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School competitive food policies appears tied to neighborhood socioeconomics

May 04, 2015

Policy changes in California to make the food and beverages that compete with school meal programs more healthy for students appear to have improved childhood overweight/obesity prevalence trends, although improvement was better among students attending schools in socioeconomically advantaged neighborhoods, according to an article published online by JAMA Pediatrics.

Many school districts have adopted policies to regulate so-called competitive food and beverages (CF&Bs) because of childhood obesity. California has enacted among the most comprehensive CF&B policies in the nation, requiring substantial changes to food in public schools. The changes have been aimed at sugar-sweetened beverages, sweeteners, fat, portion size and calories from fat, according to study background.

Emma V. Sanchez-Vaznaugh, Sc.D., M.P.H., of San Francisco State University, and coauthors compared overweight/obesity prevalence trends before (2001-2005) and after (2006-2010) CF&B policies were implemented in California public elementary schools. The study included more than 2.7 million fifth-grade students in 5,362 public schools from 2001 to 2010. The authors looked at whether childhood overweight/obesity prevalence trends differed by school neighborhood income and education levels.

The authors found the prevalence of overweight/obesity among fifth-graders was slightly higher each year from 2001 to 2005 (43.5 percent, 44.1 percent, 45.1 percent, 45.3 percent, 46.6 percent, respectively) and then stabilized from 2006 to 2010 (46.2 percent, 45.9 percent, 46 percent, 45.9 percent, 45.8 percent, respectively).

Each year from 2001 to 2010, the prevalence of overweight/obesity also was highest among students attending in schools in the least advantaged neighborhoods and lowest among those students attending schools in the most advantaged neighborhoods. For example, in 2010, the overweight/obesity prevalence was 52.8 percent in the lowest-income neighborhood compared with 36.2 percent in the highest-income neighborhood, according to study results.

After the policies were enacted, trends in the prevalence of overweight-obesity leveled off among students attending schools in more disadvantaged neighborhoods but declined among students attending schools in neighborhoods with the highest income and educational levels, according to the study.

"These findings suggest that CF&B policies may be crucial interventions to prevent child obesity but the degree of their effectiveness is also likely to depend on influences of socioeconomic resources and other contextual factors within school neighborhoods. To reduce disparities and prevent childhood obesity among all children, school policies and environmental interventions must address relevant contextual factors in neighborhoods surrounding schools," the study concludes.
(JAMA Pediatr. Published online May 4, 2015. doi:10.1001/jamapediatrics.2015.0781. Available pre-embargo to the media at

Editor's Note: An author made funding/support disclosures. Please see article for additional information, including other authors, author contributions and affiliations, etc.

Media Advisory: To contact corresponding author Emma V. Sanchez-Vaznaugh, Sc.D., M.P.H., call Beth Tagawa at 415-338-6745 or email

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