupted time series design to quantify changes in sales of non-alcoholic beverages 12 weeks and 6 months after implementation of the levy, using itemised electronic point of sale data. Main outcomes were number of SSBs and other non-alcoholic beverages sold per customer. Linear regression and multilevel random effects models, adjusting for seasonality and clustering, were used to investigate changes in SSB sales across all restaurants (n=37) and by tertiles of baseline restaurant SSB sales per customer. RESULTS: Compared with the prelevy period, the number of SSBs sold per customer declined by 11.0% (-17.3% to -4.3%) at 12 weeks and 9.3% (-15.2% to -3.2%) at 6 months. For non-levied beverages, sales per customer of children's fruit juice declined by 34.7% (-55.3% to -4.3%) at 12 weeks and 9.9% (-16.8% to -2.4%) at 6 months. At 6 months, sales per customer of fruit juice increased by 21.8% (14.0% to 30.2%) but sales of diet cola (-7.3%; -11.7% to -2.8%) and bottled waters (-6.5%; -11.0% to -1.7%) declined. Changes in sales were only observed in restaurants in the medium and high tertiles of baseline SSB sales per customer. CONCLUSIONS: Introduction of a £0.10 levy on SSBs alongside complementary activities is associated with declines in SSB sales per customer in the short and medium term, particularly in restaurants with higher baseline sales of SSBs.

Regular soda policies, school availability, and high school student consumption.

BACKGROUND: Beginning in the 2014-2015 school year, all U.S. schools participating in federally reimbursable meal programs are required to implement new nutrition standards for items sold in competitive venues. Multilevel mediation modeling examining direct, mediated, and indirect pathways between policy, availability, and student consumption might provide insight into possible outcomes of implementing aspects of the new standards. PURPOSE: To employ multilevel mediation modeling using state- and school district-level policies mandating school soda bans, school soda availability, and student soda consumption. METHODS: The 2010-2012 Monitoring the Future surveys obtained nationally representative data on high school student soda consumption; school administrators provided school soda availability data. State laws and district policies were compiled and coded. Analyses conducted in 2014 controlled for state-, school-, and student-level characteristics. RESULTS: State-district-school models found that state bans were associated with significantly lower school soda availability (c, p<0.05) but district bans showed no significant associations. No significant direct, mediated, or indirect associations between state policy and student consumption were observed for the overall sample. Among African American high school students, state policy was associated directly with significantly lower school soda availability (a, p<0.01), and-indirectly through lower school availability-with significantly lower soda consumption (a*b, p<0.05). CONCLUSIONS: These analyses indicate state policy focused on regular soda strongly affected school soda availability, and worked through changes in school availability to decrease soda consumption among African American students, but not the overall population.

Parental attitudes towards soft drink vending machines in high schools.

Soft drink vending machines are available in 98% of US high schools. However, few data are available about parents' opinions regarding the availability of soft drink vending machines in schools. Six focus groups with 33 parents at three suburban high schools were conducted to describe the perspectives of parents regarding soft drink vending machines in their children's high school. Parents viewed the issue of soft drink vending machines as a matter of their children's personal choice more than as an issue of a healthful school environment. However, parents were unaware of many important details about the soft drink vending machines in their children's school, such as the number and location of machines, hours of operation, types of beverages available, or whether the school had contracts with soft drink companies. Parents need more information about the number of soft drink vending machines at their children's school, the beverages available, the revenue generated by soft drink vending machine sales, and the terms of any contracts between the school and soft drink companies.