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 inter-viewers. 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.