Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Nutrition Policy Institute, University of California Agriculture and Natural Resources, Oakland, California.
Am J Prev Med. 2023 Jul;65(1):67-73. doi: 10.1016/j.amepre.2023.01.023. Epub 2023 Feb 8.
Healthy default beverage laws are relatively new interventions designed to improve the healthfulness of children's meals in restaurants. In this study, researchers assessed adherence to healthy default beverage laws among children's meals ordered online in Los Angeles (California statewide law effective from September 2018), Baltimore (effective from April 2018), and New York City (effective from April 2019) compared with that in Boston, where no law existed.
Between November and December 2020, researchers ordered children's meals from online ordering platforms (e.g., GrubHub, Uber Eats) from the top-grossing restaurant chains in each location (n=337 meal orders from 106 restaurants), coded these meals using four successively stricter definitions of adherence to the default beverage laws in each respective jurisdiction, and then applied each law to data collected in Boston to simulate different policy scenarios in a city with no such law. The team analyzed these data in late 2021.
Differences in adherence existed across jurisdictions, with 15% adherent in Los Angeles, 30% in Baltimore, and 43% in New York City, compared with 7%-30% in Boston, using the most lenient definition of adherence. Fewer than 3% of all meals adhered to laws when applying the strictest definition of adherence.
Overall adherence was low and variable across jurisdictions. Adherence may be lower in jurisdictions with fewer allowable default beverages, although more research is needed to assess this potential causal relation. In addition to increased resources and support for restaurants, additional policy design considerations may be necessary to increase adherence to healthy default beverage laws.
健康默认饮料法是相对较新的干预措施，旨在提高餐厅儿童餐的健康度。在这项研究中，研究人员评估了洛杉矶（2018 年 9 月生效的全州法律）、巴尔的摩（2018 年 4 月生效）和纽约市（2019 年 4 月生效）与波士顿（无法律规定）相比，网上订购的儿童餐对健康默认饮料法的遵守情况。
在 2020 年 11 月至 12 月期间，研究人员从每个地点的顶级餐厅连锁（n=106 家餐厅的 337 份餐订单）的在线点餐平台（如 GrubHub、Uber Eats）订购儿童餐，使用在每个管辖区的默认饮料法的四个逐步严格的定义对这些餐进行编码，然后将每个法应用于在波士顿收集的数据，以模拟没有此类法的城市的不同政策情景。该团队在 2021 年末分析了这些数据。
在遵守情况方面，不同的司法管辖区存在差异，洛杉矶为 15%，巴尔的摩为 30%，纽约市为 43%，而波士顿为 7%-30%，使用最宽松的遵守定义。当应用最严格的遵守定义时，所有餐中遵守法律的比例不到 3%。
总体遵守情况较低，且在司法管辖区之间存在差异。在默认饮料允许数量较少的司法管辖区，遵守情况可能更低，尽管需要更多的研究来评估这种潜在的因果关系。除了为餐厅增加资源和支持外，还可能需要更多的政策设计考虑因素来提高对健康默认饮料法的遵守。
