title: School District Policies and Adolescents' Soda Consumption.
abstract: Sugar-sweetened beverages (SSBs) are a significant source of calories and added sugars for youth ages 14-18 years in the United States. This study examined the relationship between district-level policies and practices and students' consumption of regular soda, one type of SSB, in 12 large urban school districts.
  
  
  
  Data from the 2012 School Health Policies and Practices Study and 2013 Youth Risk Behavior Surveillance System were linked by district. The outcome variable was soda consumption and exposure variables were district policies. We used multivariable logistic regression analyses to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) after controlling for student characteristics and district free/reduced-price meal eligibility.
  
  
  
  About 18% of students reported consuming regular soda at least once per day. Most districts required high schools to have nutrition education, maintain closed campuses, and required/recommended that schools restrict promotional products and sale of beverages. Fewer districts required/recommended that schools offer healthful alternative beverages. Students in districts that restricted promotional products had lower odds of regular soda consumption (AOR = .84, 95% CI = .71-1.00), as did students in districts that restricted access to SSBs and offered healthful beverages when other beverages were available (AOR = .72, 95% CI = .54-.93, AOR = .76, 95% CI = .63-.91).
  
  
  
  This study demonstrates that certain district-level policies are associated with student consumption of regular soda. These findings add to a growing consensus that policies and practices that influence the availability of healthier foods and beverages are needed across multiple settings.
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia. Electronic address: gferro@cdc.gov.
authors.forename: Gabrielle F
authors.initials: GF
authors.lastname: Miller
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sliwa
authors.affiliation: Division of Adolescent and School Health, National Center for HIV/Aids, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Brener
authors.affiliation: Division of Nutrition Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Sohyun
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Caitlin L
authors.initials: CL
authors.lastname: Merlo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D018673:Nutrition Policy / Q000331:legislation & jurisprudence*; D016017:Odds Ratio; D011159:Population Surveillance; D012309:Risk-Taking; D012574:Schools / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population
keywords: District policies; Nutrition education; SHPPS; SSB; YRBSS