School food & beverage restrictions

Competitive foods and beverages in schools can be limited through restrictions on foods not provided through the National School Lunch Program. Such restrictions can include items sold as à la carte options, in vending machines, school stores, or at fundraisers, and can be a full ban or a limit on sale times.

Expected Beneficial Outcomes (Rated)

  • Improved dietary choices

Other Potential Beneficial Outcomes

  • Reduced unhealthy food sales

  • Reduced unhealthy food consumption

  • Reduced sweetened beverage consumption

Evidence of Effectiveness

There is ­­­­­­­­­­­­­­­­­­­­­some evidence that limiting access to competitive foods and beverages in schools leads to healthier diets among children (Cradock 2011, , Gonzalez 2009, , Larson 2010). Additional evidence is needed to confirm the magnitude of these effects.

Limiting access to unhealthy foods has been associated with significant but small reductions in unhealthy food sales (, , Neumark-Sztainer 2005). Among middle school students, such policies appear to decrease consumption of foods with low nutritional value at school, without an offsetting increase in consumption at home (). Adolescents with access to competitive foods through school cafeteria snack bars consume fewer healthy foods and nutrients than those without access to such foods (Cullen 2004, ). However, policies limiting access to unhealthy foods do not appear to increase fruit and vegetable consumption ().

Limits on sugar sweetened beverages and snacks have been shown to increase consumption of healthy foods and milk in some circumstances (Gonzalez 2009, ). Efforts to restrict the availability of sugar sweetened beverages have been shown to reduce consumption for kindergarteners () and high school students in Boston (Cradock 2011), but a study of middle schoolers finds no such reduction (). In a study of 5th and 8th grade students, competitive beverage availability was associated with increased consumption of sweetened beverages among males, minorities, and children living in poverty ().

States with strong laws governing competitive food nutrition content across grade levels may reduce adolescent body mass index (BMI) increases and the likelihood of adolescents remaining overweight (Taber 2012). A California-based study connects policies limiting access to competitive foods with improvements in overall overweight trends in 5th grade boys and 7th graders in CA (); however, other studies do not show an association between competitive food sales and weight gain for children in grades 5 through 8 (Van Hook 2012).

Impact on Disparities

No impact on disparities likely

Implementation Examples

As of 2012, 39 states have policies with nutrition standards for competitive foods (CDC-Competitive foods 2012). As of 2004, only 39% of the nation’s largest school districts restricted competitive food sales (Larson 2007).

Implementation Resources

CDC MMWR-School health guidelines 2011 - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH). School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report (MMWR). 2011:60(RR-05):1-71.

Citations - Evidence

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Cradock 2011 - Cradock AL, McHugh A, Mont-Ferguson H, et al. Effect of school district policy change on consumption of sugar-sweetened beverages among high school students, Boston, Massachusetts, 2004-2006. Preventing Chronic Disease. 2011;8(4):A74.

Fernandes 2008* - Fernandes MM. The effect of soft drink availability in elementary schools on consumption. Journal of the American Dietetic Association. 2008;108(9):1445-52.

Gonzalez 2009 - Gonzalez W, Jones S, Frongillo E. Restricting snacks in US elementary schools is associated with higher frequency of fruit and vegetable consumption. Journal of Nutrition. 2009;139(1):142–4.

Jaime 2009* - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53.

Taber 2011* - Taber DR, Chriqui JF, Powell LM, Chaloupka FJ. Banning all sugar-sweetened beverages in middle schools: Reduction on in-school access and purchasing but not overall consumption. Archives of Pediatrics & Adolescent Medicine. 2012;166(3):256-62.

Whatley-Blum 2008* - Whatley Blum JE, Davee A-M, Beaudoin CM, et al. Reduced availability of sugar-sweetened beverages and diet soda has a limited impact on beverage consumption patterns in Maine high school youth. Journal of Nutrition Education and Behavior. 2008;40(6):341-7.

Sanchez-Vaznaugh 2010* - Sanchez-Vaznaugh EV, Sánchez BN, Baek J, Crawford PB. 'Competitive' food and beverage policies: Are they influencing childhood overweight trends? Health Affairs. 2010;29(3):436-46.

Taber 2012 - Taber DR, Chriqui JF, Perna FM, Powell LM, Chaloupka FJ. Weight status among adolescents in States that govern competitive food nutrition content. Pediatrics. 2012;130(3):437–44.

Van Hook 2012 - Van Hook J, Altman CE. Competitive food sales in schools and childhood obesity: A longitudinal study. Sociology of Education. 2012;85(1):23–39.

Vericker 2013* - Vericker TC. Limited evidence that competitive food and beverage practices affect adolescent consumption behavior. Health Education & Behavior. 2013;40(1):19–23.

Schwartz 2009* - Schwartz MB, Novak SA, Fiore SS. The impact of removing snacks of low nutritional value from middle schools. Health Education & Behavior. 2009;36(6):999–1011.

Cullen 2004 - Cullen KW, Zakeri I. Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school. American Journal of Public Health. 2004;94(3):463–7.

Templeton 2005* - Templeton SB, Marlette MA, Panemangalore M. Competitive foods increase the intake of energy and decrease the intake of certain nutrients by adolescents consuming school lunch. Journal of the American Dietetic Association. 2005;105(2):215–20.

Neumark-Sztainer 2005 - Neumark-Sztainer D, French SA, Hannan PJ, Story M, Fulkerson JA. School lunch and snacking patterns among high school students: associations with school food environment and policies. International Journal of Behavioral Nutrition and Physical Activity. 2005;2(1):14.

Larson 2010 - Larson N, Story M. Are “competitive foods” sold at school making our children fat? Health Affairs. 2010;29(3):430–5.

Citations - Implementation Examples

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Larson 2007 - Larson N, Story M. School foods sold outside of meals (competitive foods). Minneapolis: Healthy Eating Research; 2007.

CDC-Competitive foods 2012 - Centers for Disease Control and Prevention (CDC). Competitive foods and beverages in US schools: A state policy analysis. Atlanta: US Department of Health and Human Services (US DHHS); 2012.

Date Last Updated

Jan 19, 2014