School Vending Machine Use and Fast-Food Restaurant Use Are Associated with Sugar-Sweetened Beverage Intake in Youth
Abstract
Objective
To examine associations between use of school vending machines and fast-food restaurants and youth intake of sugar-sweetened beverages.
Design
A cross-sectional observational study.
Subjects/setting
From a group randomized obesity intervention, we analyzed baseline data from 1,474 students in 10 Massachusetts middle schools with vending machines that sold soda and/or other sweetened drinks.
Main Outcome Measures
Daily sugar-sweetened beverage consumption (regular soda, fruit drinks, and iced tea), purchases from school vending machines, and visits to fast-food restaurants in the preceding 7 days were estimated by self-report.
Statistical Analyses Performed
χ2 and nonparametric tests were performed on unadjusted data; multivariable models adjusted for sex, grade, body mass index, and race/ethnicity, and accounted for clustering within schools.
Results
Among 646 students who reported using school vending machines, 456 (71%) reported purchasing sugar-sweetened beverages. Overall, 977 students (66%) reported eating at a fast-food restaurant. Sugar-sweetened beverage intakes averaged 1.2 servings per day. In adjusted models, relative to no vending machine purchases, servings per day increased by 0.21 for one to three purchases per week (P=0.0057), and 0.71 with four or more purchases (P<0.0001). Relative to no fast-food restaurant visits, sugar-sweetened beverage servings per day increased by 0.13 with one visit per week (P=0.07), 0.49 with two to three visits (P=0.0013), and by 1.64 with four or more visits (P=0.0016).
Conclusions
Among students who use school vending machines, more report buying sugar-sweetened beverages than any other product category examined. Both school vending machine and fast-food restaurant use are associated with overall sugar-sweetened beverage intake. Reduction in added dietary sugars may be attainable by reducing use of these sources or changing product availability.
Address correspondence to: Jean L. Wiecha, PhD, Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Ave, 7th Floor, Boston, MA 02115.
a At the time of the study, D. Finkelstein was a senior data analyst, P. J. Troped was a research associate, and M. Fragala was a research assistant, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA. K. E. Peterson is an associate professor, Department of Nutrition, Harvard School of Public Health, Boston, MA.
ABSTRACT