Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health.

Objective: A systematic literature review was conducted to determine whether sweetened beverage intake increases the risk for obesity, and the extent to which it has contributed to recent increases in energy intake and adiposity in the USA. Design: The search included studies published between 1970 and 2010 that examined secular trends, mechanisms, observational associations and intervention outcomes. Observational and intervention studies were abstracted and systematically evaluated for quality. Setting: Trends in obesity prevalence in the USA and studies from industrialized (developed) countries were included. Subjects: Studies were included for all ages, genders, ethnic and socio-economic groups for which data were available. Results: Obesity rates and sweetened beverage intake have increased in tandem in the USA. Studies consistently show that higher intake of sweetened beverages is associated with higher energy intake. Energy in liquid form is not well compensated for by reductions in the intake of other sources of energy. Well-designed observational studies consistently show a significant positive relationship between sweetened beverage intake and adiposity. More importantly, several well-conducted randomized controlled trials have shown statistically significant changes in adiposity as a result of corresponding changes in sweetened beverage intake. Conclusions: All lines of evidence consistently support the conclusion that the consumption of sweetened beverages has contributed to the obesity epidemic. It is estimated that sweetened beverages account for at least one-fifth of the weight gained between 1977 and 2007 in the US population. Actions that are successful in reducing sweetened beverage consumption are likely to have a measurable impact on obesity.

No abstract

This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.

Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been documented adequately. The Healthy Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children’s diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013–2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children-guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children’s dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of “what is working” to improve the dietary behaviors that are likely to prevent obesity and improve health in children.

University nutrition policies are a useful step toward improving the food environment for students, faculty, and staff, leading to improved health outcomes for the campus community. As 1 of the first universities to adopt and implement a campus-wide nutrition policy, the objective of this report is to share the university's experience with policy development, implementation, monitoring and evaluation, challenges, facilitators, and recommendations to inform these processes for future university nutrition policies.

Competitive food and beverage legislation can increase food service revenues when accompanied by increased rates of participation in the meal program. Future studies collecting expense data will be needed to determine impact on net revenues.

This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.