Strategies to Limit Sugar-Sweetened Beverage Consumption in Young Children Proceedings of a Workshop (2017) / Chapter Skim
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4 Opportunities and Challenges to Influence Beverage Consumption in Young Children: An Exploration of Federal, State, and Local Policies and Programs
4 Opportunities and Challenges to Influence Beverage Consumption in Young Children: An Exploration of Federal, State, and Local Policies and Programs
Pages 31-44
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From page 31... ...
Natasha Frost, senior staff attorney at the Public Health Law Center, then spoke about state-level policies in child care settings. In the final presentation of the session, Kim Kessler, assistant commissioner for the Bureau of Chronic Disease Prevention and Tobacco Control at the New York City Department of Health and Mental Hygiene (NYC DOHMH)
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; the National School Lunch Program; the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) ; the School Breakfast Program; 2 This section summarizes information presented by Sara Bleich.
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Two other programs -- CACFP and the Summer Food Service Program -- allow for sugar-sweetened beverages to be served, but do not reimburse for them, Bleich said. She also drew attention to the similarities between the programs' policies and regulations related to flavored milk and 100 percent juice.
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The 2009 revisions to the food packages offered by the WIC program reduced the maximum allowance of 100 percent juice. Findings from Andreyeva et al.
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Touching on points she made earlier in her presentation, Bleich thought that participation of children in federal nutrition programs can be enhanced and that opportunities exist to further innovate at the state and local level. She ended by proposing that consistent metrics beyond participation levels across the nutrition assistance programs are needed to understand progress, identify gaps, and find solutions.
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She briefly touched on the Caring for Our Children guidelines for ECE settings (AAP et al., 2011) , which contain 46 standards relevant to obesity prevention that "go across many areas of the caloric balance, including healthy foods and beverages, physical activity, screen time, and breastfeeding." Blanck then presented the "Spectrum of Opportunity" comprised of 11 obesity prevention opportunities that can be employed by state and local ECE systems (see Figure 4-3)
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. Blanck also highlighted that DNPAO provides seed funding to ECE settings -- 18 states receive funding for nutrition-related projects, and ECE settings in all 50 states and the District of Columbia receive funding for physical activity initiatives.
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Every state has different funding streams, quality measures, licensing and administrative regulations, and definitions for what qualifies as a child care center or family child care home. These differences have led to 5 This section summarizes information presented by Natasha Frost.
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In contrast, the vast majority of states re FIGURE 4-4 Child care licensing regulations with voluntary or required restrictions on sugar-sweetened beverages in licensed child care centers and licensed family child care homes. NOTES: Red indicates limits on sugar-sweetened beverages are not mentioned in the state's child care licensing regulations.
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She cautioned that action at the local level may not always be possible, as few states expressly permit local jurisdictions to implement their own nutrition standards. Frost concluded by suggesting additional consideration is needed to define quality in family child care homes, and additional research is needed to explore the role of such child care settings on the provision of sugar-sweetened beverages.
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Food standards have been created that apply to the meals and snacks defined as percent of residents with incomes below 100 percent of the federal poverty level, per American Community Survey 2011–2013; population (based on zip code) defined as percent of non-Hispanic black and Hispanic residents, per 2010 Census; and self-reported health -- NYC DOHMH Community Health Survey, 2011–2013.
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Between 2007 and 2015, there has been a 34 percent decline of New York City adults' daily consumption of one or more sugar-sweetened beverages.9 However, she stated that disparities still persist, as evidenced by racial/ethnic differences in daily sugarsweetened beverage consumption.10 Kessler reminded the audience that there is no silver bullet for improving diets in general and sugar-sweetened beverages specifically. Therefore, she emphasized the need for crosscutting 9 Kessler presented adult daily sugar-sweetened beverage consumption data that were cited as being from the NYC DOHMH Community Health Survey 2015, and noted that the definition of sugar-sweetened beverages "includes soda and other sweetened drinks like iced tea, sports drinks, fruit punch, and other fruit-flavored drinks." 10 Kessler presented adult daily sugar-sweetened beverage consumption data that were cited as being from the NYC DOHMH Community Health Survey 2007–2015.
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In response to the question, Frost thought it is critical to engage child care providers to help think through implementation of proposed policies. Economos posed several audience questions related to federal nutrition assistance programs.
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Responding to a question about the evaluation of the impact of communication materials, Kessler reported that there is evidence that obesity rates among some young children declined after the child care regulations took effect in New York City, particularly in high-risk neighborhoods. She noted that tracking outcomes related to communication products is much more challenging.
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