Regular Soda Policies, School Availability, and High School Student Consumption

Published:January 06, 2015DOI:


      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.


      To employ multilevel mediation modeling using state- and school district–level policies mandating school soda bans, school soda availability, and student soda consumption.


      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.


      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 (alow asteriskb, p<0.05).


      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Johnston L.D.
        • O’Malley P.M.
        • Terry-McElrath Y.M.
        • Colabianchi N.
        School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results: School Years 2006–07 through 2010–11. Volume 3. Bridging the Gap Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI2013
        • U.S. Department of Agriculture
        National School Lunch Program and School Breakfast Program: nutrition standards for all foods sold in school as required by the Healthy, Hunger-Free Kids Act of 2010—Interim Final Rule..
        Fed Regist. 2013; 78: 39068-39120
        • Kubik M.Y.
        • Wall M.
        • Shen L.
        • et al.
        State but not district nutrition policies are associated with less junk food in vending machines and school stores in U.S. public schools.
        J Am Diet Assoc. 2010; 110 ( 1043-1048
        • Taber D.R.
        • Chriqui J.F.
        • Powell L.M.
        • Chaloupka F.J.
        Banning all sugar-sweetened beverages in middle schools: reduction of in-school access and purchasing but not overall consumption.
        Arch Pediatr Adolesc Med. 2012; 166 ( 256-262
        • Woodward-Lopez G.
        • Gosliner W.
        • Samuels S.E.
        • Crapo L.
        • Kao J.
        • Crawford P.B.
        Lessons learned from evaluations of California’s statewide school nutrition standards.
        Am J Public Health. 2010; 100 ( 2137-2145
        • Cullen K.W.
        • Watson K.
        • Zakeri I.
        Improvements in middle school student dietary intake after implementation of the Texas Public School Nutrition Policy.
        Am J Public Health. 2008; 98 ( 111-117
        • Taber D.R.
        • Stevens J.
        • Evenson K.R.
        • et al.
        State policies targeting junk food in schools: racial/ethnic differences in the effect of policy change on soda consumption.
        Am J Public Health. 2011; 101 ( 1769-1775
        • Chriqui J.F.
        • Pickel M.
        • Story M.
        Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review.
        JAMA Pediatr. 2014; 168 ( 279-286
        • Craddock A.L.
        • 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.
        Prev Chronic Dis. 2011; 8: A74
        • Johnson D.B.
        • Bruemmer B.
        • Lund A.E.
        • Evens C.C.
        • Mar C.M.
        Impact of school district sugar-sweetened beverage policies on student beverage exposure and consumption in middle schools.
        J Adolesc Health. 2009; 45 ( S30-S37
        • Chriqui J.F.
        • Turner L.
        • Taber D.
        • Chaloupka F.J.
        Association between district and state policies and U.S. public elementary school competitive food and beverage environments.
        JAMA Pediatr. 2013; 167 ( 714-722
        • Briefel R.R.
        • Wilson A.
        • Gleason P.M.
        Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants.
        J Am Diet Assoc. 2009; 109 ( S79-S90
        • Terry-McElrath Y.M.
        • O’Malley P.M.
        • Johnston L.D.
        School soft drink availability and consumption among U.S. secondary students.
        Am J Prev Med. 2013; 44 ( 573-582
        • MacKinnon D.P.
        Introduction to Statistical Mediation Analysis.
        Lawrence Erlbaum Associates, Taylor and Francis Group, New York, NY2008
        • Johnston L.D.
        • O׳Malley P.M.
        • Bachman J.G.
        • Schulenberg J.E.
        Monitoring the Future National Survey Results On Drug Use, 1975-2012. Volume I: Secondary School Students.
        Institute for Social Research, The University of Michigan, Ann Arbor, MI2013
      1. Johnston LD, O’Malley PM, Terry-McElrath YM, Freedman-Doan P, Brenner JS. School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results. School Years 2006–07 and 2007–08. Vol 1. Ann Arbor, MI: Bridging the Gap Program, Survey Research Center, Institute for Social Research, The University of Michigan; 2011.

