title: Association Between Student Purchases of Beverages During the School Commute and In-School Consumption of Sugar-Sweetened Beverages, San Francisco Bay Area, 2013.
abstract: BACKGROUND
  Consumption of sugar-sweetened beverages (SSBs) such as sodas, fruit-flavored drinks, and sports drinks is a major contributor to childhood obesity. One strategy to reduce children's SSB consumption has been to restrict the sale of SSBs in schools. However, such policies may not sufficiently curb students' SSB intake, because students can obtain SSBs elsewhere, including from stores located on their school commute. Little is known about students' purchases of beverages during the school commute or about whether this purchasing behavior is related to in-school SSB consumption. The objective of this study was to describe where students from low-income, ethnically diverse communities obtain the SSBs they drink during school lunchtime and to examine whether students who purchase beverages while traveling to and from school are more likely to drink SSBs during school lunchtime.
  
  
  METHODS
  We analyzed survey data from a random sample of low-income, ethnically diverse middle school students (N = 597) who participated in a randomized controlled trial of a water promotion intervention. We used logistic regression analysis to examine the association between students' purchase of beverages during the school commute and their SSB consumption during school lunchtime.
  
  
  RESULTS
  One-fifth (20.4%) of students drank an SSB during lunch. Approximately 23% of SSBs were obtained during the school commute. Students who reported buying beverages during their school commute (50.1% of all students) were more likely to report drinking SSBs during lunch than students who reported that they do not buy beverages during the school commute (adjusted odds ratio 3.32, 95% confidence interval, 2.19-5.05, P < .001).
  
  
  CONCLUSIONS
  Students' purchase of beverages during the school commute was strongly associated with SSB consumption during school lunchtime. Interventions could benefit from focusing on retail environments (e.g., encouraging retailers to promote healthy beverages, posting beverage calorie information).
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 135 Dauer Dr, 302 Rosenau Hall, CB No. 7440, Chapel Hill, NC 27599. Email: agrummon@live.unc.edu.
authors.forename: Anna H
authors.initials: AH
authors.lastname: Grummon
authors.affiliation: California Food Policy Advocates, Oakland, California.
authors.forename: Ariana
authors.initials: A
authors.lastname: Oliva
authors.affiliation: Enigami Ventures, Richmond, California.
authors.forename: Karla E
authors.initials: KE
authors.lastname: Hampton
authors.affiliation: Department of Pediatrics and the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
authors.forename: Anisha I
authors.initials: AI
authors.lastname: Patel
mesh_terms: D000293:Adolescent; D001628:Beverages / Q000706:statistics & numerical data*; D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D002648:Child; D003132:Commerce / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D019422:Dietary Sucrose; D004326:Drinking; D002149:Energy Intake; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D011203:Poverty; D012495:San Francisco; D012574:Schools; D013334:Students / Q000706:statistics & numerical data; D014195:Travel
chemical_list: D019422:Dietary Sucrose