Making a Difference: Research Informing Policy Change

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Making a Difference: Research Informing Policy Change Farm and Food Policy and Obesity Symposium University of California Davis May 21, 2010 Gail Woodward-Lopez Patricia Crawford Robert C. and Veronica Atkins C Weight and Health

Linking researchers and the community to prevent childhood obesity Research & Evaluation Community Action

Pupil Nutrition, Health and Achievement Act of 2001 (SB 19) First legislated nutrition standards for competitive foods in schools Signed but never went into effect New bills being considered: main concern financial LEAF pilot study: evaluate SB 19 in secondary schools

LEAF Evaluation $ Per Capita, Per Day $2.50 $2.00 $1.50 $1.00 $0.50 Middle School 2: Food Service Revenues Per Capita, Per Day Farm field trips SB-19 compliance, garden/cooking International Marketplace, a la carte food eliminated, daily salad bar $- Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Apr-03 May-03 Jun-03 Jul-03 Aug-03 Sep-03 Oct-03 Nov-03 Dec-03 Jan-04 Feb-04 Total Revenue A La Carte Revenue Meal Revenue Mar-04 Apr-04 May-04 Jun-04

SB 12/965 Signed into law at the Governor s Summit on obesity in 2005

Success! Sodas and most candy no longer for sale at schools Spread across the country Was the basis for the IOM standards requested by USDA Fueled the movement toward healthier school foods

But..

Few years later.. Positive but modest impact on student intake

Many unhealthy foods still offered

Top 10 Foods Sold Pre / Post Implementation of SB 12 Pre Implementation Foods Baked! Cheetos Crunchy Flamin' Hot Nature Valley Crunchy Oats N Honey Granola Bar Baked! Ruffles - Cheddar & Sour Cream Rold Gold - Classic Style - Tiny Twists Pretzels Lay's Baked! Sour Cream & Onion Kellogg's Pop Tarts - Strawberry Frosted Sunchips French Onion Pepperidge Farm Goldfish Cheddar Kellogg's Pop Tarts - Brown Sugar Cinnamon Frosted Corn Nuts Ranch Post Implementation Foods Baked! Cheetos Crunchy Flamin' Hot Sunshine - Cheez-it Reduced Fat Crackers Baked! Lay's Sour Cream & Onion Baked! Ruffles Cheddar & Sour Cream Corn Nuts Barbeque Corn Nuts Ranch General Mills Chex Mix Traditional Baked! Lay's Barbecue Rold Gold - Classic Style - Tiny Twists Pretzels Nature Valley Crunchy Oats 'N Honey Granola Bar *Items in red do not adhere to SB12 standards.

Top 10 Beverages Sold Pre / Post Implementation of SB 965 Pre Implementation Beverages Aquafina Water Dasani Water Gatorade - Fruit Punch Gatorade - Lemon-lime Powerade -Mountain Blast Powerade - Fruit Punch Gatorade - Cool Blue Gatorade - Orange Dole 100% Apple Juice Gatorade Frost - Glacier Freeze Post Implementation Beverages Aquafina Water Gatorade - Fruit Punch Dasani Water Gatorade - Lemon-lime Gatorade Orange Powerade - Mountain Blast Powerade - Fruit Punch Gatorade - Cool Blue Gatorade Frost - Glacier Freeze Dole 100% Orange Juice *The top 10 beverages adhered to SB 965 pre and post implementation.

Almost half of entrees are fast food Other Hot Entrees 4.5% Asian 4.5% Dairy 2.0% Other 3.1% Salad Entrees 10.1% Sandwiches 16.2% Fast Food Classics 46.8% Mexican 12.9%

Good start but need to look at the bigger picture

Classroom Education Component Cafeteria Promotions Component Four lessons of 20 minutes each 3 Components: Outline and Instructional Sheet Classroom Poster/Student Handout In-class taste-test of whole wheat products Whole Wheat Poster Display in the school cafeteria 67-82% and 61-44% selected whole wheat during immediately after intervention and at follow-up

Food dollars spent on foods outside the home 60% 48% 40% 26% 20% 0% 1970 2006 Year Ref: Nat l Rest Assn: Industry at a Glance 2006

Which of the following breakfast items that are served at Denny's restaurant do you think has the fewest calories: A. Ham and cheddar omelet B. Country fried steak & eggs C. Three slices of French toast w/ syrup & margarine D. Three pancakes w/ syrup & margarine

Which of the following breakfast items that are served at Denny's restaurant do you think has the fewest calories: A. Ham and cheddar omelet 595 B. Country fried steak & eggs 464 C. Three slices of French toast w/ syrup & margarine 1000 D. Three pancakes w/ syrup & margarine 650

Which of the following items that are served at McDonald's restaurant do you think has the most calories: A. Two Big Macs B. Two Egg McMuffins C. One large chocolate shake D. Four regular hamburgers

Which of the following items that are served at McDonald's restaurant do you think has the most calories: A. Two Big Macs 1080 B. Two Egg McMuffins 600 C. One large chocolate shake 1160 D. Four regular hamburgers 1000

Restaurant Intervention Haagen-Dazs Model Menu Board

SB1420 introduced by Senator Padilla in 2007

Estimated impact of calorie labeling for all Californians (based on 80% noticing it and 82% eating at fast food restaurants) 40 million pounds annually!

Governor signed bill SB1420-Sept. 30, 2008

But.. Findings have been mixed Impact on purchases has been modest; but can still have a large impact on annual calorie intake Consumers may be confused by healthy options that have more calories than less healthy options

Net increase of healthy purchases using electronic cash register data Entrees Menu Boards vs. Control NS Side dish 9.6 %*** Snack items 6.8% ** *** p<.001 ** p<.01 Could prevent the gain of 4-8 lbs per year

The biggest impacts came not from the labels but from Starbuck s change in default milk offered Subway s $5 footlong

Biggest impacts will come from policies that don t require much consumer decision-making or sacrifice: Price Product formulations (virtuous cycle) Optimal defaults

Concerns regarding pre-emption Health Care reform includes a national menu labeling requirement

Dr. Robert C. & Veronica Atkins C Weight and Health Research Informing Action Now Visit our website at cwh.berkeley.edu

Visit our website at www.cnr.berkeley.edu/cwh