August 20, 2015
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Soda bans in school lead to increase in other sugar-sweetened beverages

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High school students consumed more servings of sports drinks, energy drinks, coffee/tea and other sugar-sweetened beverages if they resided in a state that banned soda but attended a school with vending machines that sold other sugar-sweetened beverages, according to recent study data.

In 2005 and 2006, soda accounted for more energy intake compared with any other food or beverage among high school students in the United States, according to researchers. In response to unhealthy diet trends, legislators began to ban the purchase of soda in schools, particularly in districts that participated in federal meal programs. By 2011, the proportion of high school students that had access to soda in school decreased from 53.6% to 25.3%.

“Throughout the United States, schools and policymakers have made progress to remove regular soda from schools; however, evidence suggests that schools and students may be substituting soda with other sugar-sweetened beverages instead,” Daniel R. Taber, PhD, MPH, from the Institute for Health Research and Policy at the University of Illinois, told Infectious Diseases in Children.

To determine whether anti-soda policies were associated with higher consumption of other sugar-sweetened beverages, Taber and colleagues performed a cross-sectional analysis using data collected by the National Youth Physical Activity and Nutrition Study in 2010. The researchers analyzed data on 8,696 high school students in 27 states who responded to a questionnaire assessing weekly consumption of sugar-sweetened beverages. Students also reported whether their school had vending machines that sold soda, sports drinks or fruit drinks that contained less than 100% juice.  

Based on the responses, a large proportion of participants did not consume any sugar-sweetened beverages and a small proportion of participants consumed large quantities of sugar-sweetened beverages. On average, participants consumed 5.4 servings of soda, 4.1 servings of juice (< 100% fruit) and 3.5 servings of sports drinks.

Students who had access to vending machines but attended schools that banned soda (n = 2,229) reported drinking more sports drinks (RR = 1.25; 95% CI, 1.11-1.42), energy drinks (RR = 1.29; 95% CI, 1.03-1.62), coffee/tea (RR = 1.18; 95% CI, 1.01-1.36) and other sugar-sweetened beverages (RR = 1.16; 95% CI, 1.02-1.32) compared with students who had access to both soda and other sugar-sweetened beverages (n = 4,452). Similarly, students with access to soda but not vending machines (n = 969) also reported more servings of diet soda (RR = 1.4; 95% CI, 1-1.97), sports drinks (RR = 1.22; 95% CI, 1.03-1.45), energy drinks (RR = 1.33; 95% CI, 1.03-1.71) and coffee/tea (RR = 1.27; 95% CI, 1.03-1.56).

“This echoes national trends, as teenagers have been drinking lower quantities of soda but higher quantities of sports drinks and energy drinks,” Taber said.

However, intake was generally not elevated in students who attended a school that banned soda and did not have vending machines (n = 1,046).

“In other words, [sugar-sweetened beverage] consumption tended to be higher if individual state or school restrictions on [sugar-sweetened beverage] access were in place, but usually not if both state and school restrictions were in place,” Taber and colleagues wrote.

The researchers concluded that school and state policies should extend their restrictions to other sugar-sweetened beverages to ensure students have access to healthier alternatives.

Aside from soda bans, the researchers wrote that higher consumption may also be attributed to a shift in industry marketing practices that target adolescent audiences, especially when promoting energy drinks.

“Students and parents often perceive other sweetened beverages as “healthy” because the beverages are marketed as being healthy,” Taber told Infectious Diseases in Children. “For that reason, I think the biggest take-away message is that we need to recognize how the sweetened beverage market has evolved and expanded, and that kids and parents may not know what beverages are truly healthy. We need to actively promote alternatives that are healthier (eg, water, 100% fruit juice) so that kids and parents are not simply swapping one sugary beverage (soda) for another (sports drinks).”

Disclosure: The researchers report no relevant financial disclosures.