title: Assessment of a Districtwide Policy on Availability of Competitive Beverages in Boston Public Schools, Massachusetts, 2013.
abstract: BACKGROUND
  Competitive beverages are drinks sold outside of the federally reimbursable school meals program and include beverages sold in vending machines, a la carte lines, school stores, and snack bars. Competitive beverages include sugar-sweetened beverages, which are associated with overweight and obesity. We described competitive beverage availability 9 years after the introduction in 2004 of district-wide nutrition standards for competitive beverages sold in Boston Public Schools.
  
  
  METHODS
  In 2013, we documented types of competitive beverages sold in 115 schools. We collected nutrient data to determine compliance with the standards. We evaluated the extent to which schools met the competitive-beverage standards and calculated the percentage of students who had access to beverages that met or did not meet the standards.
  
  
  RESULTS
  Of 115 schools, 89.6% met the competitive beverage nutrition standards; 88.5% of elementary schools and 61.5% of middle schools did not sell competitive beverages. Nutrition standards were met in 79.2% of high schools; 37.5% did not sell any competitive beverages, and 41.7% sold only beverages meeting the standards. Overall, 85.5% of students attended schools meeting the standards. Only 4.0% of students had access to sugar-sweetened beverages.
  
  
  CONCLUSIONS
  A comprehensive, district-wide competitive beverage policy with implementation support can translate into a sustained healthful environment in public schools.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 401 Park Dr, 4th Floor West, Boston, MA 02215. Email: rmozaffa@hsph.harvard.edu.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Mozaffarian
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Kenney
authors.affiliation: Boston Public Schools Health & Wellness Department, Dorchester, Massachusetts.
authors.forename: Jill E
authors.initials: JE
authors.lastname: Carter
authors.affiliation: Boston Public Schools Health & Wellness Department, Dorchester, Massachusetts.
authors.forename: M Caitlin Westfall
authors.initials: MC
authors.lastname: Howe
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Reiner
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Angie L
authors.initials: AL
authors.lastname: Cradock
mesh_terms: D000293:Adolescent; D001628:Beverages / Q000706:statistics & numerical data*; D001900:Boston; D002253:Carbonated Beverages / Q000706:statistics & numerical data; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005509:Food Dispensers, Automatic; D005522:Food Services / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008297:Male; D018673:Nutrition Policy; D064427:Nutritive Sweeteners / Q000032:analysis; D009753:Nutritive Value; D012574:Schools; D013334:Students
chemical_list: D064427:Nutritive Sweeteners