Reducing sugary drink consumption: New York City's approach.

Studies have linked the consumption of sugary drinks to weight gain, obesity, and type 2 diabetes. Since 2006, New York City has taken several actions to reduce consumption. Nutrition standards limited sugary drinks served by city agencies. Mass media campaigns educated New Yorkers on the added sugars in sugary drinks and their health impact. Policy proposals included an excise tax, a restriction on use of Supplemental Nutrition Assistance Program benefits, and a cap on sugary drink portion sizes in food service establishments. These initiatives were accompanied by a 35% decrease in the number of New York City adults consuming one or more sugary drinks a day and a 27% decrease in public high school students doing so from 2007 to 2013.

An observational evaluation of move-to-improve, a classroom-based physical activity program, New York City schools, 2010.

INTRODUCTION: Few children in the United States achieve the recommended 60 minutes of physical activity per day. Identifying successful interventions that increase physical activity for children is critical. This observational study evaluated the effects of Move-To-Improve (MTI), a classroom-based physical education program designed for kindergarten to third-grade teachers in New York City public schools. MTI organizes 3-hour trainings for teachers that demonstrate strategies for integrating activity into daily classroom schedules. METHODS: Randomly sampled elementary schools (N = 39) with classrooms trained in MTI in spring 2010 participated in the evaluation. In each school, we observed 2 classrooms trained in MTI and 2 untrained classrooms in the same school matched by grade level for 1 full school day. We analyzed data from 72 trained and 72 untrained classrooms. RESULTS: Ninety-nine percent of MTI-trained classroom teachers led their students in physical activity. MTI-trained classrooms spent an average of 9.5 minutes in physical activity per day, compared with 2.4 minutes in untrained classrooms (P < .001), an almost fourfold increase in activity. Levels of activity were higher in trained versus untrained classrooms regardless of grade level or class size. CONCLUSION: Teachers trained in MTI led their classrooms in significantly more physical activity compared with teachers who were not trained. The MTI program is an effective strategy for increasing physical activity during the school day. A curriculum that empowers classroom teachers to incorporate activity into their regular day is a practical approach to promoting healthier living for children.

Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys.

OBJECTIVE: To assess the impact of fast food restaurants adding calorie labelling to menu items on the energy content of individual purchases. DESIGN: Cross sectional surveys in spring 2007 and spring 2009 (one year before and nine months after full implementation of regulation requiring chain restaurants' menus to contain details of the energy content of all menu items). Setting 168 randomly selected locations of the top 11 fast food chains in New York City during lunchtime hours. PARTICIPANTS: 7309 adult customers interviewed in 2007 and 8489 in 2009. MAIN OUTCOME MEASURES: Energy content of individual purchases, based on customers' register receipts and on calorie information provided for all items in menus. RESULTS: For the full sample, mean calories purchased did not change from before to after regulation (828 v 846 kcal, P = 0.22), though a modest decrease was shown in a regression model adjusted for restaurant chain, poverty level for the store location, sex of customers, type of purchase, and inflation adjusted cost (847 v 827 kcal, P = 0.01). Three major chains, which accounted for 42% of customers surveyed, showed significant reductions in mean energy per purchase (McDonald's 829 v 785 kcal, P = 0.02; Au Bon Pain 555 v 475 kcal, P<0.001; KFC 927 v 868 kcal, P<0.01), while mean energy content increased for one chain (Subway 749 v 882 kcal, P<0.001). In the 2009 survey, 15% (1288/8489) of customers reported using the calorie information, and these customers purchased 106 fewer kilocalories than customers who did not see or use the calorie information (757 v 863 kcal, P<0.001). CONCLUSION: Although no overall decline in calories purchased was observed for the full sample, several major chains saw significant reductions. After regulation, one in six lunchtime customers used the calorie information provided, and these customers made lower calorie choices.

What people buy from fast-food restaurants: caloric content and menu item selection, New York City 2007.

Fast-food restaurants provide a growing share of daily food intake, but little information is available in the public health literature about customer purchases. In order to establish baseline data on mean calorie intake, this study was completed in the Spring of 2007, before calorie labeling regulations went into effect in New York City. Receipts were collected from lunchtime customers, at randomly selected New York City fast-food chains. A supplementary survey was also administered to clarify receipt items. Calorie information was obtained through company websites and ascribed to purchases. Lunchtime purchases for 7,750 customers averaged 827 calories and were lowest for sandwich chains (734 calories); and highest for chicken chains (931 calories). Overall, one-third of purchases were over 1,000 calories, predominantly from hamburger chains (39%) and chicken chains (48%); sandwich chains were the lowest, with only 20% of purchases over 1,000 calories. "Combination meals" at hamburger chains accounted for 31% of all purchases and averaged over 1,200 calories; side orders accounted for almost one-third of these calories. Lunch meals at these fast-food chains are high in calorie content. Although calorie posting may help to raise awareness of the high calories in fast-food offerings, reducing portion sizes and changing popular combination meals to include lower calorie options could significantly reduce the average calorie content of purchases.

What consumers want to know about commercial weight-loss programs: a pilot investigation.

OBJECTIVE: In 1999, the Partnership for Healthy Weight Management recommended that providers of commercial weight-loss programs (and products) voluntarily disclose information concerning the safety, costs, and central components of their programs, as well as the credentials of program staff. These guidelines were drafted without the benefit of data from consumers concerning the specific information they desired. The present study provides such data. RESEARCH METHODS AND PROCEDURES: Participants were 90 women with a mean age of 44.02 +/- 9.17 years and body mass index of 36.11 +/- 4.82 kg/m(2) who were participants in one of two randomized weight-control trials. Before treatment, respondents were asked to imagine that they were "looking for a weight-loss plan" and to rate how important each of 16 factors would be in helping them select a plan. Ratings were made using 5-point scales, anchored by "not at all important" and "extremely important," (scored 1 and 5, respectively). Participants also identified the five factors that they thought were the most important, as well as the single most important. RESULTS: The mean rating for the importance of safety (4.57 +/- 0.60) was significantly greater than that for each of the 15 other variables (all p values < 0.05). In addition, significantly more respondents (27.8%) selected safety as the single most important factor than any other variable (all p values < 0.05). Other factors that were consistently judged as very important included information about diet (4.38 +/- 0.68), behavior modification (4.32 +/- 0.76), cost (4.19 +/- 0.92), and maintenance of weight loss (4.15 +/- 0.91). Staff credentials (3.88 +/- 0.83) were among the lowest rated items. DISCUSSION: The results generally support the disclosure guidelines proposed by the Partnership for Health Weight Management. Consumers, however, seem to desire information about weight loss, in addition to that concerning safety, cost, and central program components.