      2. Chriqui JF, Resnick EA, Schneider L, et al. School District Wellness Policies: Evaluating Progress and Potential for Improving Children׳s Health Five Years after the Federal Mandate. School Years 2006–07 Through 2010-11. Vol 3. Chicago, IL: Bridging the Gap Program, Health Policy Center, Institute for health Research and Policy, University of Illinois at Chicago; 2013.

        • Preacher K.J.
        • Zyphur M.J.
        • Zhang Z.
        A general multilevel SEM framework for assessing multilevel mediation.
        Psychol Methods. 2010; 15 ( 209-233
        • Hansen M.H.
        • Madow W.G.
        • Tepping B.J.
        An evaluation of model-dependent and probability-sampling inferences in sample surveys.
        J Am Stat Assoc. 1983; 78 ( 776-793
        • Sterba S.K.
        Alternative model-based and design-based frameworks from inference from samples to populations: from polarization to integration.
        Multivariate Behav Res. 2009; 44 ( 711-740
        • DeBoer M.D.
        • Scharf R.J.
        • Demmer R.T.
        Sugar-sweetened beverages and weight gain in 2- to 5-year-old children.
        Pediatrics. 2013; 132 ( 1-8
        • Malik V.S.
        • Schulze M.B.
        • Hu F.B.
        Intake of sugar-sweetened beverages and weight gain: a systematic review.
        Am J Clin Nutr. 2006; 84: 274-288
        • Vartanian L.R.
        • Schwartz M.B.
        • Browness K.D.
        Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis.
        Am J Public Health. 2007; 97 ( 667-675
        • Drewnowski A.
        • Rehm C.D.
        Energy intakes of U.S. children and adults by food purchase location and by specific food source.
        Nutr J. 2013; 12 ( 59
        • Barlow S.E.
        Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.
        Pediatrics. 2007; 120: S164-S192
        • IOM.
        Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.
        National Academies Press, Washington, DC2012
        • Taber D.
        • Chriqui J.F.
        • Chaloupka F.J.
        Association and diffusion of nutrition and physical activity policies on the state and district level.
        J Sch Health. 2012; 82 ( 201-209
        • Briefel R.R.
        • Wilson A.
        • Cabili C.
        • Dodd A.H.
        Reducing calories and added sugars by improving children’s beverage choices.
        J Acad Nutr Diet. 2013; 113 ( 269-275
        • Eaton D.K.
        • Kann L.
        • Kinchen S.
        • et al.
        Youth Risk Behavior Surveillance—United States, 2011.
        MMWR Surveill Summ. 2012; 61: 1-162
      3. Bridging the Gap. State laws for school snack foods and beverages.

        • Taber D.R.
        • Chriqui J.F.
        • Chaloupka F.J.
        Differences in nutrient intake associated with state laws regarding fat, sugar, and caloric content of competitive foods.
        Arch Pediatr Adolesc Med. 2012; 166 ( 452-458
        • Bassler E.J.
        • Chriqui J.F.
        • Stagg K.
        • Schneider L.M.
        • Infusino K.
        • Asada Y.
        Controlling Junk Food and the Bottom Line: Case Studies of Schools Successfully Implementing Strong Nutrition Standards for Competitive Foods and Beverages.
        Illinois Public Health Institute, Chicago, IL2012
        • Guthrie J.F.
        • Newman C.
        • Ralson K.
        • Prell M.
        • Ollinger M.
        Understanding school food service characteristics associated with higher competitive food revenues can help focus efforts to improve school food environments.
        Child Obes. 2012; 8: 298-304
        • Wharton C.M.
        • Long M.
        • Schwartz M.
        Changing nutrition standards in schools: the emerging impact on school revenue.
        J Sch Health. 2008; 78 ( 245-251
        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of childhood and adult obesity in the United States, 2011-2012.
        JAMA. 2014; 311 ( 806-814
        • Hill R.J.
        • Davies P.S.W.
        The validity of self-reported energy intake as determined using the doubly labelled water technique.
        Br J Nutr. 2001; 85 ( 415-430