title: A national evaluation of the impact of state policies on competitive foods in schools.
abstract: BACKGROUND
  Since 2003, many states have introduced policies to improve the nutritional content and restrict the availability of competitive foods, which are foods offered outside of the National School Lunch and Breakfast Programs. This article evaluates the impact of 2 types of state-level policies on the availability of competitive foods in a national sample of schools.
  
  
  METHODS
  Annual state-level data on limits, which restrict the time or venue of competitive foods sales, and standards, which regulate the nutrient content of competitive foods, was obtained from the Trust for America's Health and mapped to a national sample from the Early Childhood Longitudinal Study who were in fifth grade in 2004 and eighth grade in 2007. A logistic regression model with child fixed effects tested the association between policy enactments and changes in reported availability of competitive foods in schools. The analyses controlled for child and school characteristics.
  
  
  RESULTS
  Nineteen states introduced a standard or a limit between 2004 and 2007. After adjusting for child and school characteristics, standards were associated with lower child-reported availability of soft drinks (16.5%, p < .001), low-nutrient snacks (22.0%, p < .05), and sweets (18.1%, p < .001). The impact of limits was not statistically significant.
  
  
  CONCLUSIONS
  Standards introduced between 2004 and 2007 were associated with a decline in the availability of soft drinks, low-nutrient snacks, and sweets as reported by a national sample of children. School compliance with state competitive food policies may increase over time. Research on the impact of existing state policies could inform the development of a national policy to regulate competitive foods in schools.
authors.affiliation: Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138, USA. meena_fernandes@abtassoc.com
authors.forename: Meenakshi M
authors.initials: MM
authors.lastname: Fernandes
mesh_terms: D000293:Adolescent; D002253:Carbonated Beverages; D002648:Child; D015331:Cohort Studies; D004465:Economic Competition; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D062409:Lunch; D008297:Male; D018673:Nutrition Policy / Q000331:legislation & jurisprudence*; D012574:Schools / Q000331:legislation & jurisprudence*; D062410:Snacks; D013219:State Government; D014481:United States